Psychological evaluation of asylum seekers as a therapeutic process.

PubMed

Gangsei, David; Deutsch, Anna C

2007-01-01

Torture survivors are often reluctant to tell their stories. They typically make every effort to forget this painful, traumatic experience. Often they do not share with family, friends or healthcare professionals the fact that they have been beaten, raped or subjected to electrical shocks and other terrors. Talking means retrieving memories, triggering the feelings and emotions that accompanied the torture itself. Furthermore, refugee torture survivors feel that people won't understand or believe their experiences. However, survivors who escape their country may need to reveal their torture experience as they apply for asylum in the host country. When they prepare for the asylum process, it may well be the first time that they talk about the torture. Mental health professionals are often called upon to evaluate survivors and prepare affidavits for the asylum process, documenting the effects of torture. This creates a unique and priviliged opportunity to help survivors to address the devastating consequences of torture. Winning asylum is essential to recovery for a torture survivor in a country of refuge. Psychological evaluations of the consequences of torture can present information and evidence to asylum adjudicators which significantly increases understanding of the survivors' background and experiences as well as their manner of self-presentation in the courtroom or interview. They can empower the torture survivor to present his/her experiences more fully and confidently. Even apart from winning asylum, the process of the evaluation has many potential benefits for the survivor's emotional well-being. This includes helping the survivor understand the necessity of telling the story, illuminating the often poorly perceived link between current emotional suffering and past torture, facilitating the development of cognitive and emotional control, and healing the wounds of mistrust, humiliation, marginalization and fear.

Torture vs other cruel, inhuman, and degrading treatment: is the distinction real or apparent?

PubMed

Başoğlu, Metin; Livanou, Maria; Crnobarić, Cvetana

2007-03-01

After the reports of human rights abuses by the US military in Guantanamo Bay, Iraq, and Afghanistan, questions have been raised as to whether certain detention and interrogation procedures amount to torture. To examine the distinction between various forms of ill treatment and torture during captivity in terms of their relative psychological impact. A cross-sectional survey was conducted with a population-based sample of survivors of torture from Sarajevo in Bosnia and Herzegovina, Banja Luka in Republica Srpska, Rijeka in Croatia, and Belgrade in Serbia. A total of 279 survivors of torture accessed through linkage sampling in the community (Banja Luka, Sarajevo, and Rijeka) and among the members of 2 associations for war veterans and prisoners of war (Belgrade). Scores on the Semi-structured Interview for Survivors of War, Exposure to Torture Scale, Structured Clinical Interview for DSM-IV, and Clinician-Administered PTSD (posttraumatic stress disorder) Scale for DSM-IV. Psychological manipulations, humiliating treatment, exposure to aversive environmental conditions, and forced stress positions showed considerable overlap with physical torture stressors in terms of associated distress and uncontrollability. In regression analyses, physical torture did not significantly relate to posttraumatic stress disorder (odds ratio, 1.41, 95% confidence interval, 0.89-2.25) or depression (odds ratio, 1.41, 95% confidence interval, 0.71-2.78). The traumatic stress impact of torture (physical or nonphysical torture and ill treatment) seemed to be determined by perceived uncontrollability and distress associated with the stressors. Ill treatment during captivity, such as psychological manipulations, humiliating treatment, and forced stress positions, does not seem to be substantially different from physical torture in terms of the severity of mental suffering they cause, the underlying mechanism of traumatic stress, and their long-term psychological outcome. Thus, these procedures do amount to torture, thereby lending support to their prohibition by international law.

Torture by Governments, A Seven Part Educational Guide for High Schools.

ERIC Educational Resources Information Center

Amnesty International USA, New York, NY.

This interdisciplinary unit includes seven lessons that can be adapted to fit individual classrooms and curricular needs. The focus of the lessons is on human rights and human rights abuses. The lessons include: (1) "Who Are the Victims?"; (2) "Coping"; (3) "Torturers"; (4) "A Case for Torture?"; (5) "The Map of Torture"; (6) "The Words To Say…

[Torture survivor asylum seekers in Italy: the experience of the humanitarian association "Doctors Against Torture"].

PubMed

Di Napoli, A; Baglio, G; Bracci, C; Taviani, A; Zerbino, E; Romano, V

2005-01-01

In recent years, the arrival in Italy of people who suffered torture in their countries led a group of volunteer doctors to set up a humanitarian association, "Doctors Against Torture", to provide care and treatment for torture survivors present in Rome. The paper describes the characteristics of 354 persons having at least one access from 1-1-1999 to 31-12-2001. About 51% of the victims came from the Middle East, 43% from Africa. Mean age was 29.6 (SD 7.0). The victims have suffered beatings and other forms of blunt trauma (64%), suspension and other positional torture (14%), psychological violence (28%), inhuman conditions of detention (10%), burns/electric shock (21%), wet asphyxiation and water jets (11%), sexual violence (15%), amputation/penetrating injuries (22%), dental torture and traumatic removal of nails (6%) and 58% suffered more than one type of torture. The types of violence observed require a thorough analysis of our knowledge in the field, in order to help victims on their way to rehabilitation, which is long and uncertain; at the same time, it is fundamental that public health begins to make itself responsible for these persons.

Torture and war trauma survivors in primary care practice.

PubMed Central

Weinstein, H M; Dansky, L; Iacopino, V

1996-01-01

Close to 1 million refugees from around the world have entered the United States, fleeing repression, war, terrorism, and disease. It has been estimated that among these are thousands who have experienced torture. Many refugees and immigrants will appear in the offices of health care professionals with symptoms that may be related either directly or indirectly to torture. Both physical and psychological torture may result in long-term sequelae. Physical effects may be found in every organ system, but psychological effects are most commonly manifest in the symptoms of the post-traumatic stress disorder. For physicians to recognize how torture can affect health status, it is important to understand that history taking may be difficult and that little information may emerge that would explain the origins of scars, fractures, or disabilities. Recognizing the clues to a torture history allows physicians to assist patients in describing the trauma. In addition, knowing the subacute and chronic signs and symptoms of torture enables physicians to diagnose and treat often obscure symptoms with a much clearer understanding of the sources of the difficulty. Paying special attention to the interview process will support torture survivors in detailing often horrific events. PMID:8909162

Economic burden of torture for a refugee host country: development of a model and presentation of a country case study.

PubMed

Mpinga, Emmanuel Kabengele; Frey, Conrad; Chastonay, Philippe

2014-01-01

Torture is an important social and political problem worldwide that affects millions of people. Many host countries give victims of torture the status of refugee and take care of them as far as basic needs; health care, professional reinsertion, and education. Little is known about the costs of torture. However, this knowledge could serve as an additional argument for the prevention and social mobilization to fight against torture and to provide a powerful basis of advocacy for rehabilitation programs and judiciary claims. Development of a model for estimating the economic costs of torture and applying the model to a specific country. The estimation of the possible prevalence of victims of torture was based on a review of the literature. The identification of the socioeconomic factors to be considered was done by analogy with various health problems. The estimation of the loss of the productivity and of the economic burden of disease related to torture was done through the human capital approach and the component technique analysis. The model was applied to the situation in Switzerland of estimated torture victims Switzerland is confronted with. When applied to the case study, the direct costs - such as housing, food, and clothing - represent roughly 130 million Swiss francs (CHF) per year; whereas, health care costs amount to 16 million CHF per year, and the costs related to education of young people to 34 million CHF per year. Indirect costs, namely those costs related to the loss of the productivity of direct survivors of torture, have been estimated to one-third of 1 billion CHF per year. This jumps to 10,073,419,200 CHF in the loss of productivity if one would consider 30 years of loss per survivor. Our study shows that a rough estimation of the costs related to torture is possible with some prerequisites, such as access to social and economic indicators at the country level.

Incommunicado detention and torture in Spain:Part I: The Istanbul Protocol Project in the Basque Country.

PubMed

2016-01-01

There is increasing evidence to show that torture is a serious problem in the Basque Country. Whilst such evidence can be found in reports of international human rights monitoring bodies, sentences of Spanish and international courts, and empirical studies, they are limited in not having followed the Istanbul Protocol (IP) in order to evaluate the reliability of torture. A working group composed of professional associations of psychiatrists, psychologists, physicians and lawyers, in collaboration with the University of the Basque Country, conducted a four-year study on the medical and psychological consequences of torture in incommunicado detainees, including an assessment of credibility in line with the IP. The methodological design included a multi-level peerreviewed blind assessment and input by an external expert (from the Independent Forensic Expert Group facilitated by International Rehabilitation Council for Torture Victims (IRCT)). A sample of 45 Basque people held in short-term incommunicado detention under anti-terrorist legislation (between 1980 and 2012) in Spain who had reported ill-treatment or torture was selected. The findings are divided into four papers: the present introductory paper; the second analyses the credibility of the allegations of torture and introduces an innovative methodology that enhances the IP, the Standardized Evaluation Form (SEC); the third provides an analysis of the methods of torture and introduces the concept of Torturing Environments; and, in the last paper, the psychological and psychiatric consequences of incommunicado detention are analyzed. The collection of papers are intended to be useful not only in the documentation of torture in the Basque Country and Spain, but also as an innovative example of how the IP can be used for research purposes.

Posttraumatic Stress Disorder, Orientation to Pain, and Pain Perception in Ex-Prisoners of War Who Underwent Torture.

PubMed

Tsur, Noga; Defrin, Ruth; Ginzburg, Karni

Studies suggest that torture survivors often experience long-term chronic pain and increased pain perception. However, it is unclear whether the actual experience of torture or rather the subsequent posttraumatic stress disorder (PTSD) explains these pain problems. Furthermore, although catastrophic and fearful orientations to pain have been suggested to play a significant role in the association between trauma and pain, the underlying mechanisms remain unclear. This study examined whether chronic pain and pain perception among torture survivors are associated with torture experience or PTSD and whether catastrophic and fearful orientations mediate or moderate these associations. Fifty-nine ex-prisoners of war who underwent torture and 44 matched veterans participated in this study. Pain perception was evaluated by assessing pain threshold and reactivity to experimental suprathreshold noxious stimuli. Participants completed self-administered questionnaires assessing PTSD, chronic pain, pain catastrophizing, and fear of pain. Although chronic pain was associated with PTSD (0.44 < β < 0.49, p < .002), increased pain perception was correlated with torture (0.33 < β < 0.65, p < .05). Pain catastrophizing was found to mediate the association between PTSD and chronic pain (β = 0.18 and 0.19, respectively; p < .05). Fear of pain moderated the association between torture and pain perception (β = 0.41 and 0.42, respectively; p < .017). The findings suggest that chronic pain is contingent upon the psychological toll of torture, that is, PTSD. This study also indicates that PTSD exacerbates catastrophic orientation, which in turn may amplify chronic pain. Reactivity to experimental noxious stimuli was related to previous experiences of torture, which enhances perceived pain intensity when interacting with a fearful pain orientation. These findings highlight the significance of orientation to bodily experiences after trauma.

Listening for the sounds of silence: a nursing consideration of caring for the politically tortured.

PubMed

Racine-Welch, T; Welch, M

2000-06-01

In 1997 Amnesty International reported that 115 out of 251 countries surveyed practised torture on their citizens. Many of these victims have been forced to flee their country of origin and become refugees in the West, in countries such as Australia, Canada, the UK and the United States. However, torture itself remains an unspoken and covert problem. In addition to the obvious traumatic effects, it may induce shame and dread on the part of the victim. It may be too terrifying and too painful to talk about, and yet may affect every aspect of a person's life (Forrest 1996). All too commonly a victim of torture may pass unnoticed or unrecognised because health care providers do not know how, or may be unwilling to engage with the issue. This paper will examine the implications for nurses of caring for the tortured. It will explore the nature of torture itself, who might be the perpetrators and who might be the victims (always acknowledging that nurses and other health care staff are often both), how victims of torture may present for health care, and the possible subjective perceptions of a torture victim when faced with a Western health care process and understanding. Finally, it will argue for an increase in awareness and sensitivity on the part of all nurses in all health care settings to the needs and sensibilities of victims of torture, and suggest that caring for them is the distillation of everything good nursing practice should be.

Medical Students’ Attitudes toward Torture, Revisited

PubMed Central

Dubin, Krista; Milewski, Andrew R.; Shin, Joseph

2017-01-01

Abstract This paper reports the findings of a survey of medical students’ attitudes toward torture and discusses variables that may correlate with those attitudes. In late 2016, 483 enrolled medical and MD–PhD students at the Weill Cornell Medical College received an anonymous, institutional review board-approved survey that included questions about torture and its effectiveness, demographic questions, inquiries about personal experiences of harassment or discrimination, and questions regarding engagement in human rights activities. Some questions were drawn from a 2008 University of Illinois survey of medical students’ attitudes toward torture, the only prior such survey at a US medical university. Of the 483 students who were contacted, 121 (25%) returned completed questionnaires, with responses indicating strong opposition to torture and skepticism about its usefulness. Respondents expressed greater opposition to torture in this survey than those who participated in the 2008 survey. Respondents’ involvement in Weill Cornell’s human rights program was associated with significantly stronger opposition to torture, while personal experiences of harassment were associated with a trend toward weaker opposition to torture. Respondents’ answers closely approximate the clearly stated ethics of the profession, suggesting that human rights education during medical school may contribute to the development of proper values in young physicians even before they proceed into practice. PMID:29302181

Torture in Abu Ghraib.

PubMed

Keller, Allen S

2006-01-01

Iraqi detainees subjected to torture and mistreatment at Abu Ghraib prison may continue to suffer from significant physical and psychological consequences of their abuse. This article reports two cases of Iraqi individuals allegedly tortured at Abu Ghraib. Detailed forensic evaluations were conducted approximately one year after their abuse in accordance with international guidelines. The findings of these evaluations substantiate their allegations of torture and confirm the profound health consequences of torture. Furthermore, these cases support assertions that abuse of prisoners was not limited to being perpetrated by guards, but also occurred systematically in the context of interrogations. These cases also raise concerns about inadequate medical care for Iraqi detainees.

Human Rights, Humanitarianism, and State Violence: Medical Documentation of Torture in Turkey.

PubMed

Can, Başak

2016-09-01

State authorities invested in developing official expert discourses and practices to deny torture in post-1980 coup d'état Turkey. Documentation of torture was therefore crucial for the incipient human rights movement there in the 1980s. Human rights physicians used their expertise not only to treat torture victims but also to document torture and eventually found the Human Rights Foundation of Turkey (HRFT) in 1990. Drawing on an ethnographic and archival research at the HRFT, this article examines the genealogy of anti-torture struggles in Turkey and argues that locally mediated intimacies and/or hostilities between victims of state violence, human rights physicians, and official forensics reveal the limitations of certain universal humanitarian and human rights principles. It also shows that locally mediated long-term humanitarian encounters around the question of political violence challenge forensic denial of violence and remake the legitimate levels of state violence. © 2015 by the American Anthropological Association.

Sexual torture of Palestinian men by Israeli authorities.

PubMed

Weishut, Daniel J N

2015-11-01

In the context of the Israeli-Palestinian conflict, arrests and imprisonment of Palestinian men in their early adulthood are common practice. The Public Committee Against Torture in Israel (PCATI) collected thousands of testimonies of Palestinian men allegedly tortured or ill-treated by Israeli authorities. There are many types of torture, sexual torture being one of them. This study is based on the PCATI database during 2005-2012, which contains 60 cases-- 4% of all files in this period--with testimonies of alleged sexual torture or ill-treatment. It is a first in the investigation of torture and ill-treatment of a sexual nature, allegedly carried out by Israeli security authorities on Palestinian men. Findings show that sexual ill-treatment is systemic, with 36 reports of verbal sexual harassment, either directed toward Palestinian men and boys or toward family members, and 35 reports of forced nudity. Moreover, there are six testimonies of Israeli officials involved in physical sexual assault of arrested or imprisoned Palestinian men. Physical assault in most cases concerned pressing and/or kicking the genitals, while one testimony pertained to simulated rape, and another described an actual rape by means of a blunt object. The article provides illustrations of the various types of sexual torture and ill-treatment of boys and men in the light of existing literature, and recommendations. Copyright © 2015 Elsevier Inc. All rights reserved.

Study of knowledge, attitude and practice concerning aspects of torture.

PubMed

Sobti, J C; Chapparawal, B C; Holst, E

2000-06-01

The report presents the first attempt of the IMA-AKN Sinha Institute of continuing medical and health education and research to study the knowledge, attitude and practice of doctors regarding torture. Although, majority of the doctors in India are aware of various national and international human rights institutions, but they seem not to be aware of the human rights of the detainees. It is interesting to note that the doctors are aware of the long term physical and psychological effects of torture and also agreed that physical examination is not sufficient to detect torture sequelae. A large number of doctors have seen cases of torture, and were willing to treat them and felt reasonably competent. A significant number of doctors justified use of coercive technique and manhandling in dealing with detainees by law enforcement agencies. A small number of doctors expressed their unwillingness to get involved in the treatment of the victims of torture due to medicolegal consequence. The dissemination of information on human rights and medical ethics and incorporating them into the medical curriculum at undergraduate and postgraduate training was emphasised by majority of the respondents. Almost unanimous view was expressed by respondents on the importance of the role of medical ethics and the profession's responsibility to its members. An important finding of the study is the need for IMA to help establishing counselling and rehabilitation centres for treatment of torture victims and educate its members. A large number of doctors mentioned the need of initiating community action in case of rape, child abuse, dowry victims and sexual harassment. Further, a majority of respondents expressed the view that the medical association should take the responsibilities of protecting the doctors who fearlessly testify cases of torture besides disciplining doctors who facilitate torture. Respondents felt that the reasons for doctors' participation in torture need further study. It is encouraging that most of the responding physicians are willing to take up training and become counsellor for victims of torture to be able to provide treatment, counselling and rehabilitation.

75 FR 25271 - Office of Refugee Resettlement; Urgent Single Source Grant to Survivors of Torture International...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... effects of torture. (2) Social and legal services for victims of torture. (3) Research and training for... a large network of pro bono providers, is well known in the community, and possesses the clinical...

Torture, sex and military Orientalism.

PubMed

Owens, Patricia

2010-01-01

This article revisits the debate about recent American torture practices, particularly the use of discredited anthropological texts to validate long-held Orientalist assumptions about the sexual vulnerability of Muslim males. Such practices are placed in an historical context of older imperial constructions of sexually deviant Muslims as well as of more general forms of gendered and sexual subordination required for war. American torturers intended to produce very particular objects of torture—ones willing and able to confess their 'true' orientation in terms of a binary hetero/homo sexual code established in 19th-century Europe. The torturers had the power to confirm through confession and re-enactment their crude assumptions, irrespective of the actual sexualities of those being tortured, with consequences for the transnational and reactionary politics of sexual identity.

Access denied: institutional barriers to justice for victims of torture in Egypt.

PubMed

Khalil, Hebatullah Mahmoud

2013-01-01

This research explores the question - how do practices in key justice institutions affect the incidence and success of prosecutions of torture perpetrators in Egypt? The research question is grounded in the theory that torture prosecutions are crucial to ending the practice of torture, and based on the judgment that the number of prosecutions of torture perpetrators in Egypt is very small compared to the widespread practice of torture. This research observes practices in three main justice institutions: the Department of Public Prosecutions, the Department of Forensic Medicine and the criminal courts. Based on international and local literature, but also on interviews conducted with lawyers, forensic doctors and human rights activists, the research observes the practices most common to the three institutions, while analyzing their impact on the incidence and success of prosecutions. The research finds that different practices, backed by Egyptian legislation, and endorsed by poor institutional capabilities, violate the international standards for investigations, and affect the incidence and outcome of prosecutions.

Humiliation: the lasting effect of torture.

PubMed

Vorbrüggen, Meike; Baer, Hans U

2007-12-01

Although the physical effects of torture in surviving persons are well known, psychological wounds are lesser known and investigated. A new aspect of considerable impact is the notion of shame, self-humiliation, and the ensuing problems of degradation. Further research on the evolving concept of post-torture illness should be performed.

Politically-motivated torture and child survivors.

PubMed

Green, Crystal

2007-01-01

It is critical that healthcare providers recognize behaviors common to children who have endured politically-motivated torture in order to create a safe and reliable treatment plan for such children and their families. Three vignettes taken from actual cases illustrate the way child survivors of torture are likely to present in educational, medical, or healthcare settings. Children or youth are resilient and can be helped to process their traumatic experiences and thrive emotionally and physically if providers are observant, competent and responsive. Federally funded resource centers exist to assist in caring for children who have survived torture.

Healing after torture: the role of moving on.

PubMed

Isakson, Brian L; Jurkovic, Gregory J

2013-06-01

The experience and sociocultural context of torture and its treatment have received little attention in the biopsychosocial model of Western mental health for survivors of torture. The main focus has been on the reduction of symptoms of posttraumatic stress disorder and related conditions. Using grounded theory methodology, we investigated survivors' perceptions of the nature and process of healing after torture. The participants included 11 adult refugee torture survivors (9 men and 2 women) from African and Asian countries. Their stories of healing centered on the role of "moving on" with their lives, which included aspects of cognitive reframing and empowerment. Reliance on belief and value systems, safety measures, and social support, despite continuing psychological and physical symptomatology, enabled the moving-on process. Implications for theory, research, and practice are discussed.

Torture and the War on Terror

ERIC Educational Resources Information Center

O'Brien, Ed

2004-01-01

In this article, the author examines another dimension of human rights--the problem of torture. He looks at U.S. commitments to international conventions prohibiting torture in light of the abuses at Abu Ghraib prison in Iraq. He shows how a position adopted by the Bush administration that these international conventions did not apply to the war…

How a terror attack affects right-wing authoritarianism, social dominance orientation, and their relationship to torture attitudes.

PubMed

Lindén, Magnus; Björklund, Fredrik; Bäckström, Martin

2018-06-29

Self-reported level of right-wing authoritarianism (RWA), the two facets of social dominance orientation (SDO-Dominance and SDO-Egalitarianism) and pro-torture attitudes were measured both in the immediate aftermath (terror salience, N = 152) of the terror attacks in Paris and Brussels and when terrorism was not salient. Results showed that RWA and pro-torture attitudes, but not SDO-Dominance and SDO-Egalitarianism, were significantly higher immediately after (non-salience, N = 140). Furthermore, RWA and SDO both predicted pro-torture attitudes more strongly under terror salience. We argue that the reason why RWA is higher under terror salience is a response to external threat, and that SDO-Dominance may be more clearly related to acceptance of torture and other human-rights violations, across context. Future research on the effects of terror-related events on sociopolitical and pro-torture attitudes should focus on person-situation interactions and also attempt to discriminate between trait and state aspects of authoritarianism. © 2018 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Indecent medicine: in defense of the absolute prohibition against physician participation in torture.

PubMed

Matthews, Richard S

2006-01-01

In a recent article, Gross (2004) argues that physicians in decent societies have a civic duty to aid in the torturing of suspected terrorists during emergency conditions. The argument presupposes a communitarian society in which considerations of common good override questions of individual rights, but it is also utilitarian. In the event that there is a ticking bomb and no other alternative available for defusing it, torture must be used, and physicians must play their part. In an earlier article, Jones (1980) also argues in favour of physician participation in torture, going so far as to enthusiastically endorse the allocation of research resources as well to ensure that the ability to meet emergency situations is as efficient as scientifically possible. I argue against both these views and defend the absolute prohibition against torture generally, and against any participation by physicians in particular. I show that these arguments are incompatible with liberal or decent societies, and that the institutional requirements for making torture effective would constitute an unacceptable degradation both of medical ethics and practice, as well as of political institutions in general.

Predictors of mental health and quality of life in male tortured refugees.

PubMed

Carlsson, Jessica M; Mortensen, Erik L; Kastrup, Marianne

2006-01-01

Some of the most frequently reported mental health problems in traumatized refugees are depression, anxiety and post-traumatic stress disorder (PTSD). The aim of this paper is to describe a group of tortured refugees referred to the Rehabilitation and Research Centre for Torture Victims (RCT) and to study the importance of past trauma/torture and post-migratory factors for the present symptoms of PTSD, depression, anxiety and for health-related quality of life. The sample comprises 63 male tortured refugees admitted to a pre-treatment assessment at RCT. Data on personal background, trauma, present situation in Denmark, symptoms of depression, anxiety (Hopkins Symptom Checklist-25, HSCL-25, and Hamilton Depression Scale, HDS), PTSD (Harvard Trauma Questionnaire, HTQ), and on health-related quality of life (WHO Quality of life-Bref, WHOQOL-Bref) were collected through self-administered questionnaires and structured and semi-structured interviews. The scores in the questionnaires measuring emotional distress were high. Previous torture and trauma, lower education, fewer social contacts, no occupation and pain were identified as significant predictors of emotional distress. Few social contacts was a significant predictor of a lower health-related quality of life. Even after many years, past torture is significantly associated with emotional distress. Post-migratory factors are also significantly associated with emotional distress and health-related quality of life, and potentially modifiable factors, such as social relations and occupation, are of special interest.

The Movie "The Secret Life of Words:" Implications for Counselors

ERIC Educational Resources Information Center

Cook, Katrina

2008-01-01

Torture still occurs at an alarming rate in the world today. Because many torture victims suffer silently in isolation instead of seeking help for their symptoms of posttraumatic stress, it is impossible to know how many lives have been impacted. However, as more and more torture victims seek asylum in countries such as the United States,…

Teaching against Torture: Sacramental Catechesis in Exceptional Circumstances

ERIC Educational Resources Information Center

Mikoski, Gordon S.

2009-01-01

The ongoing crisis concerning torture and cruel, inhuman, and degrading treatment of prisoners by U.S. personnel or under U.S. auspices in the "War on Terror" raises issues central to the identity of both church and society. The practice of torture cries out for practical theological reflection inasmuch as it threatens to eviscerate the moral…

Can we prevent doctors being complicit in torture? Breaking the serpent's egg.

PubMed

O'Connor, Mike

2009-12-01

A significant minority of the tortured prisoners who survive report that a doctor was present during their torture. Yet few medical practitioners are ever criminally prosecuted or even disciplined by their regulatory bodies. Can such gross violations of the Hippocratic Code be so easily ignored or are these doctors carefully shielded from detection and prosecution by a grateful state? Mostly doctors act to vet prisoners for their capacity to withstand the torture or resuscitate them to allow torture and interrogation to continue. However, on occasion, the "healers" may be the actual torturers as happened in Russian psychoprisons in the latter part of the 20th century. This article argues that the de facto immunity which complicit doctors currently appear to enjoy must be stripped away and replaced by effective processes to detect and then prosecute criminal behaviour. This will require widespread reporting of cases and action by international bodies, including non-government organisations. Prevention is clearly preferable and this will require improvements in undergraduate and graduate medical education about international humanitarian and human rights law. There is evidence that many medical faculties pay scant attention to this education and their students graduate with serious flaws in their understanding and attitudes towards human rights. Education should target "doctors at risk" in prisons, armed forces and the police. It should address professional behaviour which tolerates or even protects cultures of abuse. A code of professional conduct would assist "doctors at risk" to resist overtures for them to become complicit in torture, Medical Practice Acts should include statements on respecting human rights when defining good professional conduct. Doctors who become complicit in torture betray their profession. Swift action should be taken to stop such abuses and perpetrators should receive strong disciplinary action from regulatory bodies.

Refugee trauma versus torture trauma: a retrospective controlled cohort study of Tibetan refugees.

PubMed

Holtz, T H

1998-01-01

A retrospective cohort study of 35 refugee Tibetan nuns and lay students who were arrested and tortured in Tibet matched with 35 controls who were not arrested or tortured was carried out in India. Subjects were administered the Hopkins Checklist-25, evaluating anxiety symptoms, effective disturbances, somatic complaints, and social impairment. The prevalence of symptom scores in the clinical range for both cohorts was 41.4% for anxiety symptoms and 14.3% for depressive symptoms. The torture survivors had a statistically significant higher proportion of elevated anxiety scores than did the nontortured cohort (54.3% vs. 28.6%, p = .05). This was not true for elevated depressive scores. The results suggest that torture has long-term consequences on mental health over and above the effects of being uprooted, fleeing one's country, and living in exile as a refugee, though the additional effects were small. Political commitment, social support in exile, and prior knowledge of and preparedness for confinement and torture in the imprisoned cohort served to foster resilience against psychological sequelae. The contribution of Buddhist spirituality plays an active role in the development of protective coping mechanisms among Tibetan refugees.

Torture and Long-Term Health Effects Among Lebanese Female Political Prisoners.

PubMed

Ghaddar, Ali; Elsouri, Ghadier; Abboud, Zeinab

2016-02-01

Lebanese prisoners during the Israeli occupation of Lebanon (1981-1999) were subject to regular torture. We examined the association between torture events and post-traumatic stress and cardiovascular diseases (CVDs) among former women political prisoners. We conducted a retrospective survey and performed health check-ups among 108 former women prisoners. Post-traumatic stress disorder (PTSD) was measured through the Clinician-Administered PTSD Scale (CAPS), and CVDs were assessed by physicians' diagnoses. The study was conducted between September 2008 and March 2010. All 67 participants in the study reported having been subjected to a variety of torture events. The prevalence of PTSD was 28.4% and that of CVD was 16.42%, respectively. PTSD and CVD were more likely to occur among women who had had longer imprisonment periods, and PTSD specifically was associated with exposure to torture (beating: OR = 1.49; 95% CI [0.48, 4.27] and threatening by rape: OR = 1.43; 95% CI [0.82, 9.30]). CVD was associated with asphyxia with water (OR = 3.86; 95% CI [0.03, 2.28]). Devoutness decreased the risk of PTSD (OR = 0.24; 95% CI [0.08, 1.41]). Torture had adverse long-term effects on prisoners' physiological and psychological health; devoutness played a significant protective role. This study highlights the importance of documenting torture events and identifying the indicators of associated morbidity among surviving political prisoners for the provision of additional resources to care. © The Author(s) 2014.

Neglect of Medical Evidence of Torture in Guantánamo Bay: A Case Series

PubMed Central

Iacopino, Vincent; Xenakis, Stephen N.

2011-01-01

Background In the wake of the September 11, 2001 attacks on the US, the government authorized the use of “enhanced interrogation” techniques that were previously recognized as torture. While the complicity of US health professionals in the design and implementation of US torture practices has been documented, little is known about the role of health providers, assigned to the US Department of Defense (DoD) at the US Naval Station Guantánamo Bay, Cuba (GTMO), who should have been in a position to observe and document physical and psychological evidence of torture and ill treatment. Methods and Findings We reviewed GTMO medical records and relevant case files (client affidavits, attorney–client notes and summaries, and legal affidavits of medical experts) of nine individuals for evidence of torture and ill treatment and documentation by medical personnel. In each of the nine cases, GTMO detainees alleged abusive interrogation methods that are consistent with torture as defined by the UN Convention Against Torture as well as the more restrictive US definition of torture that was operational at the time. The medical affidavits in each of the nine cases indicate that the specific allegations of torture and ill treatment are highly consistent with physical and psychological evidence documented in the medical records and evaluations by non-governmental medical experts. However, the medical personnel who treated the detainees at GTMO failed to inquire and/or document causes of the physical injuries and psychological symptoms they observed. Psychological symptoms were commonly attributed to “personality disorders” and “routine stressors of confinement.” Temporary psychotic symptoms and hallucinations did not prompt consideration of abusive treatment. Psychological assessments conducted by non-governmental medical experts revealed diagnostic criteria for current major depression and/or PTSD in all nine cases. Conclusion The findings in these nine cases from GTMO indicate that medical doctors and mental health personnel assigned to the DoD neglected and/or concealed medical evidence of intentional harm. Please see later in the article for the Editors' Summary PMID:21559073

Trauma Healing in Refugee Camps in Guinea: A Psychosocial Program for Liberian and Sierra Leonean Survivors of Torture and War

ERIC Educational Resources Information Center

Stepakoff, Shanee; Hubbard, Jon; Katoh, Maki; Falk, Erika; Mikulu, Jean-Baptiste; Nkhoma, Potiphar; Omagwa, Yuvenalis

2006-01-01

From 1999 to 2005, the Minneapolis-based Center for Victims of Torture (CVT) served Liberian and Sierra Leonean survivors of torture and war living in the refugee camps of Guinea. A psychosocial program was developed with 3 main goals: (1) to provide mental health care; (2) to train local refugee counselors; and (3) to raise community awareness…

Implementing Istanbul Protocol standards for forensic evidence of torture in Kyrgyzstan.

PubMed

Moreno, Alejandro; Crosby, Sondra; Xenakis, Stephen; Iacopino, Vincent

2015-02-01

The Kyrgyz government declared a policy of "zero tolerance" for torture and began reforms to stop such practice, a regular occurrence in the country's daily life. This study presents the results of 10 forensic evaluations of individuals alleging torture; they represent 35% of all criminal investigations into torture for the January 2011-July 2012 period. All individuals evaluated were male with an average age of 34 years. Police officers were implicated as perpetrators in all cases. All individuals reported being subjected to threats and blunt force trauma from punches, kicks, and blows with objects such as police batons. The most common conditions documented during the evaluations were traumatic brain injury and chronic seizures. Psychological sequelae included post-traumatic stress disorder and major depressive disorder, which was diagnosed in seven individuals. In all cases, the physical and psychological evidence was highly consistent with individual allegations of abuse. These forensic evaluations, which represent the first ever to be conducted in Kyrgyzstan in accordance with Istanbul Protocol standards, provide critical insight into torture practices in the country. The evaluations indicate a pattern of brutal torture practices and inadequate governmental and nongovernmental forensic evaluations. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

The staying power of pain. A comparison of torture survivors from Bosnia and Colombia and their rates of anxiety, depression and PTSD.

PubMed

Alexander, Abigail; Blake, Stacie; Bernstein, Michael A

2007-01-01

The article describes symptoms of anxiety, depression and PTSD among Bosnian (n=17) and Colombian (n=17) torture survivors served by the Florida Center for Survivors of Torture, a programme of Gulf Coast Jewish Family Services, Inc. Information from clients enrolled in the programme for six months or more was collated over a 14 month period in order to better prioritize and design services for the two distinct populations. On average, the Bosnians in this sample experienced torture approximately 14 years ago while the Colombians'experience was approximately six years ago. Types of torture experienced by clients are documented using HURIDOCS and the number of family and friends affected by extreme trauma are counted. Employment and education levels attained are also identified. Findings show that 100% of Bosnians are symptomatic for depression and over half possess symptoms of PTSD compared to 35% of Colombians for depression and 18% for PTSD, despite the differences in years since trauma occurred. High incidences of torture experienced by Bosnian clients and high numbers of family and friends affected support the high rates of symptoms. For the Colombian clients, high rates of employment and years of education, as well as earlier intervention, may contribute to their lower rates of symptoms. The two client groups are distinguished by the unique circumstances experienced by each, including punctuated wartime versus a prolonged insurgency, as well as the refugee versus asylum seeker experience. This exploratory project informs the torture treatment model while recognizing the importance of ethnic, political and cultural perspectives affecting the healing process.

Torture and its sequel--a comparison between victims from six countries.

PubMed

Moisander, Pia A; Edston, Erik

2003-11-26

The aim of the study was to compare torture victims from six different nations and analyse differences and similarities. From the files of the Centre for Trauma Victims in Stockholm (KTC), 160 patients were selected: 53 patients from Bangladesh, 21 from Iran, 16 from Peru, 24 from Syria, 25 from Turkey, and 21 from Uganda. The data was classified into: (i) information about social conditions and circumstances pertaining to alleged torture, (ii) type of trauma and torture methods, and (iii) acute and late sequel to torture. Descriptive and non-parametric statistics were used in the analyses. There was a strong male dominance in all but the Ugandan group where 43% were women. The majority in all but the Turkish group had college exams and/or university studies. Over 84% were members of a political organisation except in the Iranian and Syrian groups, where more than 40% had no political affiliation. The majority in all groups had travelled to Sweden alone to apply for asylum, but most refugees from Turkey, Iran, and Syria had close relatives already living in Sweden. The stories of circumstances and torture methods were similar within each group but differed a great deal between groups. Typically, in Bangladesh, Peru, and Turkey, the periods under arrest were short: from a few hours to 3 days. In Iran, Uganda, and Syria, the time in custody varied from several months to several years. A prison sentence preceded by trial was common only in Iran. Many patients, especially from Bangladesh and Turkey, had been arrested several times. Sensory deprivation by isolation and blindfolding was common in all countries except Uganda and Peru. Beating with fists, sticks, truncheons, etc. were reported in 100% in every group. In Bangladesh, police batons (lathi) were used more commonly than in any other group. Whipping with electric cords occurred frequently only in Iran and Syria. Rape was most often reported among the Ugandans. Genital torture was frequently alleged by patients from Bangladesh and Turkey. Suspension was common in all countries except for Uganda. Falaka, i.e. beating of the soles, and electric torture were common (>60%) in Bangladesh, Iran, Syria, and Turkey. Sharp injuries inflicted with knives and bayonets were often seen among the Bangladeshi and Ugandans. Burning injuries due to cigarettes were commonly seen only in patients from Bangladesh. Some methods were found to be almost exclusive for each country: "water treatment" (Bangladesh), the "tyre" (Syria), "telephono" and "submarino" (Peru). The sequel of torture differed in some respects between groups. Fractures were more common among Iranians. Patients from Uganda and Bangladesh had numerous scars. Subjectively reported symptoms were most frequent among Bangladeshi, especially joint pain and ear, nose, and throat symptoms and least frequent among Ugandans. PTSD diagnosed on the basis of a psychiatric interview and psychological tests was found in 69-92% of patients in all groups. The study shows significant differences between countries regarding circumstances, torture methods, and sequel to torture. This knowledge is of value to forensic specialists documenting alleged torture and essential for fair and valid forensic statements.

Incommunicado detention and torture in Spain, Part IV: Psychological and psychiatric consequences of ill-treatment and torture: trauma and human worldviews.

PubMed

Navarro-Lashaya, Miguel Angel; Pérez-Sales, Pau; Lopez Neyr, Gabriela; Martínez, Maitane Arnoso; Morentin, Benito

2016-01-01

Most literature on psychological consequences of torture is related to prolonged detention. Psychological consequences of intensive physical and psychological torture in brief detention have not been investigated. The aim of this study is to analyse the psychological impact of torture in short-term incommunicado detention. A sample of 45 Basque people who had allegedly been subjected to ill-treatment or torture whilst held in incommunicado detention between two and 11 days in Spain in the period 1980-2012 was analysed. The period between detention and evaluation ranged between two and 12 years. Each case was evaluated by several psychiatrists and psychologists. Clinical interviews which followed the Istanbul Protocol were assessed, as were psychometric tests (Post-traumatic Checklist-Civilian version (PCL-C), Beck Depression Inventory (BDI) and Vital Impact Assessment Questionnaire (VIVO)) and external documentary evidence. A cumulative prevalence of psychiatric diagnosis (ICD-10) from the period of detention was established. Post-traumatic stress disorder (PTSD) was the most frequent diagnosis (53%). Enduring personality change after a catastrophic experience was detected in 11% of subjects. Other diagnoses were depressive disorders (16%) and anxiety disorders (9%). Psychometric evaluation at the time of the study showed symptoms of PTSD in 52% of the subjects (with a tendency for these symptoms to diminish over time) and depressive symptoms in 56%. The VIVO questionnaire discerned two subgroups of survivors: "affected" survivors (36%); and "resilient" survivors (64%). The data demonstrated two important issues: the undervalued damaging effect of intensive torture in short-term detention and the long lasting psychological damage of the same over time.

The U.N. Convention Against Torture: Overview of U.S. Implementation Policy Concerning the Removal of Aliens

DTIC Science & Technology

2009-01-21

The United Nations Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment ( CAT ) requires signatory parties...permitted. Additionally, CAT Article 3 requires that no state party expel, return, or extradite a person to another country where there are substantial...grounds to believe he would be subjected to torture. CAT Article 3 does not expressly prohibit persons from being removed to countries where they would

Child soldiers as zones of violence in The Democratic Republic of Congo: three cases of medico-legal evidence of torture.

PubMed

Guy, Kitwe Mulunda

2009-01-01

This article sets medico legal light on torture of three former child soldiers by comparing torture methods, consequences of torture and medical observations. It is focused on these child soldiers as representatives of the many abuses of children as soldiers in armed groups. The three persons were child soldiers during 12 years in The Democratic Republic of Congo (DRC) as members of three different armed groups. They were exposed to armed conflict events, experienced torture, and participated in atrocities, sexual abuse and traditional rituals during their role in armed conflict. They were psychologically distressed with unhealthy physical and mental states. The principles for working with child soldiers are described. The model addresses basic items: The confluence of the dimensions of the items will determine the specifics of medico legal evidence of torture in child soldiers, taking into consideration inputs that are required at the macro, community and individual levels. A primary goal is to prevent violence from occurring in child soldiers. Thus, much more deliberate effort is made to address the underlying causes of recruitment of children in armed groups in DRC and to invest more resources in conflict resolution before there is an outbreak of violence. Peace education tends to be introduced too late and does little to alleviate the use of children in armed conflict in DRC.

Doctors in the decent society: torture, ill-treatment and civic duty.

PubMed

Gross, Michael L

2004-04-01

How should physicians act when faced with corporal punishment, such as amputation, or torture? In most cases, the answer is clear: international law, UN resolutions and universal codes of medical ethics absolutely forbid physicians from countenancing torture and corporal punishment in any form. An acute problem arises, however, in decent societies, but not necessarily liberal states, that are, nonetheless, welcome in the world community. The decent society is often governed, in whole or in part, by religious laws, and while these states abridge various human rights they are peace loving, generally tolerant, and offer their citizens wide avenues for political participation. Under these circumstances the prohibition against corporal punishment and torture weakens, often compelling physicians to participate. This is true in two cases. In Rawls' hypothetical nation of Kazanistan, Islamic law is the order of the day, and amputations and corporal punishment play an integral part in the execution of traditional Islamic justice. In Israel, torture is sometimes used to elicit the information needed to thwart impending terror attacks. In each case, a physician's participation is essential. In light of the near universal condemnation that accompanies torture and corporal punishment, physicians can only appeal to norms anchored in collective well-being and concern for life that override respect for human dignity in these societies. Western societies have consistently rejected this reasoning, but it is part and parcel of life in the decent society.

The Mental Health Sequelae of Traumatic Head Injury in South Vietnamese Ex-Political Detainees Who Survived Torture

PubMed Central

Mollica, Richard F.; Chernoff, Miriam C.; Berthold, S. Megan; Lavelle, James; Lyoo, In Kyoon; Renshaw, Perry

2014-01-01

Little is known about the relationship between traumatic head injury (THI) and psychiatric morbidity in torture survivors. We examine the relationship between THI and depression, PTSD, post-concussive syndrome (PCS), disability and poor health status in Vietnamese ex-political detainees who survived incarceration in Vietnamese re-education camps. A community sample of ex-political detainees (n=337) and a non-THI, non-ex-detainee comparison group (n=82) were surveyed. 78% of the ex-political detainees had experienced THI. 90.6% of the ex-political detainees and 3.6% of the comparison group had experienced 7 or more trauma events. Depression and PTSD were greater in ex-detainees than the comparison group (40.9% vs 23.2% and 13.4% vs 0%). Dose-effect relationships for THI and trauma/torture in the ex-political detainee group were significant. Logistic regression in the pooled sample of ex-detainees and the comparison group confirmed the independent impact of THI from trauma/torture on psychiatric morbidity (OR for PTSD=22.4; 95% CI: 3.0-165.8). These results demonstrate important effects of THI on depression and PTSD in Vietnamese ex-detainees who have survived torture. PMID:24962448

The mental health and psychosocial problems of survivors of torture and genocide in Kurdistan, Northern Iraq: a brief qualitative study.

PubMed

Bolton, Paul; Michalopoulos, Lynn; Ahmed, Ahmed Mohammed Amin; Murray, Laura K; Bass, Judith

2013-01-01

From 1986-9, the Kurdish population of Iraqi Kurdistan was subjected to an intense campaign of military action, and genocide by the central Iraq government. This campaign, referred to as the Anfal, included systematic attacks consisting of aerial bombings, mass deportation, imprisonment, torture, and chemical warfare. It has been estimated that around 200,000 Kurdish people disappeared. To gain a better understanding of current priority mental health and psychosocial problems among Kurdish survivors of the Anfal, and to inform the subsequent design of culturally appropriate and relevant assessment instruments and services to address these problems. The study examined 1) the nature and cause of current problems of survivors of torture and/or civilian attacks and their families, 2) what survivors do to address these problems, and 3) what they felt should be done. We used a grounded theory approach. Free list interviews with a convenience sample (n=42) explored the current problems of Kurdish persons affected by torture. Subsequent key informant interviews (n=21) gathered more detailed information on the priority mental health problem areas identified in the free list interviews. Major mental health problem areas emerging from the free list interviews (and explored in the key informant interviews) included 1) problems directly related to the torture, 2) problems related to the current situation, and 3) problems related to the perception and treatment by others in the community. Problems were similar, but not identical, to Western concepts of depression, anxiety, PTSD and related trauma, and traumatic grief. Iraqi Kurdish torture survivors in Iraq have many mental health and psychosocial problems found among torture survivors elsewhere. The findings suggest that the problems are a result of the trauma experienced as well as current stressors. Development of mental health assessment tools and interventions should therefore address both previous trauma and current stressors.

8 CFR 1208.12 - Reliance on information compiled by other sources.

Code of Federal Regulations, 2010 CFR

2010-01-01

... application, or in deciding whether the alien has a credible fear of persecution or torture pursuant to § 1208.30 of this part, or a reasonable fear of persecution or torture pursuant to § 1208.31, the asylum...

Which will Trump: human rights and professional ethics, or torture redux?

PubMed

Marks, Jonathan H

2017-03-01

Recent political developments in the United States raise concerns about the potential return of aggressive interrogation strategies, particularly in the event of another large-scale terror attack on the U.S. mainland. This essay reviews various legal, ethical and policy responses to revelations of torture during the Bush administration. It asks whether they improve the prospect that, in future, human rights will trump torture, not vice versa. The essay argues that physicians could help prevent further abuses - especially given their access, social status and expertise - but that insufficient steps have been taken to empower them to do so.

Do resettlement variables predict psychiatric treatment outcomes in a sample of asylum-seeking survivors of torture?

PubMed

Whitsett, David; Sherman, Martin F

2017-12-01

Mental health clinicians who work with asylum seekers provide services to patients who face stressful everyday living conditions. However, little is known about how these problems potentially impact psychiatric treatment within these populations. The purpose of this study was thus to examine whether resettlement factors predict outcomes of a mental health intervention for a sample of asylum-seeking survivors of torture. The study included data from a US outpatient clinic that specialized in treating asylum-seeking survivors of torture. Patients (primarily from Iraq, Afghanistan and African Countries) were evaluated on demographic factors at intake and psychiatric symptoms throughout the course of treatment. Patients experienced significant reductions in depression, anxiety and trauma symptoms, although symptoms still remained near or above clinical thresholds. Stable, uncrowded housing conditions significantly predicted lower depression, anxiety and trauma symptoms at follow-up. These findings support the hypotheses that individuals seeking asylum within the United States who have survived torture can benefit from psychiatric treatment and emphasize the importance of stable living conditions in improving treatment effectiveness. This suggests the need for further research on social predictors of treatment outcomes, as well as the need for clinicians and policymakers to target improved housing as a potentially important tool to reduce psychiatric problems related to torture and forced migration.

The mental health sequelae of traumatic head injury in South Vietnamese ex-political detainees who survived torture.

PubMed

Mollica, Richard F; Chernoff, Miriam C; Megan Berthold, S; Lavelle, James; Lyoo, In Kyoon; Renshaw, Perry

2014-10-01

Little is known about the relationship between traumatic head injury (THI) and psychiatric morbidity in torture survivors. We examine the relationship between THI and depression, PTSD, post-concussive syndrome (PCS), disability and poor health status in Vietnamese ex-political detainees who survived incarceration in Vietnamese re-education camps. A community sample of ex-political detainees (n=337) and a non-THI, non-ex-detainee comparison group (n=82) were surveyed. Seventy-eight percent of the ex-political detainees had experienced THI; 90.6% of the ex-political detainees and 3.6% of the comparison group had experienced 7 or more trauma events. Depression and PTSD were greater in ex-detainees than in the comparison group (40.9% vs 23.2% and 13.4% vs 0%). Dose-effect relationships for THI and trauma/torture in the ex-political detainee group were significant. Logistic regression in the pooled sample of ex-detainees and the comparison group confirmed the independent impact of THI from trauma/torture on psychiatric morbidity (OR for PTSD=22.4; 95% CI: 3.0-165.8). These results demonstrate important effects of THI on depression and PTSD in Vietnamese ex-detainees who have survived torture. Copyright © 2014 Elsevier Inc. All rights reserved.

Post-traumatic Stress Disorder Symptoms Resulting from Torture and Other Traumatic Events among Syrian Kurdish Refugees in Kurdistan Region, Iraq

PubMed Central

Ibrahim, Hawkar; Hassan, Chiya Q.

2017-01-01

Political violence is known to cause psychological distress. There is a large body of empirical studies drawing correlations between war trauma, torture, and post-traumatic stress disorder (PTSD). However, there are few studies on the effects of war-related trauma among Syrian refugees after events following the ‘Arab Spring’ uprisings between 2010 and 2012. This study examines the association of PTSD symptoms with torture and other traumatic events among Syrian Kurdish refugees living in Kurdistan Region, Iraq. The experiences and PTSD symptoms among 91 Syrian Kurdish refugees in the Arbat camp in the Sulaymaniyah Governorate of the Kurdistan Region of Iraq were assessed using the Harvard Trauma Questionnaire, sections I, IV, and V. Results showed that the estimated levels of PTSD symptoms were high: between 35 and 38%. There were no significant gender differences in the occurrence of PTSD symptoms. However, men reported more general traumatic experiences than women. There were significant positive correlations between PTSD symptoms with traumatic events and torture (r = 0.500, r = 0.366, respectively). Examining the mental health impact of torture and other traumatic events among refugees has possible implications for organizations managing rehabilitation programs for individuals who have been exposed to traumatic events. PMID:28265252

Post-traumatic Stress Disorder Symptoms Resulting from Torture and Other Traumatic Events among Syrian Kurdish Refugees in Kurdistan Region, Iraq.

PubMed

Ibrahim, Hawkar; Hassan, Chiya Q

2017-01-01

Political violence is known to cause psychological distress. There is a large body of empirical studies drawing correlations between war trauma, torture, and post-traumatic stress disorder (PTSD). However, there are few studies on the effects of war-related trauma among Syrian refugees after events following the 'Arab Spring' uprisings between 2010 and 2012. This study examines the association of PTSD symptoms with torture and other traumatic events among Syrian Kurdish refugees living in Kurdistan Region, Iraq. The experiences and PTSD symptoms among 91 Syrian Kurdish refugees in the Arbat camp in the Sulaymaniyah Governorate of the Kurdistan Region of Iraq were assessed using the Harvard Trauma Questionnaire, sections I, IV, and V. Results showed that the estimated levels of PTSD symptoms were high: between 35 and 38%. There were no significant gender differences in the occurrence of PTSD symptoms. However, men reported more general traumatic experiences than women. There were significant positive correlations between PTSD symptoms with traumatic events and torture ( r = 0.500, r = 0.366, respectively). Examining the mental health impact of torture and other traumatic events among refugees has possible implications for organizations managing rehabilitation programs for individuals who have been exposed to traumatic events.

8 CFR 208.12 - Reliance on information compiled by other sources.

Code of Federal Regulations, 2010 CFR

2010-01-01

... whether the alien has a credible fear of persecution or torture pursuant to § 208.30 of this part, or a reasonable fear of persecution or torture pursuant to § 208.31, the asylum officer may rely on material...

Treatment of a Multitraumatized Tortured Refugee Needing an Interpreter with Exposure Therapy

PubMed Central

Jensen, Bo Søndergaard

2013-01-01

This paper described the application and feasibility of exposure therapy treatment (ET) for posttraumatic stress disorder (PTSD) in a multitraumatized tortured refugee with chronic PTSD and depression, in need of an interpreter. The patient received 26 one-hour sessions of ET involving exposure to his trauma-related memories. Symptoms of PTSD, depression, and anxiety were assessed at pre- and posttreatment and 3-, 6-, and 12-month followup with the Harvard Trauma Questionnaire (HTQ-R), PTSD Symptom Scale-Self Report (PSS-SR), Major depression inventory (MDI), and Beck Anxiety Inventory (BAI). Treatment led to a significant improvement across all measures of posttraumatic stress disorder, anxiety, and depression, and the improvement was maintained at the 12-month follow-up. The results from this case study provide further preliminary evidence that ET may be effective in treating multi-traumatized torture survivors who are refugees and in need of an interpreter, despite the additional stressors and symptoms complexity experienced by tortured refugees. PMID:23476868

Children of Torture Victims: Reactions and Coping.

ERIC Educational Resources Information Center

Montgomery, Edith; And Others

1992-01-01

Evaluation of 11 children from 5 exile families with at least 1 parent having been subjected to torture found children were anxious, depressive, and regressive with psychosomatic symptoms, sleep disorders, and family and school problems. Coping strategies including isolation and withdrawal, mental flight, eagerness to acclimatize, and strength of…

Predictors of Psychological Sequelae of Torture among South African Former Political Prisoners

ERIC Educational Resources Information Center

Halvorsen, Joar Overaas; Kagee, Ashraf

2010-01-01

The present study investigated potential predictors of the psychological sequelae of torture among 143 former political activists who had been detained during the apartheid era in South Africa. Using multiple regression analyses, the authors found that the number of times detained for political reasons, negative social support, strong…

Psychological distress in torture survivors: pre- and post-migration risk factors in a US sample.

PubMed

Song, Suzan J; Kaplan, Charles; Tol, Wietse A; Subica, Andrew; de Jong, Joop

2015-04-01

To investigate the relationships between sociodemographic, pre- and post-migration variables with prevalence of psychological distress and global functioning in a heterogeneous sample of torture survivors. Clients referred from resettlement agencies via the Office of Refugee Resettlement (ORR) to a community clinic in the United States (N = 278) were interviewed with structured, translated questionnaires. Univariate and multivariate logistic regression analyses determined the associations of sociodemographic, pre-, and post-migration risk factors with posttraumatic stress disorder (PTSD), depression, anxiety, and global functioning. Regression data indicate that length of time between arrival in US and clinical services was significantly associated with PTSD and depression; participants receiving services after 1 year of resettlement were more likely to experience PTSD (adjusted OR = 3.29) and depression (adjusted OR = 4.50) than participants receiving services within 1 year. Anxiety was predicted by female gender (adjusted OR = 3.43), age over 40 years (adjusted OR = 3.12), Muslim religion (adjusted OR = 2.64), and receiving medical services (AOR 3.1). Severely impaired global functioning was associated with female gender (adjusted OR = 2.75) and unstable housing status (adjusted OR = 2.21). Findings highlight the importance of examining post-migration variables such as length of time in country prior to receiving services in addition to pre-migration torture history upon relocated torture survivors. Clinicians and policy-makers should be aware of the importance of early mental health screening and intervention on reducing the psychiatric burden associated with torture and forced relocation.

Outrages Against Personal Dignity: Rationalizing Abuse and Torture in the War on Terror

ERIC Educational Resources Information Center

Gregory Hooks; Clayton Mosher

2005-01-01

The outrage over revelations of torture and abuse at Abu Ghraib prison has faded from public discourse, but a number of questions remain unanswered. This paper criticizes official rationalizations offered for the abuse. We make the case that these abuses are systemic, resulting from dehumanization of the enemy and the long reliance on and…

Justifying Torture: Explaining Democratic States' Noncompliance with International Humanitarian Law

ERIC Educational Resources Information Center

Kanstroom, Emily

2007-01-01

On June 28, 1951, France ratified the 1949 Geneva Conventions, which prohibited the torture of prisoners of war. On August 2, 1955, the United States of America ratified the same document. Between 1954 and 1962, France fought a war against Algeria, which sought its independence from colonial rule. From September 11, 2001 until the present, the…

U.N. Convention Against Torture (CAT): Overview and Application to Interrogation Techniques

DTIC Science & Technology

2008-01-25

torture”); Al- Saher v. I.N.S., 268 F.3d 1143 (9th Cir. 2001) (finding that regular, severe beatings and cigarette burns inflicted upon an Iraqi alien by...continued) be of sufficient severity to constitute torture. See Al- Saher , 268 F.3d at 1143 (regular, severe beatings and cigarette burns

U.N. Convention Against Torture (CAT): Overview and Application to Interrogation Techniques

DTIC Science & Technology

2009-01-26

105 See, e.g., Zubeda v. Ashcroft, 333 F.3d 46 (3rd Cir. 2003) (“[r]ape can constitute torture”); Al- Saher v...Crimes Act have previously been found to be of sufficient severity to constitute torture. See Al- Saher , 268 F.3d at 1143 (regular, severe beatings and

Validation of a Tibetan Translation of the Hopkins Symptom Checklist-25 and the Harvard Trauma Questionnaire

ERIC Educational Resources Information Center

Lhewa, Dechen; Banu, Sophia; Rosenfeld, Barry; Keller, Allen

2007-01-01

This study sought to translate and validate the Hopkins Symptom Checklist-25 (HSCL) and the Harvard Trauma Questionnaire (HTQ) in a Tibetan population. Translated questionnaires were administered to 57 Tibetan survivors of torture/human rights abuses living in the United States and receiving services in a torture treatment program. Participants…

76 FR 53913 - Award of an Urgent Single-Source Grant to Survivors of Torture International (SOTI) in San Diego...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Office of Refugee Resettlement Award of an Urgent Single-Source Grant to Survivors of Torture International (SOTI) in San Diego, CA; Correction AGENCY: Office of... (SOTI), San Diego, CA. The document contained incorrect information in citing the statutory authority...

15 CFR 742.11 - Specially designed implements of torture, thumbscrews, and thumbcuffs; and parts and accessories...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 2 2010-01-01 2010-01-01 false Specially designed implements of torture, thumbscrews, and thumbcuffs; and parts and accessories, n.e.s. 742.11 Section 742.11 Commerce and Foreign Trade Regulations Relating to Commerce and Foreign Trade (Continued) BUREAU OF INDUSTRY AND...

Legal consequences for torture in children cases: the Gomez Paquiyauri Brothers vs Peru case.

PubMed

Tinta, Monica Feria

2009-01-01

The Gomez Paquiyauri Brothers case, before the Inter-American Court of Human Rights, was the first international case concerning the protection of children in the context of armed conflict where an international court stated the law concerning the duties of States towards children even in the context of war, and provided for reparations. As such it represents a landmark decision. The case arose from the illegal detention, torture and extrajudicial execution of two minors, Emilio and Rafael Gomez Paquiyauri, at the hands of Peruvian Police in 1991, under the Fujimori Administration at a time when the internal war in Peru was at its peak. Unlike most cases coming to the jurisdiction of the Inter-American Court, the case had been subject to domestic criminal investigations that had led to the convictions of two low ranking policemen. Yet a more subtle pattern of impunity lied at the root of the case. Torture had been denied by the State, and the prosecutions of low ranking policemen had intended to cover up the responsibility of those who ordered a policy of torture and executions (including the existence of secret codes for the torture and elimination of suspects of "terrorism") during the years of the internal armed conflict in Peru. The joint work of legal and medical expertise in the litigation of the case permitted the establishment of the facts and the law, obtaining an award of 740,500 dollars for the victims and a number of measures of reparation including guarantees of non-repetition and satisfaction, such as the naming of a school after the victims.

Human dignity, humiliation, and torture.

PubMed

Luban, David

2009-09-01

Modern human rights instruments ground human rights in the concept of human dignity, without providing an underlying theory of human dignity. This paper examines the central importance of human dignity, understood as not humiliating people, in traditional Jewish ethics. It employs this conception of human dignity to examine and criticize U.S. use of humiliation tactics and torture in the interrogation of terrorism suspects.

Forensic standardizations in torture and death in custody investigations

PubMed Central

2012-01-01

Torture and death in custody have incurred rapid development as juridical subject in recent years in Europe, with the implementation of the European Convention of Human Rights. Evaluation of sufferance severity, which is the consequence of pathology with chronic evolution, the predictability of decompensation of a subclinical pathology, and translating these medical information on a scale measuring the severity of detention consequences, are all challenges for the modern detention healthcare system, in which most allegations of torture are due to lack of appropriate medical treatment administered to inmates. Where ethics are concerned, the main data difficulties are addressed in ethical conflicts between officials and experts of the parties and also between experts and judiciary officials who handle cases of torture or death in detention; this is why standardization is very important in such cases both in clinical expertise and in autopsies or exhumations. Discussions: We must improve the forensic expertise methodology, the process of collecting data with statistical purposes, and sound evaluation criteria, all in a strong connection with the need for a balanced legal framework applied in the case of civil compensations granted after death in custody, and the biunique relation between medico-legal expertise and case investigation has to be standardized. PMID:24265878

Human Rights and torture.

PubMed

1998-01-01

1998 marks the 50th anniversary of the historic Universal Declaration of Human Rights, which proclaims that all peoples are born free and equal and sets out the basic principles of equality and nondiscrimination in the enjoyment of fundamental freedoms and human rights. Yet, despite the many covenants and conventions stemming from this declaration and signed by nations around the world, human rights continue to be violated by powerful groups, by individuals, often even by family members. On 26 June, which has been declared UN International Day in Support of Victims of Torture, attention will be focused on torture--a grave violation of a person's human rights still practised in its many insidious forms in many countries. INR reviews the work of the organizations trying to help stop the perpetrators and participation of health professionals; rehabilitate the survivors; and educate health professionals and the public.

Countershock: mobilizing resistance to electroshock weapons.

PubMed

Martin, Brian; Wright, Steve

2003-01-01

Electroshock, stun and restraint technologies are often used for torture and as tools of repression. There is much information available exposing the problems with such technologies, but little about how to be effective in challenging their use. The concept of political ju-jitsu--the process by which an attack on a non-violent resister can backfire on the attackers--is introduced and adapted to examine challenges to electroshock weapons. In order to make these weapons backfire, it is important to emphasize the value of potential targets, to expose secret dealings, to reveal the harm caused by the weapons and to communicate clearly to a wide audience. A longer-term goal is policy change to deny access by torturing states to such repressive tools. Countershock strategies and methodologies are introduced here as potential tools to create ever-expanding torture-technology-free zones.

Uruguay's military physicians. Cogs in a system of state terror.

PubMed

Bloche, M G

The military junta that ruled Uruguay until March 1985 was engaged in a systematic program of clandestine detention and torture of political detainees. Bloche went to Uruguay in December 1985 on behalf of the American Association for the Advancement of Science to investigate claims that physicians collaborated in this program. He reports on the extent to which evidence supported allegations that physicians engaged in performing clinical examinations on detainees that yielded information used for planning torture, prepared pathological reports that covered up acts of brutality, failed to provide adequate medical assistance, designed a prison regimen to harm inmates' mental health, and abused neuroleptic drugs. He concludes that, although evidence regarding some of the allegations was inconclusive, the investigation proved overall that clinicians played a significant role in the Uruguayan apparatus of physical and psychological torture.

Renditions: Constraints Imposed by Laws on Torture

DTIC Science & Technology

2007-10-12

14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT Same as Report (SAR) 18. NUMBER OF PAGES 30 19a...limit or bar U.S. participation in renditions, including S. 1876, the National Security with Justice Act of 2007, and H.R. 1352, the Torture...civil case on a number of grounds, including that certain claims raised against U.S. officials implicated national security and foreign policy

A Practical Approach to Replication of Abstract Data Objects

DTIC Science & Technology

1990-05-01

rigorous torture testing. Torture testing was done with the aid of a basher program that allows the user to configure an object and perform a specified...number of transactions, each containing a specified number of operations on the object. There are separate basher programs for RSMs and MRSMs. The...modify the object (Writes and Erases, for RSMs). The basher maintains a local, non- replicated table that tracks the RSM that is under test. Each

Los torturadores medicos: medical collusion with human rights abuses in Argentina, 1976-1983.

PubMed

Perechocky, Andrew

2014-12-01

Medical collaboration with authoritarian regimes historically has served to facilitate the use of torture as a tool of repression and to justify atrocities with the language of public health. Because scholarship on medicalized killing and biomedicalist rhetoric and ideology is heavily focused on Nazi Germany, this article seeks to expand the discourse to include other periods in which medicalized torture occurred, specifically in Argentina from 1976 to 1983, when the country was ruled by the Proceso de Reorganización Nacional military regime. The extent to which medical personnel embedded themselves within the Proceso regime's killing apparatus has escaped full recognition by both scholars and human rights activists. This article reconstructs the narrative of the Proceso's human rights abuses to argue that health professionals knowingly and often enthusiastically facilitated, oversaw, and participated in every phase of the "disappearance," torture, and mass murder process.

Proteus rebound: reconsidering the "torture of nature".

PubMed

Pesic, Peter

2008-06-01

Though Carolyn Merchant has agreed that Francis Bacon did not advocate the "torture of nature," she still maintains that "the very essence of the experimental method arose out of human torture transferred onto nature." Her arguments do not address serious problems of logic, context, and contrary evidence. Her particular insistence on the influence of the torture of witches ignores Bacon's skepticism about witchcraft as superstitious or imaginary. Nor do the writings of his successors sustain her claim that they carried forward his supposed program to abuse nature. We should be wary of metaphorical generalizations that ignore the context of the metaphor, the larger intent of the writers, and the fundamental limitations of such metaphors as descriptions of science. There are no scientific methods which alone lead to knowledge! We have to tackle things experimentally, now angry with them and now kind, and be successively just, passionate, and cold with them. One person addresses things as a policeman, a second as a father confessor, a third as an inquisitive wanderer. Something can be wrung from them now with sympathy, now with force; reverence for their secrets will take one person forwards, indiscretion and roguishness in revealing their secrets will do the same for another. We investigators are, like all conquerors, discoverers, seafarers, adventurers, of an audacious morality and must reconcile ourselves to being considered on the whole evil.

Voyage to the Dark Side: The Tortured Path of United States’ Detainee Interrogation Policy

DTIC Science & Technology

2007-08-13

against cruel, inhuman, or degrading treatment or punishment under this section. (c) Limitation on Supersedure .--The provisions of this section...this section. (c) Limitation on Supersedure .--The provisions of this section shall not be superseded, except by a provision of law enacted after the...University Press, New York, New York 2006) 35-83. 417 David Butler , “The Power of TV Torture,” The Associated Press, Reading Eagle, 18 February 2007, E8. 87

Psychopathology and Associated Risk Factors Among Forcibly Displaced Syrian Children and Adolescents.

PubMed

Gormez, Vahdet; Kılıç, Hale Nur; Orengul, A Cahid; Demir, Merve Nursoy; Demirlikan, Şeyma; Demirbaş, Sibel; Babacan, Betül; Kınık, Kerem; Semerci, Bengi

2018-06-01

More than half of the 2.7 million registered Syrian refugees in Turkey are under 18 years of age. This study investigates prevalence of psychopathology and associated risk factors in refugee children in Turkey. Of a total of 218 children aged 9-15 years, 56.2% lost someone important to them, 55.1% saw dead or wounded people, 70.4% witnessed explosions or gun battles, 42.5% witnessed people being tortured and 25.6% personally experienced cruelty/torture during war. Prevalence of PTSD was 18.3% and that of anxiety-related disorders were as high as 69.0%. Death of an important person (p = .032) and male gender (p = .040) were associated with PTSD; whilst exposure to cruelty or torture (p = .014) and increasing duration of refuge (p = .042) were significantly associated with development of anxiety disorders. Findings of the present study reveals existence of the expected but unspoken mental health needs among the Syrian children in Turkey.

Positive Adjustment Among American Repatriated Prisoners of the Vietnam War: Modeling the Long-Term Effects of Captivity.

PubMed

King, Daniel W; King, Lynda A; Park, Crystal L; Lee, Lewina O; Kaiser, Anica Pless; Spiro, Avron; Moore, Jeffrey L; Kaloupek, Danny G; Keane, Terence M

2015-11-01

A longitudinal lifespan model of factors contributing to later-life positive adjustment was tested on 567 American repatriated prisoners from the Vietnam War. This model encompassed demographics at time of capture and attributes assessed after return to the U.S. (reports of torture and mental distress) and approximately 3 decades later (later-life stressors, perceived social support, positive appraisal of military experiences, and positive adjustment). Age and education at time of capture and physical torture were associated with repatriation mental distress, which directly predicted poorer adjustment 30 years later. Physical torture also had a salutary effect, enhancing later-life positive appraisals of military experiences. Later-life events were directly and indirectly (through concerns about retirement) associated with positive adjustment. Results suggest that the personal resources of older age and more education and early-life adverse experiences can have cascading effects over the lifespan to impact well-being in both positive and negative ways.

Positive Adjustment Among American Repatriated Prisoners of the Vietnam War: Modeling the Long-Term Effects of Captivity

PubMed Central

King, Daniel W.; King, Lynda A.; Park, Crystal L.; Lee, Lewina O.; Kaiser, Anica Pless; Spiro, Avron; Moore, Jeffrey L.; Kaloupek, Danny G.; Keane, Terence M.

2015-01-01

A longitudinal lifespan model of factors contributing to later-life positive adjustment was tested on 567 American repatriated prisoners from the Vietnam War. This model encompassed demographics at time of capture and attributes assessed after return to the U.S. (reports of torture and mental distress) and approximately 3 decades later (later-life stressors, perceived social support, positive appraisal of military experiences, and positive adjustment). Age and education at time of capture and physical torture were associated with repatriation mental distress, which directly predicted poorer adjustment 30 years later. Physical torture also had a salutary effect, enhancing later-life positive appraisals of military experiences. Later-life events were directly and indirectly (through concerns about retirement) associated with positive adjustment. Results suggest that the personal resources of older age and more education and early-life adverse experiences can have cascading effects over the lifespan to impact well-being in both positive and negative ways. PMID:26693100

Validation of a French adaptation of the Harvard Trauma Questionnaire among torture survivors from sub-Saharan African countries

PubMed Central

de Fouchier, Capucine; Blanchet, Alain; Hopkins, William; Bui, Eric; Ait-Aoudia, Malik; Jehel, Louis

2012-01-01

Background To date no validated instrument in the French language exists to screen for posttraumatic stress disorder (PTSD) in survivors of torture and organized violence. Objective The aim of this study is to adapt and validate the Harvard Trauma Questionnaire (HTQ) to this population. Method The adapted version was administered to 52 French-speaking torture survivors, originally from sub-Saharan African countries, receiving psychological treatment in specialized treatment centers. A structured clinical interview for DSM was also conducted in order to assess if they met criteria for PTSD. Results Cronbach's alpha coefficient for the HTQ Part 4 was adequate (0.95). Criterion validity was evaluated using receiver operating characteristic curve analysis that generated good classification accuracy for PTSD (0.83). At the original cut-off score of 2.5, the HTQ demonstrated high sensitivity and specificity (0.87 and 0.73, respectively). Conclusion Results support the reliability and validity of the French version of the HTQ. PMID:23233870

POWs versus torturers: forensic evaluation of military personnel.

PubMed

Levin, Andrew P; Gold, Liza H; Onorato, Anthony A

2009-01-01

In April 2002, 17 American prisoners of war (POWs) and 37 of their family members brought an action in federal district court in Washington, D.C., against the Republic of Iraq, Saddam Hussein, and the Iraqi Intelligence Service for torture the POWs alleged they endured in 1991, following their capture during Operation Desert Storm. This action was the first in which prisoners of war sued a sovereign state for torture. As part of their case, the plaintiffs claimed psychological damage, and presented forensic evaluations of the POWs and their families in support. This article will address the novel questions and problems in this case, including: the legal context of the action; the logistical difficulties in evaluating a large number of plaintiffs in diverse locations; the challenges of establishing psychological injury in military personnel; the relationship between the forensic findings and the literature on POWs; the potential bias and secondary trauma experienced by the examiners; and the outcome of the action and prospects for similar actions in the future.

On turning a blind eye and a deaf ear: society's response to the use of torture.

PubMed

Thomas, Nina K

2011-01-01

The present paper undertakes an individual and group psychoanalytic examination of what happens to the citizens of a society that not only condones but authorizes torture. Drawing on the experiences of countries like those in Latin America during the period of the military dictatorships of the 1970s and 1980s, South Africa during the apartheid years, the Nazi era in Germany in the 1930s and 1940s, and Eastern Europe in the Communist era, the author focuses on the denial that was necessary to maintain daily life. At the same time, such denial and its accompanying "compartmentalization" produced a citizenry that was both blind and deaf to the practices and ultimately supported the dangerous hypocrisy of the respective political regimes. The impact of such "blindness" and "deafness" to the use of torture and abrogation of basic civil rights on the psychological life of individuals and society is examined for its parallels to our current times within the United States.

A comparative study of the use of the Istanbul Protocol amongst civil society organizations in low-income countries.

PubMed

Kelly, Toby; Jensen, Steffen; Koch Andersen, Morten; Christiansen, Catrine; Sharma, Jeevan Raj

2016-01-01

The Istanbul Protocol (IP) is one of the great success stories of the global anti-torture movement, setting out universal guidelines for the production of rigorous, objective and reliable evidence about allegations of torture and ill-treatment. The IP is explicitly designed to outline 'minimum standards for States'. However, it is all too often left to civil society organizations to investigate allegations of torture and ill-treatment. In this context, important questions remain as to how and where the IP can be used best by such organizations. These questions are particularly acute in situations where human rights groups may have limited institutional capacity. This paper explores the practical challenges faced by civil society in using the IP in Low-Income Countries. It is based on qualitative research in three case studies: Nepal, Kenya and Bangladesh. This research involved over 80 interviews with human rights practitioners. The conclusions of the paper are that the Istanbul Protocol provides a useful framework for documentation, but more comprehensive forms of documentation will often be limited to a very small - albeit important - number of legal cases. In many cases, the creation of precise and standardized forms of evidence is not necessarily the most effective form of documentation for redress or accountability. In the absence of legal systems willing and able to respond effectively to allegations of torture and ill-treatment, there are severe limitations on the practical effectiveness of detailed and technical forms of documentation.

Why Did U.S. Healthcare Professionals Become Involved in Torture During the War on Terror?

PubMed

Balfe, Myles

2016-09-01

This article examines why U.S. healthcare professionals became involved in "enhanced interrogation," or torture, during the War on Terror. A number of factors are identified including a desire on the part of these professionals to defend their country and fellow citizens from future attack; having their activities approved and authorized by legitimate command structures; financial incentives; and wanting to prevent serious harm from occurring to prisoners/detainees. The factors outlined here suggest that psychosocial factors can influence health professionals' ethical decision-making.

Gathering of Human Intelligence in Counter-Insurgency Warfare: The French Experience During the Battle of Algiers (January - October 1957)

DTIC Science & Technology

2009-01-01

eradication of any possible Muslim “third” force with which a compromise peace should have been reached. As Albert Camus said, any resort to torture saved...and polarization of the population as it drove into the insurgent camp undecided and moderate Muslims. As the French writer and Algiers native Albert ... Camus concluded: “torture has perhaps saved some at the expense of honor, by uncovering thirty bombs, but at the same time it has created fifty new

Statement on virginity testing.

PubMed

2015-07-01

Virginity testing (virginity examination) is a gynecological examination that is intended to correlate the status and appearance of the hymen with previous sexual contact to determine whether a female has had or is habituated to sexual intercourse. Virginity examinations are practiced in many countries, often forcibly, including in detention places; on women who allege rape or are accused of prostitution; and as part of public or social policies to control sexuality. The Independent Forensic Expert Group (IFEG) - thirty-five preeminent independent forensic experts from eighteen countries specialized in evaluating and documenting the physical and psychological effects of torture and ill-treatment - released a statement on the practice in December 2014. In its statement, the IFEG outlines the physical and psychological effects of forcibly conducting virginity examinations on females based on its collective experience. The Group assesses whether, based on the effects, forcibly conducted virginity examinations constitute cruel, inhuman, or degrading treatment or torture. Finally, the IFEG addresses the medical interpretation, relevance, and ethical implications of such examinations. The IFEG concludes that virginity examinations are medically unreliable and have no clinical or scientific value. These examinations are inherently discriminatory and, in almost all instances, when conducted forcibly, result in significant physical and mental pain and suffering, thereby constituting cruel, inhuman and degrading treatment or torture. When virginity examinations are forcibly conducted and involve vaginal penetration, the examination should be considered as sexual assault and rape. Involvement of health professionals in these examinations violates the basic standards and ethics of the professions. Copyright © 2015 Torture. Published by Elsevier Ltd.. All rights reserved.

Prevalence of mental disorders and torture among Tibetan refugees: A systematic review

PubMed Central

Mills, Edward J; Singh, Sonal; Holtz, Timothy H; Chase, Robert M; Dolma, Sonam; Santa-Barbara, Joanna; Orbinski, James J

2005-01-01

Background Many Tibetan refugees flee Tibet in order to escape physical and mental hardships, and to access the freedoms to practice their culture and religion. We aimed to determine the prevalence of mental illnesses within the refugee population and determine the prevalence of previous torture reported within this population. Methods We performed a systematic literature search of 10 electronic databases from inception to May 2005. In addition, we searched the internet, contacted all authors of located studies, and contacted the Tibetan Government-in-exile, to locate unpublished studies. We included any study reporting on prevalence of mental illness within the Tibetan refugee populations. We determined study quality according to validation, translation, and interview administration. We calculated proportions with exact confidence intervals. Results Five studies that met our inclusion criteria (total n = 410). All studies were conducted in North India and 4 were specifically in adult populations. Four studies provided details on the prevalence of torture and previous imprisonment within the populations. The prevalence of post-traumatic stress disorder ranged from 11–23%, anxiety ranged from 25–77%, and major depression ranged from 11.5–57%. Conclusion Our review indicates that the prevalence of serious mental health disorders within this population is elevated. The reported incidence of torture and imprisonment is a possible contributor to the illnesses. Non-government organizations and international communities should be aware of the human rights abuses being levied upon this vulnerable population and the mental health outcomes that may be associated with it. PMID:16280079

Cross-sectional study on awareness and knowledge of torture investigation and documentation among Greek doctors and senior medical students.

PubMed

Orfanou, Christina; Tsiamis, Costas; Karamagioli, Evika; Pikouli, Anastasia; Terzidis, Agis; Pikoulis, Emmanuel

2018-06-05

Doctors in Greece face the possibility of encountering a person that has suffered torture, especially since the high rates of refugees' and migrants' inflows that took place over the last years. In order to assess the awareness and the knowledge of doctors and senior medical students in Greece regarding a manual on effective investigation and documentation of torture such as Istanbul Protocol (official United Nation document since 1999), a cross-sectional study was conducted using a structured anonymous questionnaire. The sample was doctors practicing in public hospitals in Greece, doctors volunteering at a non-governmental organization (NGO) and undergraduate medical students in their final year of studies in the Medical School of National and Kapodistrian University of Athens. The data were analyzed using IBM SPSS version 23, using descriptive statistics and statistical significance tests.In a total of 289 participants, the mean total score of Istanbul Protocol knowledge was 4.43 ± 1.104 (the maximum possible score was 10) and the mean total score of Istanbul Protocol awareness was 2.04 ± 1.521 (the maximum possible score was 10). The most important conclusion was that among doctors and senior medical students, there seem to be knowledge, awareness, and information deficit about Istanbul Protocol and several issues relating to torture. The overall research outcome highlights the need for the development of a relevant informative/educational program, in order to cover the corresponding existing needs of the population of doctors in Greece.

Standardizing psycho-medical torture during the War on Terror: Why it happened, how it happened, and why it didn't work.

PubMed

Balfe, Myles

2016-12-01

After 9/11/2001 the United States launched a global War on Terror. As part of this War, terrorism suspects were detained by the U.S. military and by the C.I.A. It is now widely recognized that the United States tortured a number of these detainees in the context of its 'enhanced interrogation' programme. This article examines how and why U.S. organizations developed standards that allowed healthcare professionals to become involved in torture; why the standards developed by U.S. security institutions failed to control the actions of enhanced interrogation personnel on the ground; and what the role of standards were in stopping the enhanced interrogation initiative. The article concludes by discussing the general lessons that the enhanced interrogation programme has for social science research on standards, namely that individuals can experience ambivalence when caught between competing organizational and professional standards and that it might be inherently difficult to successfully enact certain protocols when these relate to deviant or destructive acts. Copyright © 2016 Elsevier Ltd. All rights reserved.

Stress-tension reduction in the treatment of sexually tortured women--an exploratory study.

PubMed

Larsen, H; Pagaduan-Lopez, J

1987-01-01

Three women who had been tortured and sexually abused during imprisonment as political prisoners during the dictatorship in the Philippines were treated with a nonverbal, manual stress-tension reduction therapy (STRT). All women had difficulty in sexual and social relationships and a series of unspecific complaints such as headache, dizziness, irritability, aggressiveness toward their own children, etc. The therapy is described. A series of four sessions was given each woman, followed by group training. A remarkable improvement was noted, and it is suggested that STRT may be use in other sexological disorders.

Impunity or immunity: wartime male rape and sexual torture as a crime against humanity.

PubMed

Zawati, Hilmi M

2007-01-01

This paper seeks to analyze the phenomenon of wartime rape and sexual torture of Croatian and Iraqi men and to explore the avenues for its prosecution under international humanitarian and human rights law. Male rape, in time of war, is predominantly an assertion of power and aggression rather than an attempt on the part of the perpetrator to satisfy sexual desire. The effect of such a horrible attack is to damage the victim's psyche, rob him of his pride, and intimidate him. In Bosnia- Herzegovina, Croatia, and Iraq, therefore, male rape and sexual torture has been used as a weapon of war with dire consequences for the victim's mental, physical, and sexual health. Testimonies collected at the Medical Centre for Human Rights in Zagreb and reports received from Iraq make it clear that prisoners in these conflicts have been exposed to sexual humiliation, as well as to systematic and systemic sexual torture. This paper calls upon the international community to combat the culture of impunity in both dictator-ruled and democratic countries by bringing the crime of wartime rape into the international arena, and by removing all barriers to justice facing the victims. Moreover, it emphasizes the fact that wartime rape is the ultimate humiliation that can be inflicted on a human being, and it must be regarded as one of the most grievous crimes against humanity. The international community has to consider wartime rape a crime of war and a threat to peace and security. It is in this respect that civilian community associations can fulfill their duties by encouraging victims of male rape to break their silence and address their socio-medical needs, including reparations and rehabilitation.

Are healthcare professionals working in Australia's immigration detention centres condoning torture?

PubMed

Isaacs, David

2016-07-01

Australian immigration detention centres are in secluded locations, some on offshore islands, and are subject to extreme secrecy, comparable with 'black sites' elsewhere. There are parallels between healthcare professionals working in immigration detention centres and healthcare professionals involved with or complicit in torture. In both cases, healthcare professionals are conflicted between a duty of care to improve the health of patients and the interests of the government. While this duality of interests has been recognised previously, the full implications for healthcare professionals working in immigration detention have not been addressed. The Australian Government maintains that immigration detention is needed for security checks, but the average duration of immigration detention has increased from 10 weeks to 14 months, and detainees are not informed of the progress of their application for refugee status. Long-term immigration detention causes major mental health problems, is illegal in international law and arguably fulfils the recognised definition of torture. It is generally accepted that healthcare professionals should not participate in or condone torture. Australian healthcare professionals thus face a major ethical dilemma: patients in immigration detention have pressing mental and physical health needs, but providing healthcare might support or represent complicity in a practice that is unethical. Individual healthcare professionals need to decide whether or not to work in immigration detention centres. If they do so, they need to decide for how long and to what extent restrictive contracts and gagging laws will constrain them from advocating for closing detention centres. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

What Torture Survivors Teach Assessors About Being More Fully Human.

PubMed

Evans, F Barton

2016-01-01

This article illustrates the complex sociocultural components in the forensic psychological assessment of a young Ethiopian woman's claim for political asylum due to a well-founded fear of persecution and for relief under the Convention Against Torture. It draws attention to the subtle social and cultural influences in the practice of forensic psychological assessment with an emphasis of reflective practice, which is contextualized in the interpersonal theory of Sullivan. In the interpersonal approach, the essential work of the assessor is to pay careful attention to the microinteractions between the client and the assessor as reflections of the interpersonal (meaning social and cultural) processes, eschewing the illusion of objectivity. In this case study, I illustrate the particular cultural dilemmas for client and assessor in conducting a forensic assessment of psychological trauma, including cross-cultural, gender, and legal difficulties in arriving at an informed, objective, and compassionate assessment of an individual seeking asylum after an especially brutal experience of torture. I argue that collaborative therapeutic assessment methods adapted for forensic practice offer an approach to assessment of psychological trauma that provides more accurate and compassionate assessment than so-called neutral standard forensic assessment practice.

Trauma healing in refugee camps in Guinea: a psychosocial program for Liberian and Sierra Leonean survivors of torture and war.

PubMed

Stepakoff, Shanee; Hubbard, Jon; Katoh, Maki; Falk, Erika; Mikulu, Jean-Baptiste; Nkhoma, Potiphar; Omagwa, Yuvenalis

2006-11-01

From 1999 to 2005, the Minneapolis-based Center for Victims of Torture (CVT) served Liberian and Sierra Leonean survivors of torture and war living in the refugee camps of Guinea. A psychosocial program was developed with 3 main goals: (a) to provide mental health care, (b) to train local refugee counselors, and (c) to raise community awareness about war trauma and mental health. Utilizing paraprofessional counselors under the close, on-site supervision of expatriate clinicians, the treatment model blended elements of Western and indigenous healing. The core component consisted of relationship-based supportive group counseling. Clinical interventions were guided by a 3-stage model of trauma recovery (safety, mourning, reconnection), which was adapted to the realities of the refugee camp setting. Over 4,000 clients were provided with counseling, and an additional 15,000 were provided with other supportive services. Results from follow-up assessments indicated significant reductions in trauma symptoms and increases in measures of daily functioning and social support during and after participation in groups. The treatment model developed in Guinea served as the basis for CVT's ongoing work with survivors in Sierra Leone and Liberia. ((c) 2006 APA, all rights reserved).

A narrative study of refugee women who have experienced violence in the context of war.

PubMed

Berman, Helene; Girón, Estella Rosa Irías; Marroquín, Antonia Ponce

2006-12-01

Although women are rarely on the frontlines of battle, as in many other realms of contemporary life they bear a disproportionate burden of the consequences of war. Many have experienced torture firsthand or been witnesses to the torture or killing of family, friends, and loved ones. The use of rape and other forms of sexual torture has been well documented. For those who are forced to flee their homes and countries, separation from spouses, children, and other family members is common. Because of the sheer magnitude of global conflict, the number of refugees and displaced persons throughout the world has risen exponentially. It has been estimated that women constitute more than half of the world's refugee population. The purpose of this narrative study was to examine the experiences of refugee women who experienced violence in the context of war. Data analysis revealed 8 themes: lives forever changed, new notions of normality, a pervasive sense of fear, selves obscured, living among and between cultures, a woman's place in Canada, bearing heavy burdens--the centrality of children, and an uncaring system of care. Implications for research and practice, including limitations associated with individualized Western approaches, are discussed.

The effects of gender discrimination on refugee torture survivors: a cross-cultural traumatology perspective.

PubMed

Kira, Ibrahim A; Smith, Iris; Lewandowski, Linda; Templin, Thomas

2010-09-01

Trauma developmental theory identifies gender discrimination (GD) as a type of persistent, ongoing trauma that has the potential for serious, negative effects on mental health. This study was conducted to examine the potential role of GD in the development of cumulative trauma disorders (CTD) and symptoms of posttraumatic stress disorder (PTSD) as well as the role of GD in mediating the effects of other traumas on these disorders. The sample included 160 female torture survivors from more than 30 countries. Measures of PTSD, CTD, and types of trauma exposure were acquired as part of a larger study on refugee torture survivors. Structural equation modeling was used to test several plausible models for the direct and indirect effects of GD on PTSD and CTD, within the context of other trauma exposure. Results suggest that GD mediates the effects of identity traumas on CTD and PTSD. GD also had direct effects on CTD, including relationships with dissociation, suicidality, and deficits in executive function. GD did not appear to directly influence the development of PTSD. The implications of these results for assessment and treatment of women's trauma-related disorders as well as strategies for their prevention are discussed.

Medical ethics at Guantanamo Bay and Abu Ghraib: the problem of dual loyalty.

PubMed

Clark, Peter A

2006-01-01

Although knowledge of torture and physical and psychological abuse was widespread at both the Guantanamo Bay detention facility and Abu Ghraib prison in Iraq, and known to medical personnel, there was no official report before the January 2004 Army investigation of military health personnel reporting abuse, degradation or signs of torture. Military medical personnel are placed in a position of a "dual loyalty" conflict. They have to balance the medical needs of their patients, who happen to be detainees, with their military duty to their employer. The United States military medical system failed to protect detainee's human rights, violated the basic principles of medical ethics and ignored the basic tenets of medical professionalism.

Prevention of torture and inhuman or degrading treatment: medical implications of a new European convention.

PubMed

Harding, T W

1989-05-27

A new European convention creates a mechanism for the prevention of torture and inhuman or degrading treatments of detained people through visits by outside, independent teams with unlimited access to places of detention. The convention has important implications for the medical profession: firstly, visits to psychiatric hospitals will be included and, in particular, to secure facilities, where the risk of human rights abuses is well established; and, secondly, the adequacy and ethics of medical care in prisons will be a key issue in assessing the protection of prisoners' human rights. The convention should be welcomed by the medical profession as a stimulus to the improvement of medical care for detained people.

Brain structural abnormalities and mental health sequelae in South Vietnamese ex-political detainees who survived traumatic head injury and torture.

PubMed

Mollica, Richard F; Lyoo, In Kyoon; Chernoff, Miriam C; Bui, Hoan X; Lavelle, James; Yoon, Sujung J; Kim, Jieun E; Renshaw, Perry F

2009-11-01

A pilot study of South Vietnamese ex-political detainees who had been incarcerated in Vietnamese reeducation camps and resettled in the United States disclosed significant mental health problems associated with torture and traumatic head injury (THI). To identify structural brain alterations associated with THI and to investigate whether these deficits are associated with posttraumatic stress disorder and depression. Cross-sectional neuroimaging study. Massachusetts General Hospital and McLean Hospital. A subsample of Vietnamese ex-political detainees (n = 42) and comparison subjects (n = 16) selected from a community study of 337 ex-political detainees and 82 comparison subjects. Scores on the Vietnamese versions of the Hopkins Symptom Checklist-25 (HSCL) and Harvard Trauma Questionnaire for depression and posttraumatic stress disorder, respectively; cerebral regional cortical thickness; and manual volumetric morphometry of the amygdala, hippocampus, and thalamus. Ex-political detainees exposed to THI (n = 16) showed a higher rate of depression (odds ratio, 10.2; 95% confidence interval, 1.2-90.0) than those without THI exposure (n = 26). Ex-political detainees with THI had thinner prefrontotemporal cortices than those without THI exposure (P < .001 by the statistical difference brain map) in the left dorsolateral prefrontal and bilateral superior temporal cortices, controlling for age, handedness, and number of trauma/torture events (left superior frontal cortex [SFC], P = .006; left middle frontal cortex, P = .01; left superior temporal cortex [STC], P = .007; right STC, P = .01). Trauma/torture events were associated with bilateral amygdala volume loss (left, P = .045; right, P = .003). Cortical thinning associated with THI in the left SFC and bilateral STC was related to HSCL depression scores in THI-exposed (vs non-THI-exposed) ex-political detainees (left SFC, P for interaction = .007; left STC, P for interaction = .03; right STC, P for interaction = .02). Structural deficits in prefrontotemporal brain regions are linked to THI exposures. These brain lesions are associated with the symptom severity of depression in Vietnamese ex-political detainees.

[Neoliberalism in health: the torture of the health care workers of the Bogota's Instituto Materno Infantil (child and maternity hospital)].

PubMed

Abadía, César B; Pinilla, María Y A; Ariza, Katerine R; Ruíz, Héctor C S

2012-06-01

To link, from a historical point of view, the most significant transformations of the Instituto Materno Infantil (IMI) [the oldest child and maternity hospital of the country] during its process of crisis, closure and liquidation with the experiences of the hospital workers. To find experience-based and theoretical elements that can interconnect the process of health care privatization of the country with the workers' experiences of resistance and pain/suffering. Critically-oriented ethnography based on continuous collective field work, historical research (primary and secondary sources) and semi-structured interviews with 5 women who worked at the IMI for more than 15 years. A time line of 4 main periods: Los años de gloria [The golden years] (up to 1990); Llega el neoliberalismo [Neoliberalism arrives] (1990-2000); La crisis y las resistencias [Crisis and resistances] (2001-2005); and Liquidación [Liquidation (2006-20??)]. The narratives of the interviewed women unveil multiple aggressions that have intensified since 2006, have caused pain and suffering and are examples of violations of human and labour rights. We suggest to analyze the links between the different kinds of violence and pain and suffering as torture. This category is defined as the set of violent actions that cause physical and emotional pain, which are performed by actors in positions of power over other people who challenge that power and are part of modern States' ideological principles around a defined moral social order. For the IMI workers' case, the ideological principle that is being challenged is health care neoliberalism. From the analyses of bureaucracy, confinement, torturing agents, and the breaking-off of the body-mind unit we conclude that this relationship between neoliberalism and torture aims to eliminate the last health care workers of the country who had job stability and full-benefits through public labour contracts. Their elimination furthers the accumulation of capital generated by increasing over-exploitation of labour and commodification of health care.

Asylum Seekers, Violence and Health: A Systematic Review of Research in High-Income Host Countries

PubMed Central

Hossain, Mazeda; Kiss, Ligia; Zimmerman, Cathy

2013-01-01

We performed a systematic review of literature on violence and related health concerns among asylum seekers in high-income host countries. We extracted data from 23 peer-reviewed studies. Prevalence of torture, variably defined, was above 30% across all studies. Torture history in clinic populations correlated with hunger and posttraumatic stress disorder, although in small, nonrepresentative samples. One study observed that previous exposure to interpersonal violence interacted with longer immigration detention periods, resulting in higher depression scores. Limited evidence suggests that asylum seekers frequently experience violence and health problems, but large-scale studies are needed to inform policies and services for this vulnerable group often at the center of political debate. PMID:23327250

Collusion, torture, and inequality: Understanding the actions of the American Psychological Association as institutional betrayal.

PubMed

Gómez, Jennifer M; Smith, Carly P; Gobin, Robyn L; Tang, Shin Shin; Freyd, Jennifer J

2016-01-01

The Hoffman Report (Hoffman et al., 2015) documented devastating information about the American Psychological Association (APA) and the profession of psychology in the United States, prompting a public apology and a formal commitment by APA to correct its mistakes (APA, 2015). In the current article, we utilize betrayal trauma theory (Freyd, 1997), including betrayal blindness (e.g., Freyd, 1996; Tang, 2015) and institutional betrayal (Smith & Freyd, 2014b), to understand and learn from APA's behaviors. We further situate this discussion in the context of inequality, both within APA and in American society generally. We detail how the impact of APA's institutional betrayals extended beyond the organization, its members, and the psychology profession, highlighting the potential for disproportionate harm to minorities, including those who were tortured; Muslims, Middle Easterners, Afghans, and non-Americans who were not tortured; and other minority individuals (Gómez, 2015d). Acknowledging, understanding, and addressing its institutional betrayals offers APA the opportunity to take meaningful corrective and preventive measures. We propose several institutional reparations, including making concrete changes with transparency and conducting self-assessments to inform further needed changes (Freyd & Birrell, 2013). By engaging in institutional courage, APA has the potential to grow into an ethical governing body that fulfills its mission to "advance the creation, communication and application of psychological knowledge to benefit society and improve people's lives" (APA, 2016).

Palliative Care and Human Rights: A Decade of Evolution in Standards.

PubMed

Ezer, Tamar; Lohman, Diederik; de Luca, Gabriela B

2018-02-01

Human rights standards to address palliative care have developed over the last decade. This article aims to examine key milestones in the evolution of human rights standards to address palliative care, relevant advocacy efforts, and areas for further growth. The article provides an analysis of human rights standards in the context of palliative care through the lens of the right to health, freedom from torture and ill treatment, and the rights of older persons and children. Significant developments include the following: 1) the first human rights treaty to explicitly recognize the right to palliative care, the Inter-American Convention on the Rights of Older Persons; 2) the first World Health Assembly resolution on palliative care; 3) a report by the UN Special Rapporteur on Torture with a focus on denial of pain treatment; 4) addressing the availability of controlled medicines at the UN General Assembly Special Session on the World Drug Problem. Development of human rights standards in relation to palliative care has been most notable in the context of the right to health, freedom from torture and ill treatment, and the rights of older persons. More work is needed in the context of the rights of children, and human rights treaty bodies are still not consistently addressing state obligations with regards to palliative care. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Gender bias torture in place of work.

PubMed

Pathak, P R

1999-11-01

Gender bias torture specially sexual harassment of women at the work place is now a hard reality, the ultimate form of control that repressed men, especially those in position of authority, can have today. They are generally being allowed to get away with it. Mainly because women are fearful and totally unorganized, managements are complacent and the law takes much too long to work if it ever does. Global picture is horrifying. Child abuse, women abuse and even some men are sexually abused. The fear of loss of job, hostility at work and social stigma still prevent women from complaining about sexual harassment. It has been recognized as human rights violation by the Supreme Court which has even drawn up legally binding guidelines directing employers to implement preventive and remedial measures in the work place.

LM Lederman's Life

Science.gov Websites

"little league" and other related institutions designed to torture pre-teenagers was much less late at night. This led to laboratory research. The oscilloscope was my essential companion as we

Analysis of the Metabolic and Structural Brain Changes in Patients With Torture-Related Post-Traumatic Stress Disorder (TR-PTSD) Using 18F-FDG PET and MRI

PubMed Central

Zandieh, Shahin; Bernt, Reinhard; Knoll, Peter; Wenzel, Thomas; Hittmair, Karl; Haller, Joerg; Hergan, Klaus; Mirzaei, Siroos

2016-01-01

Abstract Many people exposed to torture later suffer from torture-related post-traumatic stress disorder (TR-PTSD). The aim of this study was to analyze the morphologic and functional brain changes in patients with TR-PTSD using magnetic resonance imaging (MRI) and positron emission tomography (PET). This study evaluated 19 subjects. Thirteen subcortical brain structures were evaluated using FSL software. On the T1-weighted images, normalized brain volumes were measured using SIENAX software. The study compared the volume of the brain and 13 subcortical structures in 9 patients suffering from TR-PTSD after torture and 10 healthy volunteers (HV). Diffusion-weighted imaging (DWI) was performed in the transverse plane. In addition, the 18F-FDG PET data were evaluated to identify the activity of the elected regions. The mean left hippocampal volume for the TR-PTSD group was significantly lower than in the HV group (post hoc test (Bonferroni) P < 0.001). There was a significant difference between the gray matter volume of the patients with TR-PTSD and the HV group (post hoc test (Bonferroni) P < 0.001). The TR-PTSD group showed low significant expansion of the ventricles in contrast to the HV group (post hoc test (Bonferroni) P < 0.001). Diffusion-weighted imaging revealed significant differences in the right frontal lobe and the left occipital lobe between the TR-PTSD and HV group (post hoc test (Bonferroni) P < 0.001). Moderate hypometabolism was noted in the occipital lobe in 6 of the 9 patients with TR-PTSD, in the temporal lobe in 1 of the 9 patients, and in the caudate nucleus in 5 of the 9 patients. In 2 cases, additional hypometabolism was observed in the posterior cingulate cortex and in the parietal and frontal lobes. The findings from this study show that TR-PTSD might have a deleterious influence on a set of specific brain structures. This study also demonstrated that PET combined with MRI is sensitive in detecting possible metabolic and structural brain changes in TR-PTSD. PMID:27082610

Analysis of the Metabolic and Structural Brain Changes in Patients With Torture-Related Post-Traumatic Stress Disorder (TR-PTSD) Using ¹⁸F-FDG PET and MRI.

PubMed

Zandieh, Shahin; Bernt, Reinhard; Knoll, Peter; Wenzel, Thomas; Hittmair, Karl; Haller, Joerg; Hergan, Klaus; Mirzaei, Siroos

2016-04-01

Many people exposed to torture later suffer from torture-related post-traumatic stress disorder (TR-PTSD). The aim of this study was to analyze the morphologic and functional brain changes in patients with TR-PTSD using magnetic resonance imaging (MRI) and positron emission tomography (PET). This study evaluated 19 subjects. Thirteen subcortical brain structures were evaluated using FSL software. On the T1-weighted images, normalized brain volumes were measured using SIENAX software. The study compared the volume of the brain and 13 subcortical structures in 9 patients suffering from TR-PTSD after torture and 10 healthy volunteers (HV). Diffusion-weighted imaging (DWI) was performed in the transverse plane. In addition, the 18F-FDG PET data were evaluated to identify the activity of the elected regions. The mean left hippocampal volume for the TR-PTSD group was significantly lower than in the HV group (post hoc test (Bonferroni) P < 0.001). There was a significant difference between the gray matter volume of the patients with TR-PTSD and the HV group (post hoc test (Bonferroni) P < 0.001). The TR-PTSD group showed low significant expansion of the ventricles in contrast to the HV group (post hoc test (Bonferroni) P < 0.001). Diffusion-weighted imaging revealed significant differences in the right frontal lobe and the left occipital lobe between the TR-PTSD and HV group (post hoc test (Bonferroni) P < 0.001). Moderate hypometabolism was noted in the occipital lobe in 6 of the 9 patients with TR-PTSD, in the temporal lobe in 1 of the 9 patients, and in the caudate nucleus in 5 of the 9 patients. In 2 cases, additional hypometabolism was observed in the posterior cingulate cortex and in the parietal and frontal lobes. The findings from this study show that TR-PTSD might have a deleterious influence on a set of specific brain structures. This study also demonstrated that PET combined with MRI is sensitive in detecting possible metabolic and structural brain changes in TR-PTSD.

Torture Victims Relief Reauthorization Act of 2010

THOMAS, 111th Congress

Sen. Klobuchar, Amy [D-MN

2009-12-04

Senate - 05/13/2010 Placed on Senate Legislative Calendar under General Orders. Calendar No. 375. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

American Anti-Torture Act of 2009

THOMAS, 111th Congress

Rep. Nadler, Jerrold [D-NY-8

2009-02-04

House - 07/23/2009 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

22 CFR 95.2 - Application.

Code of Federal Regulations, 2011 CFR

2011-04-01

... would be in danger of being subjected to torture. (2) For the purpose of determining whether there are..., where applicable, the existence in the State concerned of a consistent pattern of gross, flagrant or...

22 CFR 95.2 - Application.

Code of Federal Regulations, 2010 CFR

2010-04-01

... would be in danger of being subjected to torture. (2) For the purpose of determining whether there are..., where applicable, the existence in the State concerned of a consistent pattern of gross, flagrant or...

8 CFR 253.1 - Parole.

Code of Federal Regulations, 2010 CFR

2010-01-01

... last habitual residence (if not a national of any country) because of fear of persecution in that... opinion, or because of fear of torture is eligible to apply for asylum or withholding of removal under 8...

Crimes of obedience: "groupthink" at abu ghraib.

PubMed

Post, Jerrold M; Panis, Lara K

2011-01-01

Clear evidence of authorization at the highest levels belies administration statements to the effect that the torture at Abu Ghraib was an aberration and simply unauthorized actions by rogue soldiers. The administration reflected a "group mind," demonstrating many qualities of "groupthink." Whatever was necessary, including torture and violation of the Geneva accords, the system in effect authorized, because of the perceived danger to the system and the desperate requirement to get the information out of "them" by whatever means necessary, information that could save lives. The sanctioned violence demonstrated the qualities identified by Kelman and Hamilton (1989) in their study of the Mylai massacre as characteristic of sanctioned massacres: authorization, routinization, and dehumanization. It would seem that officials and participants exhibited all of these characteristics in the decision to conduct extreme interrogation on the "unlawful combatants" imprisoned at Abu Ghraib.

Green College lectures. The responsibility of the doctor.

PubMed

Havard, J D

1989-08-19

Havard's theme is that there are situations in which the medical profession's concept of its responsibility to patients and to society may come into conflict with the law. Havard illustrates this theme with examples of consent issues, torture, and confidentiality. Among the consent issues he discusses are legal standards for disclosure, consent by and for minors and the mentally handicapped, and police requests for physician cooperation in obtaining forensic samples. Havard's discussion of torture concludes that physicians are individually responsible for taking a firm stand against any involvement that may cause harm to persons in detention. His overview of medical confidentiality is critical of England's Law Reform and Criminal Law Revision Committees, and includes the observation that "it would be difficult to name a democracy in the Western world that pays less respect to confidential medical information than the United Kingdom."

A longitudinal investigation of changes to social resources associated with psychological distress among Kurdish torture survivors living in Northern Iraq.

PubMed

Hall, Brian J; Bonanno, George A; Bolton, Paul A; Bass, Judith K

2014-08-01

Social resources can buffer against psychological distress following potentially traumatic events. Psychological distress can also lead to social resource deterioration. This longitudinal study evaluated whether baseline psychological distress symptoms and changes in these symptoms were associated with changes in social resources 5 months later among 96 adult male (52.6%) and female treatment-seeking torture survivors residing in Kurdistan, Iraq. Adapted versions of the Hopkins Symptom Checklist-25, Harvard Trauma Questionnaire, and a traumatic grief measure were used. Locally derived scales measured perceived social support, social integration, and frequency of social contact. Multinomial logistic regression models assessed the association between symptoms and loss or gain in social resources. We hypothesized that higher mental health symptoms would relate to decreased social resources. Higher baseline depression (adjusted conditional odds ratio [ACOR] = 1.14), posttraumatic stress disorder (PTSD; ACOR = 1.09), and traumatic grief symptoms (ACOR = 1.14) increased the odds of loss of social integration. For some, higher traumatic grief symptoms were associated with increased social integration (ACOR = 1.17). Increased anxiety (ACOR = 1.23) and PTSD symptoms (ACOR = 1.07) was associated with declines in social contact; decreased depression (ACOR = 1.06) and PTSD symptoms (ACOR = 1.04) were related to gaining social contact. This study highlights the complex relationship between mental health symptoms and losses and gains in social resources among torture survivors. Copyright © 2014 International Society for Traumatic Stress Studies.

Torture Victims Relief Reauthorization Act of 2009

THOMAS, 111th Congress

Rep. Smith, Christopher H. [R-NJ-4

2009-03-16

Senate - 07/23/2009 Received in the Senate and Read twice and referred to the Committee on Foreign Relations. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Equitable Compensation for American Victims of Torture Act of 2009

THOMAS, 111th Congress

Rep. Sestak, Joe [D-PA-7

2009-05-04

House - 06/12/2009 Referred to the Subcommittee on Immigration, Citizenship, Refugees, Border Security, and International Law. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Understanding human behavior in times of war.

PubMed

Vetter, Stefan

2007-12-01

The Third Geneva Convention reflects on the values of humanism, declaring the rights of humaneness, honor, and protection before torture and final discharge of war prisoners after the end of a war. These days, the occurrences in Baghdad Central Detention Center (formerly known as Abu Ghraib Prison), the actions of British soldiers in Basra, and the inflamed public discussion of whether torture might be an appropriate method to obtain crucial information from terrorists put the Third Geneva Convention back in the spotlight. The aforementioned occurrences raise questions regarding the psychological mass phenomena that make us vulnerable to think and to act against our education, habits, and beliefs. Only an understanding of these phenomena will help us to act against behavior we condemn. This article is an attempt to show how cognition of societies and individuals slowly changes during longer conflicts. Furthermore, it tries to summarize the possibilities we have to confront these tendencies.

The preventive approach: OPCAT and the prevention of violence and abuse of persons with mental disabilities by monitoring places of detention.

PubMed

Sveaass, Nora; Madrigal-Borloz, Victor

Adopted in December 2002, the United Nations Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment establishes a system of regular visits undertaken by independent international and national bodies to places where people are deprived of their liberty, in order to prevent torture and other cruel, inhuman or degrading treatment or punishment. The article explores how this collaboration between national and international bodies, with independent mandates to carry out such unannounced visits, represents an important effort in the process of protecting persons with mental disabilities who are detained and who are particularly exposed to exploitation and other forms of serious human rights violations, contrary to Article 16 of the Convention on the Rights of Persons with Disabilities. Copyright © 2017 Elsevier Ltd. All rights reserved.

British torture in the 'war on terror'.

PubMed

Blakeley, Ruth; Raphael, Sam

2017-06-01

Despite long-standing allegations of UK involvement in prisoner abuse during counterterrorism operations as part of the US-led 'war on terror', a consistent narrative emanating from British government officials is that Britain neither uses, condones nor facilitates torture or other cruel, inhuman or degrading treatment and punishment. We argue that such denials are untenable. We have established beyond reasonable doubt that Britain has been deeply involved in post-9/11 prisoner abuse, and we can now provide the most detailed account to date of the depth of this involvement. We argue that it is possible to identify a peculiarly British approach to torture in the 'war on terror', which is particularly well-suited to sustaining a narrative of denial. To explain the nature of UK involvement, we argue that it can be best understood within the context of how law and sovereign power have come to operate during the 'war on terror'. We turn here to the work of Judith Butler, and explore the role of Britain as a 'petty sovereign', operating under the state of exception established by the US executive. UK authorities have not themselves suspended the rule of law so overtly; indeed, they have repeatedly insisted on their commitment to it. Nevertheless, they have been able to construct a rhetorical, legal and policy 'scaffold' that has enabled them to demonstrate at least procedural adherence to human rights norms while, at the same time, allowing UK officials to acquiesce in the arbitrary exercise of sovereignty over individuals who are denied any access to appropriate representation or redress in compliance with the rule of law.

Pain as a fact and heuristic: how pain neuroimaging illuminates moral dimensions of law.

PubMed

Pustilnik, Amanda C

2012-05-01

In legal domains ranging from tort to torture, pain and its degree do important definitional work by delimiting boundaries of lawfulness and of entitlements. Yet, for all the work done by pain as a term in legal texts and practice, it has a confounding lack of external verifiability. Now, neuroimaging is rendering pain and myriad other subjective states at least partly ascertainable. This emerging ability to ascertain and quantify subjective states is prompting a "hedonic" or a "subjectivist" turn in legal scholarship, which has sparked a vigorous debate as to whether the quantification of subjective states might affect legal theory and practice. Subjectivists contend that much values-talk in law has been a necessary but poor substitute for quantitative determinations of subjective states--determinations that will be possible in the law's "experiential future." This Article argues the converse: that pain discourse in law frequently is a heuristic for values. Drawing on interviews and laboratory visits with neuroimaging researchers, this Article shows current and in-principle limitations of pain quantification through neuroimaging. It then presents case studies on torture-murder, torture, the death penalty, and abortion to show the largely heuristic role of pain discourse in law. Introducing the theory of "embodied morality," the Article describes how moral conceptions of rights and duties are informed by human physicality and constrained by the limits of empathic identification. Pain neuroimaging helps reveal this dual factual and heuristic nature of pain in the law, and thus itself points to the translational work required for neuroimaging to influence, much less transform, legal practice and doctrine.

Recognition and treatment of law enforcement violence against detainees and prisoners: A survey among Israeli physicians and medical students.

PubMed

Benninga, Zvi; Steiner-Birmanns, Bettina; Arbel, Revital; Abu Akar, Firas; Aboo Dia, Mushira

2017-01-01

Physicians regularly encounter victims of violence. Although some at-risk groups are increasingly recognized as such, the risks faced by prisoners and detainees are often overlooked. The scope of violence against them is unknown and their treatment is often hampered by unique social and institutional impediments. This article reviews the need for improved recognition and protection of such patients and the associated obstacles, while presenting information on the experience, knowledge and attitudes of physicians in Israel regarding the maltreatment of prisoners and detainees. We sent a questionnaire to physicians and medical students in Israel to enquire about their knowledge concerning examination and treatment of persons under police custody who appear to be victims of violence as well as their attitude concerning torture. We received answers from 443 physicians and 114 medical students. Most physicians would correctly examine and document the injuries, but only 59% would report their suspicions of violence to the Ministry of Health. Though 60% of physicians objected in principle to the use of torture, a majority endorsed the use of physical and psychological pressure during interrogation. Moreover, 29% of physicians thought it is permissible for physicians to examine detainees and verify their health so that torture can begin or continue. Our study shows that there is a need for development and implementation of treatment and reporting protocols as well as educational programs concerning the ethical and legal requirements of physicians towards detainees and prisoners in Israel. Limitations of our study are discussed.

Insects of war, terror and torture

USDA-ARS?s Scientific Manuscript database

From plagues to malaria transmission, insects and other arthropods have been natural or intentional health and agricultural threats to military and civilian populations throughout human history. The success or failure of military operations frequently has been determined by correctly anticipating in...

A novel bio-psycho-social approach for rehabilitation of traumatized victims of torture and war in the post-conflict context: a pilot randomized controlled trial in Kosovo.

PubMed

Wang, Shr-Jie; Bytyçi, Ardiana; Izeti, Selvi; Kallaba, Melita; Rushiti, Feride; Montgomery, Edith; Modvig, Jens

2016-01-01

Some evidence showed that multidisciplinary rehabilitation in Western countries is effective for treating war-related trauma, but it remains unclear whether this approach is applicable to civilians living in resource-poor countries affected by war. In 2012-14, Danish Institute against Torture (DIGNITY) conducted a randomized controlled trial (RCT), in partnership with Kosova Rehabilitation Centre for Torture Victims (KRCT), to examine the effects of multidisciplinary intervention among victims of torture and war in Kosovo. A single-center, randomized, parallel-arm, single-masked, waiting-list controlled trial was implemented in northern Kosovo. Thirty-four participants meeting the recruiting criteria were randomized to either intervention group, which received integrated treatments plus a once-daily multivitamin, or the waiting list group, which received multivitamin alone. The integrated treatments consisted of 10 weekly individual 60-min sessions of cognitive behavioral therapy (CBT), based on an adapted prolonged exposure therapy manual, an individual 20-min breathing exercise with an emWave biofeedback device, and 90-min group physiotherapy. The waiting list group also received the same treatment after the intervention group had completed their sessions. Outcome assessments were conducted at 3, 6 and 9 months after baseline assessment. Outcomes measures consisted of 4 subtypes: mental, emotional, physical health, functioning and social outcomes, i.e. PTSD, depression, anxiety, chronic pain, anger and hatred expression, body mass index, handgrip strength, standing balance, income, employment rate and disability score. Over 1/3 of PTSD cases were successfully treated. Inconsistent patterns with mental health and chronic pain outcomes were observed while there was a definite impact of intervention on functioning and social outcomes, i.e. the employment rate, which increased nearly 15 %, and the monthly wage, which rose 45-137 %. There was also a noticeable improvement in handgrip strength and disability score; the feelings of anger and hatred diminished. However, most of these changes did not reach statistical significance. The impact of bio-psycho-social intervention is likely sensitive to the context of post-war economy in Kosovo and the treatment goals. The potential for improving the emotional well-being and employment outcome in victims was demonstrated. A larger scale RCT in a similar setting is needed, with close monitoring of treatment integrity and data reliability. Clinicaltrials.gov (NCT01696578).

Redistricting Is Less Torturous When a Computer Does the Nitty-Gritty for You.

ERIC Educational Resources Information Center

Rust, Albert O.; Judd, Frank F.

1984-01-01

Describes "optimization" computer programing to aid in school redistricting. Using diverse demographic data, the computer plots district boundaries to minimize children's walking distance and maximize safety, improve racial balance, and keep enrollment within school capacity. (TE)

76 FR 50744 - Notice To Announce the Award of an Urgent Single-Source Grant to Survivors of Torture...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-16

... United States. SOTI is well positioned to provide medical, psychological, social, and legal services to... network of pro bono service providers and possesses the clinical and programmatic expertise to serve...

31 CFR Appendix A to Part 558 - Executive Order 13664

Code of Federal Regulations, 2014 CFR

2014-07-01

... any civilians through the commission of acts of violence (including killing, maiming, torture, or rape or other sexual violence), abduction, forced displacement, or attacks on schools, hospitals... stability of South Sudan and the surrounding region, including widespread violence and atrocities, human...

British torture in the ‘war on terror’

PubMed Central

Blakeley, Ruth; Raphael, Sam

2016-01-01

Despite long-standing allegations of UK involvement in prisoner abuse during counterterrorism operations as part of the US-led ‘war on terror’, a consistent narrative emanating from British government officials is that Britain neither uses, condones nor facilitates torture or other cruel, inhuman or degrading treatment and punishment. We argue that such denials are untenable. We have established beyond reasonable doubt that Britain has been deeply involved in post-9/11 prisoner abuse, and we can now provide the most detailed account to date of the depth of this involvement. We argue that it is possible to identify a peculiarly British approach to torture in the ‘war on terror’, which is particularly well-suited to sustaining a narrative of denial. To explain the nature of UK involvement, we argue that it can be best understood within the context of how law and sovereign power have come to operate during the ‘war on terror’. We turn here to the work of Judith Butler, and explore the role of Britain as a ‘petty sovereign’, operating under the state of exception established by the US executive. UK authorities have not themselves suspended the rule of law so overtly; indeed, they have repeatedly insisted on their commitment to it. Nevertheless, they have been able to construct a rhetorical, legal and policy ‘scaffold’ that has enabled them to demonstrate at least procedural adherence to human rights norms while, at the same time, allowing UK officials to acquiesce in the arbitrary exercise of sovereignty over individuals who are denied any access to appropriate representation or redress in compliance with the rule of law. PMID:29708134

78 FR 17413 - Announcement of the Award of an Urgent Single-Source Grant to the Center for Survivors of Torture...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-21

... of extreme violence in the Democratic Republic of Congo and recent arrivals have shown a compelling... include schools, health clinics, and social services agencies on refugee mental health issues. Due to the...

28 CFR 0.72 - National Security Division.

Code of Federal Regulations, 2010 CFR

2010-07-01

... relating to terrorism; (6) Prosecute matters involving torture, genocide, and war crimes to the extent such... the Foreign Intelligence Surveillance Act; (7) Prosecute Federal crimes involving national security... offenses (49 U.S.C. 46501-07); aircraft sabotage (18 U.S.C. 32); crimes against internationally protected...

28 CFR 0.72 - National Security Division.

Code of Federal Regulations, 2014 CFR

2014-07-01

... relating to terrorism; (6) Prosecute matters involving torture, genocide, and war crimes to the extent such... the Foreign Intelligence Surveillance Act; (7) Prosecute Federal crimes involving national security... offenses (49 U.S.C. 46501-07); aircraft sabotage (18 U.S.C. 32); crimes against internationally protected...

28 CFR 0.72 - National Security Division.

Code of Federal Regulations, 2012 CFR

2012-07-01

... relating to terrorism; (6) Prosecute matters involving torture, genocide, and war crimes to the extent such... the Foreign Intelligence Surveillance Act; (7) Prosecute Federal crimes involving national security... offenses (49 U.S.C. 46501-07); aircraft sabotage (18 U.S.C. 32); crimes against internationally protected...

28 CFR 0.72 - National Security Division.

Code of Federal Regulations, 2013 CFR

2013-07-01

... relating to terrorism; (6) Prosecute matters involving torture, genocide, and war crimes to the extent such... the Foreign Intelligence Surveillance Act; (7) Prosecute Federal crimes involving national security... offenses (49 U.S.C. 46501-07); aircraft sabotage (18 U.S.C. 32); crimes against internationally protected...

28 CFR 0.72 - National Security Division.

Code of Federal Regulations, 2011 CFR

2011-07-01

... relating to terrorism; (6) Prosecute matters involving torture, genocide, and war crimes to the extent such... the Foreign Intelligence Surveillance Act; (7) Prosecute Federal crimes involving national security... offenses (49 U.S.C. 46501-07); aircraft sabotage (18 U.S.C. 32); crimes against internationally protected...

Scholarly Discord

ERIC Educational Resources Information Center

Pellegrinelli, Lara

2009-01-01

Even with President Barack Obama's promises to close the Guantanamo Bay detention camp and withdraw troops from Iraq, the subject of torture keeps making the news. With all that detainees have had to endure during their incarcerations--the recent memos detail stress positions, cramped confinement, and waterboarding, among other tactics--perhaps…

A Victimologist Looks at Terrorism.

ERIC Educational Resources Information Center

Phelps, Thomas

1986-01-01

State terrorism is defined as terrorism undertaken by a government against people within its own national boundaries. This article reviews the 12-point anti-terrorism program of Amnesty International, lists the psychological needs of victims, and catalogs the various methods of torture used in state terrorism. (JDH)

Seeking Asylum: Challenges Faced by the LGB Community.

PubMed

Piwowarczyk, Linda; Fernandez, Pedro; Sharma, Anita

2017-06-01

A retrospective chart review was completed of patients self-identified as lesbian, gay, or bisexual seen through a program for survivors of torture between June 9, 2009 and December 31, 2014 (n = 50). Almost all (98 %) experienced persecution due to their sexual orientation and 84 % were survivors of torture. The circumstances under which the disclosure of sexual orientation took place in the country of origin were often traumatic. In several, efforts were made to change their sexual orientation often through forced marriage. Those in same sex relationships had relationships often marred by tragedy. Women were more likely to be forced to move from place to place, experience rape/sexual assault and threats whereas men were more likely to be persecuted by people on the street. All presented with symptoms of depression and anxiety. Providers need to be attuned to the potential traumatic histories of those fleeing persecution due to sexual orientation, and the medical, social, psychological, and legal implications.

Memories of Boys, Girls, and Adolescent Victims of Political Prison and Torture by the Chilean Military-Civilian Dictatorship.

PubMed

Faúndez, Ximena; Cárdenas, Manuel; Hatibovic, Fuad; Palma, Evelyn; Bravo, Diego

2017-08-01

This article reconstructs and analyzes the memories of victims of political prison and torture during the Chilean Military-Civilian Dictatorship who were minors when they experienced this violence. Participants in the study were 11 adults, six women and five men from the region of Valparaíso, who were victims of State terrorism during childhood and adolescence. The information production technique used was the focus group. A textual analysis was performed, based on interdisciplinary contributions from interpretation theory and discourse theories. The analysis of the information identified distinctive elements in the traumatic memories according to the sex-gender system associated with the private/public and passivity/agency dimensions. The results of this study reveal the urgent need to recognize boys, girls, and adolescents as people with rights who should be protected by both adults and States. Moreover, these results emphasize the need to implement early intervention programs in people affected by psychosocial traumas and disasters of different types, and improve their quality of life.

Stigma Is the Origin of Bullying

ERIC Educational Resources Information Center

Huggins, Mike

2016-01-01

Bullying in schools has escalated far beyond childhood teasing. In recent years, torture, murder, and suicide have been associated with bullying (van der Kolk, Weisaeth, & McFarlane, 2007). While bullying is unacceptable behavior in any school, it is particularly problematic in Catholic schools, which must embody Gospel values. Catholic…

Animal Torture Prevention Act of 2010

THOMAS, 111th Congress

Rep. Peters, Gary C. [D-MI-9

2010-05-18

House - 07/26/2010 Referred to the Subcommittee on Crime, Terrorism, and Homeland Security. (All Actions) Notes: For further action, see H.R.5566, which became Public Law 111-294 on 12/9/2010. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

"Preserving Intellectual Capital"

ERIC Educational Resources Information Center

Stewart, Pearl

2008-01-01

In 2005, living in his native Democratic Republic of the Congo, Dr. Felix Kaputu was arrested and accused of participating in a separatist movement outlawed by the government--charges he denied. He and other political detainees were incarcerated for several months, enduring beatings and torture. Amnesty International and other human rights groups…

The Portrayal of Mathematicians and Mathematics in Popular Culture

ERIC Educational Resources Information Center

Barba, Kimberly

2018-01-01

Mathematicians are often inimically portrayed in popular culture, resulting in an abundance of non-mathematical identities in the classroom. Various tropes are propagated by the media that dominate our mental schemas of what makes a mathematician: the eccentric Einstein-like old man; the young, tortured genius; and the "genetically…

Violation of human rights and the nursing profession.

PubMed

Tornbjerg, A; Jacobsen, L

1985-01-01

In Denmark, at Copenhagen's University Hospital there is an International Rehabilitation and Research Centre for Torture Victims where work began early in the 1980's. Since May, 1984 treatment has taken place and two nurses, working with Centre, described the situation at the ICN Congress in Tel Aviv.

Rights of the Child in Guatemala.

ERIC Educational Resources Information Center

Fernandez, Silvia Rodriguez

This report to the United Nations Convention on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the Convention by Guatemala. The report's introductory summary asserts that the end of armed conflict in Guatemala and the establishment of a peace process coupled with other…

Why Students Find Writing to be Torture.

ERIC Educational Resources Information Center

Newkirk, Thomas

Five pressures make writing difficult for freshman composition students: the pressure of perfectionism, the pressure of interesting an audience, the pressure of length, the pressure of finding an appropriate topic, and the pressure of time. Teachers can help students deal with these pressures through individual conferences with each student and by…

Finding The Right Way: Towards an Army Institutional Ethic

DTIC Science & Technology

2012-03-22

professionally and ethically," "demonstrate organisational values and codes of conduct," and "display high ethical and professional standards in all aspects of...government officials may find it necessary to violate that legal ban (official disobedience) in those instances.薍 Charitably , this is a tortured

Rights of the Child in Guatemala.

ERIC Educational Resources Information Center

Bagozzi, Daniela

This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the Convention on the Rights of the Child by the Republic of Guatemala. The report's introductory summary asserts that although Guatemala has begun to undertake institutional…

A Teachable Ethics Scandal

ERIC Educational Resources Information Center

Handelsman, Mitchell M.

2017-01-01

In this article, I describe a recent scandal involving collusion between officials at the American Psychological Association (APA) and the U.S. Department of Defense, which appears to have enabled the torture of detainees at the Guantanamo Bay detention facility. The scandal is a relevant, complex, and engaging case that teachers can use in a…

Rights of the Child in Turkey.

ERIC Educational Resources Information Center

Naqvi, Yasmin

This report to the United Nations Convention on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the Convention by Turkey and observations regarding violence against girls in Turkey. The report is presented in three major parts. Part 1 asserts that despite the considerable…

8 CFR 208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2010 CFR

2010-01-01

... actions authorized by law, including the death penalty, but do not include sanctions that defeat the... procedures calculated to disrupt profoundly the senses or the personality; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or...

8 CFR 208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2012 CFR

2012-01-01

... actions authorized by law, including the death penalty, but do not include sanctions that defeat the... procedures calculated to disrupt profoundly the senses or the personality; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or...

8 CFR 208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2013 CFR

2013-01-01

... actions authorized by law, including the death penalty, but do not include sanctions that defeat the... procedures calculated to disrupt profoundly the senses or the personality; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or...

8 CFR 208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2014 CFR

2014-01-01

... actions authorized by law, including the death penalty, but do not include sanctions that defeat the... procedures calculated to disrupt profoundly the senses or the personality; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or...

8 CFR 1208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2014 CFR

2014-01-01

... imposed sanctions and other enforcement actions authorized by law, including the death penalty, but do not...; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or suffering, or the administration or application of mind altering...

8 CFR 1208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2013 CFR

2013-01-01

... imposed sanctions and other enforcement actions authorized by law, including the death penalty, but do not...; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or suffering, or the administration or application of mind altering...

8 CFR 1208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2012 CFR

2012-01-01

... imposed sanctions and other enforcement actions authorized by law, including the death penalty, but do not...; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or suffering, or the administration or application of mind altering...

Rights of the Child in Algeria.

ERIC Educational Resources Information Center

Mejia, Fernando

This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the Convention on the Rights of the Child by Algeria. The report's introduction asserts that although OMCT welcomes legislative and institutional efforts made by Algeria since…

8 CFR 208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2011 CFR

2011-01-01

... actions authorized by law, including the death penalty, but do not include sanctions that defeat the... procedures calculated to disrupt profoundly the senses or the personality; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or...

8 CFR 1208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2010 CFR

2010-01-01

... imposed sanctions and other enforcement actions authorized by law, including the death penalty, but do not...; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or suffering, or the administration or application of mind altering...

8 CFR 1208.18 - Implementation of the Convention Against Torture.

Code of Federal Regulations, 2011 CFR

2011-01-01

... imposed sanctions and other enforcement actions authorized by law, including the death penalty, but do not...; (iii) The threat of imminent death; or (iv) The threat that another person will imminently be subjected to death, severe physical pain or suffering, or the administration or application of mind altering...

"Torture Memos" vs. Academic Freedom

ERIC Educational Resources Information Center

Glenn, David

2009-01-01

When people gathered last May for the commencement ceremony at the University of California at Berkeley's Boalt Hall School of Law, they were greeted by chanting activists from the National Lawyers Guild and other left-wing groups. The university, protesters shouted, should fire John C. Yoo, a tenured professor who has taught at the law school…

Rights of the Child in Ghana.

ERIC Educational Resources Information Center

Lacroix, Anne Laurence

This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the U.N. Convention on the Rights of the Child by the Republic of Ghana. The report's introduction asserts that although OMCT welcomes the measures taken by the Ghanian…

Savages in a Civilized War: The Native Americans as French Allies in the Seven Years War, 1754-1763

DTIC Science & Technology

2013-06-14

akin to their treatment of animals. Indian cosmology also made no distinction between animals and people and the torture fulfilled a ritualistic...stand out as principal examples that are definitive , and clear in their illustration. First, the defeat of Major-General Edward Braddock at Fort

8 CFR 1208.31 - Reasonable fear of persecution or torture determinations involving aliens ordered removed under...

Code of Federal Regulations, 2010 CFR

2010-01-01

... OFFICE FOR IMMIGRATION REVIEW, DEPARTMENT OF JUSTICE IMMIGRATION REGULATIONS PROCEDURES FOR ASYLUM AND... provide the alien with an opportunity to correct errors therein. The asylum officer shall create a written... the authority described in § 1208.9(c). (e) Referral to Immigration Judge. If an asylum officer...

Rights of the Child in Ethiopia.

ERIC Educational Resources Information Center

Schonveld, Ben; Mejia, Fernando

This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the U.N. Convention on the Rights of the Child by the nation of Ethiopia. The report's introduction asserts that despite the considerable lip service being paid by Ethiopia's…

Rights of the Child in Nigeria.

ERIC Educational Resources Information Center

Lacroix, Anne Laurence; Shoenberg, Cheryl; Schonveld, Ben

This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the U.N. Convention on the Rights of the Child by the Federation of Nigeria. The report's introduction asserts that the rule by decree of Nigeria's present military regime has…

PTSD and Impaired Eye Expression Recognition: A Preliminary Study

ERIC Educational Resources Information Center

Schmidt, Jakob Zeuthen; Zachariae, Robert

2009-01-01

This preliminary study examined whether posttraumatic stress disorder (PTSD) was related to difficulties in identifying the mental states of others in a group of refugees. Sixteen Bosnian refugees, referred to treatment in an outpatient treatment center for survivors of torture and war-related trauma in Denmark (CETT), were compared to 16 non-PTSD…

38 CFR 1.18 - Guidelines for establishing presumptions of service connection for former prisoners of war.

Code of Federal Regulations, 2010 CFR

2010-07-01

... experienced by prisoners of war (such as malnutrition, torture, physical abuse, or psychological stress); (3... circumstances of the study population. (g) Contracts for Scientific Review and Analysis. To assist in making determinations under this section, the Secretary may contract with an appropriate expert body to review and...

Rights of the Child in Nepal.

ERIC Educational Resources Information Center

Schonveld, Ben

This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the U.N. Convention on the Rights of the Child by the country of Nepal. The report's introductory summary asserts that although the Nepal government's passage of the Act to…

Photographic documentation, a practical guide for non professional forensic photography.

PubMed

Ozkalipci, Onder; Volpellier, Muriel

2010-01-01

Forensic photography is essential for documentation of evidence of torture. Consent of the alleged victim should be sought in all cases. The article gives information about when and how to take pictures of what as well as image authentication, audit trail, storage, faulty pictures and the kind of camera to use.

Rights of the Child in the Democratic Republic of the Congo.

ERIC Educational Resources Information Center

Cosandey, Olivier

This report to the United Nations Convention on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the Convention by Democratic Republic of the Congo (DRC). The report's introductory summary asserts that although the DRC has ratified the Convention and other international…

Does Narrative Exposure Therapy Reduce PTSD in Survivors of Mass Violence?

ERIC Educational Resources Information Center

McPherson, Jane

2012-01-01

Purpose: This review examines the effectiveness of narrative exposure therapy (NET) , a short-term intervention for posttraumatic stress disorder (PTSD) in survivors of mass violence and torture, who have often suffered multiple traumas over several years. Methods: Randomized control trials were reviewed if they measured PTSD outcome and were…

Rights of the Child in Burundi.

ERIC Educational Resources Information Center

Feller, Markus

This report to the United Nations (U.N.) Committee on the Rights of the Child contains observations of the World Organisation against Torture (OMCT) concerning the application of the Convention on the Rights of the Child by Burundi. The report is presented in seven parts. Part 1 outlines preliminary observations regarding Burundi's ratification of…

[A false historic representation of the martyrdom of St. Apollonia: decapitation].

PubMed

de Paiva Boléo, J

1976-02-01

The author quotes the only known historical witness on the life and death of Santa Apollonia: the description given by the historian Eusebius. According to his description of the martyrdom of the Saint, her teeth were extracted and her jawbones broken. An extensive iconography exists in museums, churches and private collections. According to statues and images of the Saint, the martyrdom took place by stoning or else by the use of instruments of torture such as pincers, gouge and gammer, and dentists' forceps. Although it is most probable that recourse was taken to lapidation, it is also likely that the above instruments were used, because it agrees with the technic then in use in dental surgery and does not disagree in any way with the historical facts. Such is not the case regarding the beheading. However, the author quotes three groups of iconographic documents displaying that kind of torture. One of them, shown for the first time, appears in a Book of hours of French origin, dating from the 15th century, which exists in the Calouste Gulbenkian Museum, in Lisbon, Portugal.

The social organization of violence toward hostages: does violence in captivity indicate which kidnappers will kill?

PubMed

Phillips, Everard M

2013-04-01

It is questionable whether violence toward a hostage varies according to criminal or radical orientation of their kidnappers who hold them for ransom. This notion is important because it relates to the assumption that how the hostage is treated may indicate whether the victim may survive the ordeal. To investigate, 181 kidnappings cases were cross-tabulated with four previously identified violent tactics (inflicting pain, terror, psychological torture, and reward tactics) and three distinctive type of kidnappers (common criminal, organized criminal, and radical/terrorist groups). The results indicated that criminal groups tended to use a range of violent tactics to coerce a hostage in captivity, while radical groups more often specialized in psychological torture. Regardless of these observations, specific forms of violence, for example inflicting pain, provided a better indication of whether the hostage would be killed by his or her kidnappers. This suggests that the intensity of violence and not the type of group conducting the kidnapping indicates whether the hostage will be killed. The implications to the social organization of kidnapping groups are discussed further.

Intercultural encounters in counselling and psychotherapy--communication with the help of interpreters.

PubMed

Wenk-Ansohn, Mechthild; Gurris, Norbert

2011-01-01

Treatment and rehabilitation of torture victims and persons traumatized by war or persecution can require working in an intercultural setting, as is the case when working with refugees and migrants. The following article offers practical advice for diagnostics, counselling and treatment of patients from other cultures who are not speaking the language of the therapist.

Boletin del Consejo Hispano de Alfabetizacion (Bulletin of the Hispanic Literacy Council).

ERIC Educational Resources Information Center

Boletin del Consejo Hispano de Alfabetizacion, 1990

1990-01-01

The three issues of this newsletter published during 1990 contain the following articles: "You Can't Run before You Learn To Walk" (Jose Manuel Ventura); "The Truth about Police Torture" (J. Maya R.); "A Student's Testimony"; "Voices from the Community" (Gabriel Ramirez and Others); "Books and Authors" (Jose Hunter); "You and Your Health" (Arnaldo…

A Horrible Experiment.

PubMed

Weiss, Michael H

2015-07-01

A patient presented to my office who had been tortured in the course of a wartime medical experiment many years ago. Seeing him prompted me to explore my personal reaction to his case and to reflect on the history of the ethics of medical experimentation in the 20th century. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Mental Self-Exploration in Samuel Beckett's "Molloy": A Jungian Approach

ERIC Educational Resources Information Center

Jamalinesari, Ali; Feilinezhad, Nabieh

2015-01-01

Samuel Beckett is categorized as an absurdist dramatist. Martin Esslin in his book "The Theatre of Absurd," states that absurdist writers dealt with the theme of man's sense of anguish and torture caused by living without any purpose. All characters of Beckett's dramas are deformed just like Molloy who deteriorates as the novel comes to…

Post-Traumatic Stress Disorder and the Military: A Selected Bibliography

DTIC Science & Technology

2005-11-11

Post - Traumatic Stress Disorder ( PTSD ) and its presentation in military personnel. This bibliography...Richard. "Psychopathology of Post - Traumatic Stress Disorder ( PTSD ): Boundaries of the Syndrome." In Torture and Its Consequences: Current Treatment...Wright. "Understanding and Treating Post - Traumatic Stress Disorder Symptoms in Female Partners of Veterans with PTSD ." Journal of Marital and

Losing American Students, Mexican Universities Struggle against a Scary Image

ERIC Educational Resources Information Center

Ambrus, Steven

2012-01-01

Like most Mexicans, Eugenio Yarce has been deeply affected by the violence between drug cartels and the Mexican army, which has filled news coverage with accounts of kidnappings, assassinations, and torture. But for Mr. Yarce, deputy rector for outreach here at the private Autonomous Popular University of the State of Puebla, or Upaep, the…

Children in War: A Guide to the Provision of Services. A Study for UNICEF.

ERIC Educational Resources Information Center

Ressler, Everett M.; And Others

The sad reality of children killed, tortured, imprisoned, and orphaned by war substantiates the need for renewed local, national, and international commitment to these children. This guide examines: (1) the impacts present-day armed conflicts have on children and their families; (2) what special needs of children should be anticipated and…

Rights of the Child in South Africa: Violence against Girls in South Africa.

ERIC Educational Resources Information Center

Benninger-Budel, Carin

This report to the United Nations Committee on the Rights of the Child contains observations of the World Organisation Against Torture (OMCT) concerning the application of the U.N. Convention on the Rights of the Child by the nation of South Africa. Noting that the Convention is the only "mainstream" human rights instrument that…

From Archi Torture to Architecture: Undergraduate Students Design and Implement Computers Using the Multimedia Logic Emulator

ERIC Educational Resources Information Center

Stanley, Timothy D.; Wong, Lap Kei; Prigmore, Daniel; Benson, Justin; Fishler, Nathan; Fife, Leslie; Colton, Don

2007-01-01

Students learn better when they both hear and do. In computer architecture courses "doing" can be difficult in small schools without hardware laboratories hosted by computer engineering, electrical engineering, or similar departments. Software solutions exist. Our success with George Mills' Multimedia Logic (MML) is the focus of this paper. MML…

8 CFR 208.31 - Reasonable fear of persecution or torture determinations involving aliens ordered removed under...

Code of Federal Regulations, 2010 CFR

2010-01-01

... HOMELAND SECURITY IMMIGRATION REGULATIONS PROCEDURES FOR ASYLUM AND WITHHOLDING OF REMOVAL Credible Fear of... officer shall review the summary with the alien and provide the alien with an opportunity to correct... determinations under this section shall have the authority described in § 208.9(c). (e) Referral to Immigration...

8 CFR 208.14 - Approval, denial, referral, or dismissal of application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... is found to have a credible fear of persecution or torture based on information elicited from the... proceedings under section 240 of the Act, without conducting a separate credible fear interview pursuant to § 208.30. If such applicant is not found to have a credible fear based on information elicited at the...

8 CFR 1208.14 - Approval, denial, referral, or dismissal of application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... applicant is found to have a credible fear of persecution or torture based on information elicited from the... proceedings under section 240 of the Act, without conducting a separate credible fear interview pursuant to § 1208.30. If such applicant is not found to have a credible fear based on information elicited at the...

Renditions: Constraints Imposed by Laws on Torture

DTIC Science & Technology

2009-01-22

AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY ...suspended after the Italian government said testimony could reveal state secrets threatening Italy’s national security . “CIA-Linked Kidnapping Trial...raised against U.S. officials implicated national security and foreign policy considerations, and assessing the propriety of those considerations was

Is Education a Lost Cause? Zizek, Schooling, and Universal Emancipation

ERIC Educational Resources Information Center

Cooley, Aaron

2009-01-01

This paper discusses the work of Slavoj Zizek and links several of his ideas to educational contexts. After giving a brief background on his unique intellectual perspective, I pull three themes (control, torture, and politics) from his body of work, and I consider their educational connections and implications. I conclude by speculating on the…

Pedagogy, Torture, and Exhibition: A Curricular Palimpsest

ERIC Educational Resources Information Center

Goulding, Cathlin; Walter, Mia; Friedrich, Daniel

2013-01-01

In this article the authors focus on three sites in different areas of the world that share the characteristic of having been schools, prisons, concentration camps, and, in two cases, museums, sometimes in that order and on all occasions with periods of overlapping functions. The main goal of the authors will be to explore the questions that…

"The Brain within Its Groove": Language and Struggling Students

ERIC Educational Resources Information Center

De Mers, Kathleen D.

2010-01-01

Words are the foundation of literacy. Words can express, in part, the joys, loves, triumphs, and sorrows of life. One person's thoughts, expressed through words, can powerfully influence and inspire audiences or readers and long outlive their author. But not everyone is enamored of words. For some students, words are a kind of torture. For them…

Video Games and the First Amendment: "Brown v. Entertainment Merchants Association"

ERIC Educational Resources Information Center

Schwinn, Steven D.

2011-01-01

Video games today give players an unprecedented opportunity to become part of the game. They literally put players in the game. And with rapid technological improvements and endless creativity, games are only becoming more realistic. They are also becoming more violent. Today's games allow players to kill, maim, dismember, and torture victims by…

Psychological, social and welfare interventions for psychological health and well-being of torture survivors.

PubMed

Patel, Nimisha; Kellezi, Blerina; Williams, Amanda C de C

2014-11-11

Torture is widespread, with potentially broad and long-lasting impact across physical, psychological, social and other areas of life. Its complex and diverse effects interact with ethnicity, gender, and refugee experience. Health and welfare agencies offer varied rehabilitation services, from conventional mental health treatment to eclectic or needs-based interventions. This review is needed because relatively little outcome research has been done in this field, and no previous systematic review has been conducted. Resources are scarce, and the challenges of providing services can be considerable. To assess beneficial and adverse effects of psychological, social and welfare interventions for torture survivors, and to compare these effects with those reported by active and inactive controls. Randomised controlled trials (RCTs) were identified through a search of PsycINFO, MEDLINE, EMBASE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Depression, Anxiety and Neurosis Specialised Register (CCDANCTR), the Latin American and Caribbean Health Science Information Database (LILACS), the Open System for Information on Grey Literature in Europe (OpenSIGLE), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and Published International Literature On Traumatic Stress (PILOTS) all years to 11 April 2013; searches of Cochrane resources, international trial registries and the main biomedical databases were updated on 20 June 2014. We also searched the Online Library of Dignity (Danish Institute against Torture), reference lists of reviews and included studies and the most frequently cited journals, up to April 2013 but not repeated for 2014. Investigators were contacted to provide updates or details as necessary. Full publications of RCTs or quasi-RCTs of psychological, social or welfare interventions for survivors of torture against any active or inactive comparison condition. We included all major sources of grey literature in our search and used standard methodological procedures as expected by The Cochrane Collaboration for collecting data, evaluating risk of bias and using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods to assess the quality of evidence. Nine RCTs were included in this review. All were of psychological interventions; none provided social or welfare interventions. The nine trials provided data for 507 adults; none involved children or adolescents. Eight of the nine studies described individual treatment, and one discussed group treatment. Six trials were conducted in Europe, and three in different African countries. Most people were refugees in their thirties and forties; most met the criteria for post-traumatic stress disorder (PTSD) at the outset. Four trials used narrative exposure therapy (NET), one cognitive-behavioural therapy (CBT) and the other four used mixed methods for trauma symptoms, one of which included reconciliation methods. Five interventions were compared with active controls, such as psychoeducation; four used treatment as usual or waiting list/no treatment; we analysed all control conditions together. Duration of therapy varied from one hour to longer than 20 hours with a median of around 12 to 15 hours. All trials reported effects on distress and on PTSD, and two reported on quality of life. Five studies followed up participants for at least six months.No immediate benefits of psychological therapy were noted in comparison with controls in terms of our primary outcome of distress (usually depression), nor for PTSD symptoms, PTSD caseness, or quality of life. At six-month follow-up, three NET and one CBT study (86 participants) showed moderate effect sizes for intervention over control in reduction of distress (standardised mean difference (SMD) -0.63, 95% confidence interval (CI) -1.07 to -0.19) and of PTSD symptoms (SMD -0.52, 95% CI -0.97 to -0.07). However, the quality of evidence was very low, and risk of bias resulted from researcher/therapist allegiance to treatment methods, effects of uncertain asylum status of some people and real-time non-standardised translation of assessment measures. No measures of adverse events were described, nor of participation, social functioning, quantity of social or family relationships, proxy measures by third parties or satisfaction with treatment. Too few studies were identified for review authors to attempt sensitivity analyses. Very low-quality evidence suggests no differences between psychological therapies and controls in terms of immediate effects on post-traumatic symptoms, distress or quality of life; however, NET and CBT were found to confer moderate benefits in reducing distress and PTSD symptoms over the medium term (six months after treatment). Evidence was of very low quality, mainly because non-standardised assessment methods using interpreters were applied, and sample sizes were very small. Most eligible trials also revealed medium to high risk of bias. Further, attention to the cultural appropriateness of interventions or to their psychometric qualities was inadequate, and assessment measures used were unsuitable. As such, these findings should be interpreted with caution.No data were available on whether symptom reduction enabled improvements in quality of life, participation in community life, or in social and family relationships in the medium term. Details of adverse events and treatment satisfaction were not available immediately after treatment nor in the medium term. Future research should aim to address these gaps in the evidence and should include larger sample sizes when possible. Problems of torture survivors need to be defined far more broadly than by PTSD symptoms, and recognition given to the contextual influences of being a torture survivor, including as an asylum seeker or refugee, on psychological and social health.

Torture Victims Relief Reauthorization Act of 2014

THOMAS, 113th Congress

Rep. Smith, Christopher H. [R-NJ-4

2014-06-26

House - 06/26/2014 Referred to the Committee on Foreign Affairs, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Relations Between the U.S. and Iran

DTIC Science & Technology

2013-03-01

British and Russians were taken over by the United State as the dominant superpower in Iran, becoming the leading foreign power both economically and...domestic security and intelligent service, began repressive operations including murdering, jailing and torturing, quickly becoming a nightmare for the...Samuel Huntington,48 and influenced the U.S. decision makers, becoming an important part of geopolitical discussions in international relations and

Telling Tales of Torture: Repositioning Young Adults' Views of Asylum Seekers

ERIC Educational Resources Information Center

Watts, Michael F.

2004-01-01

This paper explores the changing attitudes of a group of young adults towards asylum seekers in the UK. Based on the experience of sixth form students attending a workshop hosted by a former refugee from Pinochet's Chile, it argues for the importance of personal stories and their wider contexts and suggests that each is necessary to enable…

A Test That Isn't Torture: A Field-Tested Performance-Based Assessment

ERIC Educational Resources Information Center

Eastburn, Mark

2006-01-01

This article discusses the author's use of a performance-based evaluation in his fifth grade Spanish class in a K-5 public elementary school located in Princeton, New Jersey. The author realized the need to break the old testing paradigm and discover a new way of demonstrating student language acquisition since the traditional tests did not seem…

Harry Potter and the Ghost Teacher: Resurrecting the Lost Art of Lecturing

ERIC Educational Resources Information Center

McDaniel, Kathryn N.

2010-01-01

A significant image of classroom lectures is the one presented in J. K. Rowling's "Harry Potter" series. At Harry's Hogwarts School of Witchcraft and Wizardry, the most torturous class is easily History of Magic, which is, incidentally, the only class in the school taught by a ghost. Being taught by a ghost could be quite exciting: not so in…

American Anti-Torture Act of 2014

THOMAS, 113th Congress

Rep. Nadler, Jerrold [D-NY-10

2014-12-09

House - 12/09/2014 Referred to the Committee on Armed Services, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Do South African former detainees experience post-traumatic stress? Circumventing the demand characteristics of psychological assessment.

PubMed

Kagee, Ashraf

2004-09-01

Most research on persons subjected to physical or psychological torture for political reasons has framed this experience as traumatic, with the sequelae approximating the diagnostic criteria of post-traumatic stress disorder (PTSD). Yet, critiques of the trauma model have called attention to the fact that PTSD represents a Western conceptualization of the concerns of persons who have survived stressful experiences. In order to determine whether symptoms of traumatization are salient psychiatric phenomena for South African former detainees, semi-structured qualitative interviews were conducted with 20 respondents who were detained and tortured for political reasons during the apartheid era. Interviews were transcribed and analysed for thematic content using a grounded theory approach. Results showed that although the main concerns expressed were unrelated to traumatization, participants also indicated that they experienced symptoms of post-traumatic stress. These data suggest that although too great a focus on traumatic responses may be misplaced, it remains important to consider the possibility that former detainees may exhibit symptoms of this nature. Consequently, critiques of the trauma discourse as a Western phenomenon need to be tempered with evidence of the lived reality of psychological sequelae experienced by this population.

Development and Preliminary Validation of Refugee Trauma History Checklist (RTHC)—A Brief Checklist for Survey Studies

PubMed Central

Gottvall, Maria; Vaez, Marjan

2017-01-01

A high proportion of refugees have been subjected to potentially traumatic experiences (PTEs), including torture. PTEs, and torture in particular, are powerful predictors of mental ill health. This paper reports the development and preliminary validation of a brief refugee trauma checklist applicable for survey studies. Methods: A pool of 232 items was generated based on pre-existing instruments. Conceptualization, item selection and item refinement was conducted based on existing literature and in collaboration with experts. Ten cognitive interviews using a Think Aloud Protocol (TAP) were performed in a clinical setting, and field testing of the proposed checklist was performed in a total sample of n = 137 asylum seekers from Syria. Results: The proposed refugee trauma history checklist (RTHC) consists of 2 × 8 items, concerning PTEs that occurred before and during the respondents’ flight, respectively. Results show low item non-response and adequate psychometric properties Conclusions: RTHC is a usable tool for providing self-report data on refugee trauma history surveys of community samples. The core set of included events can be augmented and slight modifications can be applied to RTHC for use also in other refugee populations and settings. PMID:28976937

"And so They Ordered Me to Kill a Person": Conceptualizing the Impacts of Child Soldiering on the Development of Moral Agency

ERIC Educational Resources Information Center

Wainryb, Cecilia

2011-01-01

Approximately 300,000 child soldiers serve in various armed groups around the world, and become directly implicated in the perpetration of kidnappings, killings, and torture. Considering that children construct moral concepts and a sense of themselves as moral beings in the context of their everyday interactions with others, the concern with how…

Bahrain: Reform, Security, and U.S. Policy

DTIC Science & Technology

2016-08-29

field in Saudi Arabia that the Saudi government has set aside for Bahrain’s use. In 2004, the United States and Bahrain signed a free trade agreement...or minimally implemented those recommendations that address prevention of torture, provision of legal counsel, allowing free access to media, holding...terrorism financing and money laundering. In 2013, the government amended the Charity Fundraising Law of 1956 to tighten terrorism financing monitoring

Population Isolation in the Philippine War: A Case Study

DTIC Science & Technology

2015-05-21

concentration camps appear as unnecessary and extremely harsh punishment. In one example of many, extreme charges of hostage taking, rape, and... torture from the Filipinos in Candelaria warranted an Army investigation.13 Secondary sources address environmental effects of population isolation...themselves targeted and potentially killed by the native forces.32 Public displays of these murders and assassinations meant to convince the population to

Egypt: Background and U.S. Relations

DTIC Science & Technology

2016-02-25

terrorism-related crimes , 14 shields the police from penalties for “proportionate use of force,” and fines journalists for contradicting the government’s...problems were excessive use of force by security forces, including unlawful killings and torture ; the suppression of civil liberties, including...for journalists with at least (as of December 2015) 20 currently detained.” 20 Alleged Murder of Italian Student in Egypt In February 2016, the

Subtle Tortures of the Neo-liberal Age: Teachers, Students, and the Political Economy of Schooling in Chile

ERIC Educational Resources Information Center

Pastrana, Jill Pinkney

2007-01-01

In the late 1970s following a military coup, Chile, with its population brutally suppressed, became the first testing ground for the changes that now define neo-liberal recommendations by international funding agencies such as the IMF and World Bank. The changes were dramatic and extensive. The population could not negotiate the terms of change.…

Torture: A Feasible means for National Security Strategy

DTIC Science & Technology

2007-06-15

with sensory deprivation, stress, and hypnosis . Results as presented during testimony to Congress were unproductive and inconclusive (Miles 2006, 14...impaired concentration, impaired memory , difficulties in establishing trust and intimate relationships, increased risk of suicide, and fear of the medical...cite the fact that the prohibition on oppressing others is based on Jewish historical memories best summed up in the quote from ibn Ezra on Exodus 22

Southern Honor and Northern Piety: Henry Tutwiler, Alva Woods, and the Problem of Discipline at the University of Alabama, 1831-1837

ERIC Educational Resources Information Center

Windham, Kevin Lee

2010-01-01

The University of Alabama opened its doors in April 1831, and over the next six years, the first president, Alva Woods, was confronted by numerous episodes of student misdeeds. Knife fights, dueling, shootings, slave baiting, hazing, the torture of animals, and the destruction of property were common events on campus. Woods--a Baptist minister…

"Where Is the Love?": The Ethics of Empathy in Abu Ghraib

ERIC Educational Resources Information Center

Sturgeon, Elizabeth M.

2007-01-01

Abu Ghraib. The name conjures horrifying images of abuse, torture, and man's inhumanity to man. In one photograph, a pyramid of naked detainees huddles outside a jail cell; in another, a soldier holds the end of a dog leash which is attached at the neck to a prostrate prisoner; in another, a soldier gives the thumbs-up sign in front of a line of…

Rebuilding the City on the Hill

DTIC Science & Technology

2012-03-22

authorized “enhanced interrogation” techniques widely perceived as torture by many Americans. Following an abuse scandal at the Abu Ghraib prison in Iraq...1. REPORT DATE (DD-MM-YYYY) 22-03-2012 2. REPORT TYPE Strategy Research Project 3. DATES COVERED (From - To) OCT 2011 – FEB 2012 4. TITLE AND...code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std. Z39.18 USAWC STRATEGY RESEARCH PROJECT REBUILDING THE CITY ON

Operations Brigade S3 Replaced by Operations Battalion

DTIC Science & Technology

2012-12-06

Prisoner abuse exposed at Abu Ghraib prison in Iraq between October and December 2003 highlighted the need for modifications in detainee protocols and... Abu Ghraib Torture and Prisoner Abuse,” www.martinfrost.ws/htmlfiles/ abughraib2.html (accessed 19 June 2012). 2 Many Arabs and Muslims associated...operations in an effort to further the standardization process initially set in motion after the Abu Ghraib investigations. 7 LTG Miller’s directives

Central Asia: Regional Developments and Implications for U.S. Interests

DTIC Science & Technology

2010-08-10

to Romania for resettlement processing, after the United States and others raised concerns that they might be tortured if returned to Uzbekistan.26...missionaries, and pious Muslims face religious rights abuses, and unfair elections increase political alienation and violence aimed against the regimes...55 In November 2006, the State Department designated Uzbekistan a “country of particular concern” (CPC) for severe religious and other human rights

JPRS Report, East Europe

DTIC Science & Technology

1991-04-04

be called anything else but Against Violence ] which joined the same program, "A an attempt at revolt, as an attempt to gain decisive Chance for...toward a return to the fold. The materials: the resolution excluding Zbigniew Mitzner year 1990 was the year of violence systematically from the PZPR...communist Securitate abandon mittee on Human Rights was to hold its annual meeting their methods of violence and torture? that summer. But he was arrested

JPRS Report, Soviet Union, Political Affairs.

DTIC Science & Technology

1989-05-23

implement ods of work. political reform is the reorganization of the apparatus of party committees. What are the characteristics of this [Gruzinform] What...most characteristically expressed in the speech by the nost, and punishment of all the guilty parties, no matter writer, Yuri Karyakin: "The forces...and otherwise when impressionism came into being? And tortured, and to their near ones and dear ones. didn’t the public get upset when romanticism

The Longitudinal Studies of Prisoners of War and Their Families. The Prisoner of War and His Family. The Captivity Experience of American Prisoners of War in Southeast Asia. Positive and Negative Residuals of Prolonged Stress

DTIC Science & Technology

1977-08-08

of a career mili- tary officer. The enemy countered this resolve with a concerted campaign of torture, terror and deprivation of food, medical...The Wing identified the prescribed forms of comunications and defined the release posture. Another product of this POW organization was the

Executions and scientific anatomy.

PubMed

Dolezal, Antonín; Jelen, Karel; Stajnrtova, Olga

2015-12-01

The very word "anatomy" tells us about this branch's connection with dissection. Studies of anatomy have taken place for approximately 2.300 years already. Anatomy's birthplace lies in Greece and Egypt. Knowledge in this specific field of science was necessary during surgical procedures in ophthalmology and obstetrics. Embalming took place without public disapproval just like autopsies and manipulation with relics. Thus, anatomical dissection became part of later forensic sciences. Anatomical studies on humans themselves, which needed to be compared with the knowledge gained through studying procedures performed on animals, elicited public disapprobation and prohibition. When faced with a shortage of cadavers, anatomists resorted to obtaining bodies of the executed and suicide victims - since torture, public display of the mutilated body, (including anatomical autopsy), were perceived as an intensification of the death penalty. Decapitation and hanging were the main execution methods meted out for death sentences. Anatomists preferred intact bodies for dissection; hence, convicts could thus avoid torture. This paper lists examples of how this process was resolved. It concerns the manners of killing, vivisection on people in the antiquity and middle-ages, experiments before the execution and after, vivifying from seeming death, experiments with galvanizing electricity on fresh cadavers, evaluating of sensibility after guillotine execution, and making perfect anatomical preparations and publications during Nazism from fresh bodies of the executed.

Psychological Perspectives on Interrogation.

PubMed

Vrij, Aldert; Meissner, Christian A; Fisher, Ronald P; Kassin, Saul M; Morgan, Charles A; Kleinman, Steven M

2017-11-01

Proponents of "enhanced interrogation techniques" in the United States have claimed that such methods are necessary for obtaining information from uncooperative terrorism subjects. In the present article, we offer an informed, academic perspective on such claims. Psychological theory and research shows that harsh interrogation methods are ineffective. First, they are likely to increase resistance by the subject rather than facilitate cooperation. Second, the threatening and adversarial nature of harsh interrogation is often inimical to the goal of facilitating the retrieval of information from memory and therefore reduces the likelihood that a subject will provide reports that are extensive, detailed, and accurate. Third, harsh interrogation methods make lie detection difficult. Analyzing speech content and eliciting verifiable details are the most reliable cues to assessing credibility; however, to elicit such cues subjects must be encouraged to provide extensive narratives, something that does not occur in harsh interrogations. Evidence is accumulating for the effectiveness of rapport-based information-gathering approaches as an alternative to harsh interrogations. Such approaches promote cooperation, enhance recall of relevant and reliable information, and facilitate assessments of credibility. Given the available evidence that torture is ineffective, why might some laypersons, policymakers, and interrogation personnel support the use of torture? We conclude our review by offering a psychological perspective on this important question.

Doctors and torture: the police surgeon.

PubMed

Burges, S H

1980-09-01

Much has been written by many distinguished persons about the philosophical, religious and ethical considerations of doctors and their involvement with torture. What follows will not have the erudition or authority of the likes of St Augustine, Mahatma Gandi, Schopenhauer or Thomas Paine. It represents the views of a very ordinary person; a presumption defended by the submission that many very ordinary persons have been, and will be, instruments for effecting, assisting or condoning the physical or mental anguish of others. As practitioners of medicine, we are particularly vulnerable, since our particular knowledge and our privileged position may be so easily abused--to the detriment of others. Those of us who practice clinical forensic medicine have even greater responsibility by virtue of our daily contact with the enforcement of law, criminal procedure, and the machinations of the judiciary. We are thus particularly well placed to monitor, encourage or discourage the occurrence of evil practices within the community. It is imperative, therefore, that the ordinary doctor should be cognisant of, and be party to, a code of conduct formulated by his peers and having reference to his obligations as a citizen, and doctor, and to his ability to manipulate human activity. Forensic physicians have further discretionary powers as arbiters in the marriage of the art and ethics of healing with the principles and practice of justice.

Economic Peace Through the Israeli Lens

DTIC Science & Technology

2014-03-01

37 Before the resurgence of Modern Hebrew between 1890 and 1914, widely attributed to Eliezer Ben-Yehuda, the nation of Israel shared neither a...other things,” The Guardian, July 6, 2012. 38 Mosche Nahir, “Micro Language Planning and the Revival of Hebrew : A Schematic Framework” in...solution to the long, torturous, and cruel history of Jewish persecution. The term “Zionism,” from the Hebrew Tziyon or “Jerusalem,” emerged in the

Medical and psychological examination of women seeking asylum: documentation of human rights abuses.

PubMed

Laws, A; Patsalides, B

1997-01-01

Human rights abuses of women are ubiquitous throughout the world. Those perpetrated by governments entitle women to seek political asylum, and many women refugees do so in the United States. The asylum process often requires medical or psychological evaluations to corroborate women's reports of torture or other abuses. This article provides an overview of how to conduct such examinations and how to document findings for the asylum process.

Trafficking in Persons: U.S. Policy and Issues for Congress

DTIC Science & Technology

2009-07-02

rape; torture; trafficking; incest; domestic violence; sexual assault; abusive sexual contact; prostitution; sexual exploitation; female genital ...that approximately 600,000 to 800,000 people are trafficked across borders each year—80% of whom are female and up to 50% of whom are minors.7 If... Female traffickers reportedly play a more prominent role in TIP than in other international crimes with available data.21 Their role in TIP may vary

Moving the mental health equity dialogue forward: the promise of a social entrepreneur framework.

PubMed

Kidd, Sean A; McKenzie, Kwame J

2013-03-01

In this commentary the authors highlight the difficulties developed countries have had in generating effective means of addressing inequities in mental health. Limitations in research, policy, and service responses are discussed and the social entrepreneurship framework is suggested as a means of better understanding how mental health disparities might be addressed. The example of the Canadian Centre for Victims of Torture is provided to illustrate the points made.

POW/MIA Issues. Volume 1. The Korean War

DTIC Science & Technology

1994-01-01

individuals. Forensic analyses suggest that these remains are not American, thus this re- port makes no references to alleged "repatriations." There is...The U.S. gov- ernment funded ground-breaking basic research in forensic sciences in an effort to identify remains with a high degree of certainty. In...application of sound psychological and educational techniques. This confirms that drugs and hypnosis were not used and physical torture was not employed in any

Lack of cortisol response in patients with posttraumatic stress disorder (PTSD) undergoing a diagnostic interview

PubMed Central

Kolassa, Iris-Tatjana; Eckart, Cindy; Ruf, Martina; Neuner, Frank; de Quervain, Dominique JF; Elbert, Thomas

2007-01-01

Background According to DSM-IV, the diagnosis of posttraumatic stress disorder (PTSD) requires the experience of a traumatic event during which the person's response involved intense fear, helplessness, or horror. In order to diagnose PTSD, clinicians must interview the person in depth about his/her previous experiences and determine whether the individual has been traumatized by a specific event or events. However, asking questions about traumatic experiences can be stressful for the traumatized individual and it has been cautioned that subsequent "re-traumatization" could occur. This study investigated the cortisol response in traumatized refugees with PTSD during a detailed and standardized interview about their personal war and torture experiences. Methods Participants were male refugees with severe PTSD who solicited an expert opinion in the Psychological Research Clinic for Refugees of the University of Konstanz. 17 patients were administered the Vivo Checklist of War, Detention, and Torture Events, a standardized interview about traumatic experiences, and 16 subjects were interviewed about absorption behavior. Self-reported measures of affect and arousal, as well as saliva cortisol were collected at four points. Before and after the experimental intervention, subjects performed a Delayed Matching-to-Sample (DMS) task for distraction. They also rated the severity of selected PTSD symptoms, as well as the level of intrusiveness of traumatic memories at that time. Results Cortisol excretion diminished in the course of the interview and showed the same pattern for both groups. No specific response was detectable after the supposed stressor. Correspondingly, ratings of subjective well-being, memories of the most traumatic event(s) and PTSD symptoms did not show any significant difference between groups. Those in the presumed stress condition did not perform worse than persons in the control condition after the stressor. However, both groups performed poorly in the DMS task, which is consistent with memory and concentration problems demonstrated in patients with PTSD. Conclusion A comprehensive diagnostic interview including questions about traumatic events does not trigger an HPA-axis based alarm response or changes in psychological measures, even for persons with severe PTSD, such as survivors of torture. Thus, addressing traumatic experiences within a safe and empathic environment appears to impose no unacceptable additional load to the patient. PMID:17916253

Post-Traumatic Stress Disorder and the Casual Link to Crime: A Looming National Tragedy

DTIC Science & Technology

2008-04-01

Edited by Mardi J. Horowitz. New York and London: New York University Press. 1999, 19. Sigmund Freud . Introduction to Psycho-Analysis and the...placed. Horowitz, Freud , and Smith all discuss the draconian measures used by nearly all parties to the conflict in returning cowards and malingerers...stop the torturous process- -even return to the fighting.40 Binneveld and Freud both note that this type of “punishment” oriented treatment fell into

Terrorism: A Selected Bibliography

DTIC Science & Technology

2009-12-01

and the Courts. New York: Oxford University Press, 2007. 319pp. (KF5060 .P67 2007) Ramsay , Maureen. "Can the Torture of Terrorist Suspects Be...Perceptions of the United States since 9/11. Princeton: Princeton University Press, 2007. 187pp. (E169.1 .W31 2007) Forest, James J. F . The Making of a...Anne Marie, and Paul F . Steinberg. The Road to Martyrs’ Square: A Journey into the World of the Suicide Bomber. New York: Oxford University Press

Lawfare: A Current Threat or Much Ado About Nothing?

DTIC Science & Technology

2013-04-01

Citizens in the War on Terrorism , 66 Fed. Reg. 57831, reprinted in Karen J. Greenberg and Joshua L. Dratel, eds., The Torture Papers: The Road to Abu Ghraib ...The Road to Abu Ghraib (New York: Cambridge University Press, 2005), 29. 30 Id., 37. 19 31 Goldsmith, The Terror Presidency, 120-126. 32...from other events such as Abu Ghraib or other confirmed stories71 of the use of “advanced interrogation techniques”, and not emanating from the

Understanding Cultural Landmines in the Balkans: How the Land and Its History Have Kept a People at War

DTIC Science & Technology

2001-10-01

property , forcible eviction of entire villages, widespread rape and torture, and massacres of innocent women, children, and the elderly BALKANS-1 6...and Italy also have unresolved issues dating from World War II over property and ethnic minority rights. Serbia and Montenegro also dispute Croatia’s...positions (Jayne, 1910). Dating from the Ottoman occupation, Moslem nobles and landlords held all land other than gardens and residential properties

Treatment of Battlefield Detainees in the War on Terrorism

DTIC Science & Technology

2005-01-13

available at [http://hrw.org/press/2002/01/us012802-ltr.htm]. 19 See Civil and Political Rights, Including the Question of Torture and Detention, Report of...war expert Hayes Parks, who advocates a purely de facto standard, without regard to political factors). 64 See INTERNATIONAL COMMITTEE OF THE RED...Prosecutor v. Kassem , 47 I.L.R. 470 (1971) (excerpts reprinted in DOCUMENTS ON PRISONERS OF WAR, document no. 160 (U.S. Naval War College 1979

Treatment of ’Battlefield Detainees’ in the War on Terrorism

DTIC Science & Technology

2007-01-23

Political Rights, Including the Question of Torture and Detention, Report of the Working Group on Arbitrary Detention, U.N. Commission on Human Rights...June 1999 (citing interview with DOD law of war expert Hayes Parks, who advocates a purely de facto standard, without regard to political factors). 72...Military Prosecutor v. Kassem , 47 I.L.R. 470 (1971) (excerpts reprinted in DOCUMENTS (continued...) GPW Art. 4A(1): Does Al Qaeda Form “Part of” the

The psychological effects of political repression on Chilean exiles in the U.S.

PubMed

Gonsalves, C J

1990-01-01

Interviews with 32 Chilean refugees elicited descriptive findings on the effects of detention and torture and subsequent exile in the U.S. It is suggested that exile for this group constitutes a continuation rather than a cessation of their suffering. Marital problems, economic hardship, and loneliness are recounted by the adults, while teachers and parents report adjustment and behavioral difficulties among the children. The influence of sociopolitical factors on these outcomes is discussed.

Any Time, Any Place, Any Gender The Risks and Rewards of Integrating Females into Special Operations Forces

DTIC Science & Technology

2015-06-02

operations advanced by Admiral McRaven. See McRaven, Spec Ops: Case Studies in Special Operations Warfare, Theory and Practice (Novato, CA: Presidio, 1996...which cheating, stealing, lying, torture, and even assassination were standard practices to obtain and safeguard information. Donovan quickly learned...Hired as a farm hand in Creuse, France, Hall cooked for the farmer, tended to his animals, and in the process was able to identify and establish

JPRS Report, Near East & South Asia

DTIC Science & Technology

1989-04-26

the sexes in the pri- mary, secondary, and higher schools have resulted in the proliferation of bastards. Depravity has spread, and we see that...citizen turns to a party or an official to obtain benefits from this Ummah, there is, in my opinion, no wise man who will contradict my claim that the...the result was bloodshed which benefited the East and the West at the expense of Islam. The members of this group were arrested and tortured. In

"Enhanced" interrogation of detainees: do psychologists and psychiatrists participate?

PubMed Central

Halpern, Abraham L; Halpern, John H; Doherty, Sean B

2008-01-01

After revelations of participation by psychiatrists and psychologists in interrogation of prisoners at Guantánamo Bay and Central Intelligence Agency secret detention centers, the American Psychiatric Association and the American Psychological Association adopted Position Statements absolutely prohibiting their members from participating in torture under any and all circumstances, and, to a limited degree, forbidding involvement in interrogations. Some interrogations utilize very aggressive techniques determined to be torture by many nations and organizations throughout the world. This paper explains why psychiatrists and psychologists involved in coercive interrogations violate the Geneva Conventions and the laws of the United States. Whether done with ignorance of professional ethical obligations or not, these psychiatrists and psychologists have crossed an ethical barrier that may best be averted from re-occurring by teaching medical students and residents in all medical specialties about the ethics principles stemming from the 1946–1947 Nuremberg trials and the Geneva Conventions, together with the Ethics Codes of the World Medical Association and the American Medical Association; and, with regard to psychiatric residents and psychological trainees, by the teaching about The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry and the Ethical Principles of Psychologists and Code of Conduct, respectively. In this way, all physicians and psychologists will clearly understand that they have an absolute moral obligation to "First, do no harm" to the human beings they professionally encounter. PMID:18817568

["Palimpsest scar" lesions in a context of torture (Darfur, Sudan)].

PubMed

Charlier, P; Bou Abdallah, F; Mostefai Dulac, Y; Deo, S; Jacqueline, S; Brun, L; Hervé, C

2017-11-01

As a result of the current exponentially growing refugee population from the Middle-East and East Africa (Sudan, Darfur, Eritrea), clinicians (including forensic pathologists) are seeing atypical skin lesions, mainly of a traumatic nature, but in some cases associated with long-standing lesions related to ethnic practices. A case of torture sequelae is presented herein in a patient originally from Darfur (Sudan): cutaneous incisions were made on old scars several times using a knife. The clinical presentation of scarification lesions and that of atypically healed wounds (presumably an effect of inflammation induced by the introduction of irritating foreign bodies such as sand, salt, etc.) are completely different: in all cases they indicate a relative timeframe of the facts, which the clinician should not overlook in reconstructing the patient's course and the injuries to which he has been subjected (hence the proposed designation of "palimpsest scar", in the sense that a palimpsest is a manuscript on a parchment that previously contained writing but has been scratched clean to be overwritten). Thus, a "palimpsest scar" constitutes a fresh scar on top of and hiding another (ritual) scar in a context of ethnic cleansing. The diagnostic and clinical significance comes from the importance of differentiating between ethnic-type lesions and those induced by physical violence and abuse in a context of war. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Psychiatric Sequelae of Former "Comfort Women," Survivors of the Japanese Military Sexual Slavery during World War II.

PubMed

Lee, Jeewon; Kwak, Young-Sook; Kim, Yoon-Jung; Kim, Eun-Ji; Park, E Jin; Shin, Yunmi; Lee, Bun-Hee; Lee, So Hee; Jung, Hee Yeon; Lee, Inseon; Hwang, Jung Im; Kim, Dongsik; Lee, Soyoung Irene

2018-04-01

"Comfort women" refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. "Comfort women" endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former "comfort women" currently alive in South Korea is introduced. The participants' unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former "comfort women" after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former "comfort women" throughout their lives, and even to the present day.

Satisfaction with daily occupations amongst asylum seekers in Denmark.

PubMed

Morville, Anne-Le; Erlandsson, Lena-Karin; Danneskiold-Samsøe, Bente; Amris, Kirstine; Eklund, Mona

2015-05-01

The aim of this study was to describe asylum seekers' satisfaction with daily occupations and activity level while in a Danish asylum centre, and whether this changed over time. Another aim was to describe whether exposure to torture, self-rated health measures, and ADL ability were related to their satisfaction with daily occupations and activity level. A total of 43 asylum seekers at baseline and 17 at follow-up were included. The questionnaires Satisfaction with Daily Occupations, Major Depression Inventory, WHO-5 Wellbeing, Pain Detect, a questionnaire covering torture, and basic social information were used as well as Assessment of Motor and Process Skills. The results showed a low level of satisfaction with daily occupations at both baseline and follow-up. There was no statistically significant change in satisfaction or activity level between baseline and the follow-up. Associations between AMPS process skills--education, worst pain and activity level--were present at baseline, as was a relationship between AMPS process skills and satisfaction. At follow-up, associations between WHO-5 and satisfaction and activity level and between MDI scores and activity level were found. Asylum seekers experience a low level of satisfaction with daily occupations, both at arrival and after 10 months in an asylum centre. There is a need for further research and development of occupation-focused rehabilitation methods for the asylum seeker population.

The development and evaluation of a trauma curriculum for psychiatry residents.

PubMed

Ferrell, Noor Jarun; Melton, Bengi; Banu, Sophia; Coverdale, John; Valdez, M Renee

2014-10-01

This study aims to briefly describe a curriculum on trauma in order to help other educators in their own planning and development of teaching on trauma. The 12-week course was offered to third-year psychiatry residents as part of their didactics scheduling. The classes included information on a wide variety of types of trauma including natural disasters, childhood trauma, refugee trauma, survivors of torture, intimate partner violence, and military sexual trauma. The course also offered techniques in therapy informed by transference and countertransference along with role-playing activities with the resident participants. Residents completed a pre- and postcourse survey in order to assess the attitudes, comfort, and knowledge in screening for trauma exposure. The proportion of residents who reported that it was very important to screen for trauma increased. Similarly, the proportion of residents who indicated they now screen for trauma increased as well. However, these were nonsignificant changes. There was no change in the proportion of residents who felt comfortable assessing for trauma before and after the curriculum. Even after the course, almost half of the respondents reported that they were still not comfortable in asking about refugee's experience of trauma or torture More residents reported that they screen for trauma after the curriculum. An ongoing development and evaluation of model curricula including possible expansion across specialties and health-care disciplines is warranted for this critically important topic area.

CTC Sentinel. Volume 4, Issue 6, June 2011

DTIC Science & Technology

2011-06-01

arrest and torture of teenagers who had written anti- regime graffiti sparked a wave of demonstrations in the southern Syrian city of Deraa. As a...more support, the easier it is for them to carry out activity. While its tactics are less popular, al-Qa`ida has managed to build a sizeable base of...militants managed to escape from the Wadi el-Natrun prison, where they had been detained.7 A couple of weeks later, on February 16, 2011, Chehab was

The ’Torture Memos’: A Failure of Strategic Leadership

DTIC Science & Technology

2009-05-11

were issued in August 2002, both signed by Yoo’s superior, Assistant Attorney General (and OLC chief) Jay Bybee . 16 The first memo, addressed to...investigation into the professional responsibility of Yoo, Bybee , and another OLC attorney, underway for nearly 5 years, was completed in 2008 but has...Office of Legal Counsel, Jay S. Bybee , “Re: Standards of Conduct for Interrogation under 18 U.S.C. §§2340-2340A," memorandum for Alberto R. 23 Gonzales

Algeria in Transition: The Islamic Threat and Government Debt

DTIC Science & Technology

1994-06-01

and couscous ". Duran includes the lack of a free press in the human rights but also focused on the use of torture (including minors). Specifically, when...chance for jobs and couscous ? What role did the Islamists play? D. ECONOMIC REFORMS Several accounts of the riots imply a conspiracy of sorts. It’s not...has the land of " couscous and the casbah" been viewed by others- by the United States in particular? What separated a "communist" from one who was

Should a Christian Officer Support Nuclear War?

DTIC Science & Technology

1982-02-01

of pagan gods to risking the occasions of sin endemic in the military life of the day. (24:19) I "a. ,.-."-."• ." -." .." ..’.v. ’ ’. ".. v v...34....".-".-.."’.-".-...-.•"." €’a Rome did not have mandatory military service and there was little...positions. They refused to take part in the civil state because of the participation in sacrifices, oath taking, and torture that Rome demanded of civ- il

The Fight for the High Ground: The U.S. Army and Interrogation during Operation Iraqi Freedom I, May 2003-April 2004

DTIC Science & Technology

2009-06-12

Regimental Detainee Holding Area in al-Qaim: CW3 Welshofer stuffed Mowhoush into a sleeping bag head first, wrapped the bag tightly with electrical ...greater risk of similar abuse from their captors. 24 This section went on to list examples of illegal physical torture, to include " electric shock...of Iraqis turned against coalition forces as law and order, electricity , garbage disposal, and other essential services failed to quickly materialize

Chosin Reservoir: Defensive, Retrograde, Winter, 1st Marine Division, 27 November-11 December 1950

DTIC Science & Technology

1983-06-30

This Japanese rule was one in which cruelty , execution. and torture abounded and which provided no Korean governmental infrastructure. The Atericans...would beat the CCF. One reason for this self-confidence of their ability to defeat the CCF was provided by Fox Company, 7th Marines, which for five...was again repulsed. On the third night, CCF came on less surely, though by that time Fox company had taken heavy losses. The next two nights, however

The Military Commissions Act of 2009 (MCA 2009): Overview and Legal Issues

DTIC Science & Technology

2014-03-07

crimes : attacking civilians, taking hostages , employing poison or similar weapon, using protected persons as a shield, torture or cruel or inhuman...Hamdan agreed that conspiracy is not a war crime under the traditional law of war.68 The crime of “ murder in violation of the law of war,” which...Defense, Manual for Military Commissions 2012 (M.M.C. 2012). 71 Id. at IV-14 (comment to the crime of murder in violation of the law of war). Oddly, that

A Review of Australian and New Zealand Investigations on Aeronautical Fatigue During the Period April 2011 to March 2013

DTIC Science & Technology

2013-04-01

properties in high-strength coarse grain titanium alloy with rough and torturous fatigue surfaces - Kevin Walker, (DSTO and RMIT University Australia), and...Wanhill, R. J. H. (1995) Damage tolerance engineering property evaluations of aerospace aluminium alloys with emphasis on fatigue crack growth. National...T6/T651 alloys . The testing of 7075-T6 C(T) coupons confirmed that the properties are very similar to the 7075-T651 material. Baseline

The Ironic Hypocrisy of Killing: How Sanctioned Counterinsurgency Policies of the Philippine War Ends in the Court-Martial of Major Littleton Waller

DTIC Science & Technology

2013-04-01

Both civilian and military leaders dehumanized the Philippine people through predisposed racial socioeconomic stereotypes which were not uncommon in... dehumanized by his military and civilian superiors. While no defense will be made in support for Maj Waller specifically, when taken into context, his...States that dehumanized the Filipino, thus legitimizing, in the minds of U.S. soldiers, brutal measures such as burning villages, torture and executions

Looking Backward, Looking Forward: The Long, Torturous Struggle with Mosquitoes.

PubMed

Patterson, Gordon M

2016-10-19

The American anti-mosquito movement grew out of the discovery of the role of mosquitoes in transferring pathogens and public concern about pest and nuisance mosquitoes in the late 1800s. In the 20th century, organized mosquito control in the United States passed through three eras: mechanical, chemical, and integrated mosquito control. Mosquito control in the 21st century faces the challenge of emerging pathogens, invasive mosquito species, and balancing concerns about the environment with effective control strategies.

Trauma and PTSD rates in an irish psychiatric population

PubMed Central

Wilson, Fiona E; Hennessy, Eilis; Dooley, Barbara; Kelly, Brendan D; Ryan, Dermot A

2013-01-01

Although Western mental health services are increasingly finding themselves concerned with assisting traumatized individuals migrating from other countries, trauma and posttraumatic stress disorder (PTSD) are under-detected and undiagnosed in psychiatric populations. This study examined and compared rates of traumatic experiences, frequency of traumatic events, trauma symptomatology levels, rates of torture, rates of PTSD and chart documentation of trauma and PTSD between (a) Irish and migrant service-users and (b) forced migrant and voluntary migrant service-users in Dublin, Ireland. Data were gathered from 178 psychiatric outpatients attending using a sociodemographic questionnaire, the Harvard Trauma Questionnaire-Revised Cambodian Version and the SCID-I/P. A substantial number of service-users had experienced at least one lifetime trauma (71.3%), and a high percentage of both the Irish (47.4%) and migrant groups (70.3%) of service-users had experienced two or more events. Overall, analyses comparing rates between Irish, forced migrant and voluntary migrant service-users found that forced migrants displayed more traumatic life events, posttraumatic symptoms, and higher levels of PTSD than their voluntary migrant and Irish counterparts, with over 50% experiencing torture prior to arrival in Ireland. The lifetime rate of PTSD in the overall sample was 15.7% but only 53.57% of cases were documented in patient charts. The results of this study are informative about the nature and extent of the problem of trauma and PTSD among migrant mental health service users as well as highlighting the under-detected levels of trauma among native-born service users. PMID:28228990

Psychiatric Sequelae of Former “Comfort Women,” Survivors of the Japanese Military Sexual Slavery during World War II

PubMed Central

Lee, Jeewon; Kwak, Young-Sook; Kim, Yoon-Jung; Kim, Eun-Ji; Park, E Jin; Shin, Yunmi; Lee, Bun-Hee; Lee, So Hee; Jung, Hee Yeon; Lee, Inseon; Hwang, Jung Im; Kim, Dongsik; Lee, Soyoung Irene

2018-01-01

“Comfort women” refers to young women and girls who were forced into sexual slavery by the Imperial Japanese military during World War II. They were abducted from their homes in countries under Imperial Japanese rule, mostly from Korea, and the rest from China, Philippines, Malaysia, Taiwan, Indonesia, the Netherlands, etc. “Comfort women” endured extreme trauma involving rape, sexual torture, physical abuse, starvation, threats of death, and witnessed many others being tortured and killed. This article reviews all the studies that have investigated the psychiatric or psychosocial sequelae of the survivors of the Japanese military sexual slavery. Most importantly, a recent study which conducted a psychiatric evaluation on the former “comfort women” currently alive in South Korea is introduced. The participants’ unmarried rate was relatively high and their total fertility rate was relatively low. Majority of the participants reported having no education and being the low economic status. They showed high current and lifetime prevalence of posttraumatic disorder, major depressive disorder, somatic symptom disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Participants showed high suicidality and majority of the participants still reported being ashamed of being former “comfort women” after all these years. This article high-lights the fact that the trauma has affected the mental health and social functioning of former “comfort women” throughout their lives, and even to the present day. PMID:29669407

Medical evidence of human rights violations against non-Arabic-speaking civilians in Darfur: a cross-sectional study.

PubMed

Tsai, Alexander C; Eisa, Mohammed A; Crosby, Sondra S; Sirkin, Susannah; Heisler, Michele; Leaning, Jennifer; Iacopino, Vincent

2012-01-01

Ongoing conflict in the Darfur region of Sudan has resulted in a severe humanitarian crisis. We sought to characterize the nature and geographic scope of allegations of human rights violations perpetrated against civilians in Darfur and to evaluate their consistency with medical examinations documented in patients' medical records. This was a retrospective review and analysis of medical records from all 325 patients seen for treatment from September 28, 2004, through December 31, 2006, at the Nyala-based Amel Centre for Treatment and Rehabilitation of Victims of Torture, the only dedicated local provider of free clinical and legal services to civilian victims of torture and other human rights violations in Darfur during this time period. Among 325 medical records identified and examined, 292 (89.8%) patients from 12 different non-Arabic-speaking tribes disclosed in the medical notes that they had been attacked by Government of Sudan (GoS) and/or Janjaweed forces. Attacks were reported in 23 different rural council areas throughout Darfur. Nearly all attacks (321 [98.8%]) were described as having occurred in the absence of active armed conflict between Janjaweed/GoS forces and rebel groups. The most common alleged abuses were beatings (161 [49.5%]), gunshot wounds (140 [43.1%]), destruction or theft of property (121 [37.2%]), involuntary detainment (97 [29.9%]), and being bound (64 [19.7%]). Approximately one-half (36 [49.3%]) of all women disclosed that they had been sexually assaulted, and one-half of sexual assaults were described as having occurred in close proximity to a camp for internally displaced persons. Among the 198 (60.9%) medical records that contained sufficient detail to enable the forensic medical reviewers to render an informed judgment, the signs and symptoms in all of the medical records were assessed to be consistent with, highly consistent with, or virtually diagnostic of the alleged abuses. Allegations of widespread and sustained torture and other human rights violations by GoS and/or Janjaweed forces against non-Arabic-speaking civilians were corroborated by medical forensic review of medical records of patients seen at a local non-governmental provider of free clinical and legal services in Darfur. Limitations of this study were that patients seen in this clinic may not have been a representative sample of persons alleging abuse by Janjaweed/GoS forces, and that most delayed presenting for care. The quality of documentation was similar to that available in other conflict/post-conflict, resource-limited settings.

The UN's water torture.

PubMed

Miller, Henry I

2010-01-01

The United Nations is a bastion of corruption, profligacy and incompetence that is a particular threat to the inhabitants of poor nations. Its policies, programs and agencies have made a growth industry of the unscientific regulation of important technologies-of which gene-splicing [also known as recombinant DNA technology or genetic modification (GM)] is only one. The UN's actions regularly defy scientific consensus and common sense, instead pandering to extremists. The result is vastly inflated research and development costs, less innovation, and diminished exploitation of superior techniques and products that could offer monumental humanitarian and economic benefits.

Death in the "microwave oven": A form of execution by carbonization.

PubMed

Durão, Carlos; Machado, Marcos P; Daruge Júnior, Eduardo

2015-08-01

Death in the "microwave oven" has nothing to do with microwaves energy. It is the jargon name given to a criminal form of execution by carbonization that has been adopted by drug dealers in Rio de Janeiro (Brazil). The goal is to torture and intimidate victims, in an attempt of corpse occultation and to make identification harder or impossible. This paper brings to attention of the forensic international community an unusual and very cruel form of execution as a way to document these situations. Copyright © 2015. Published by Elsevier Ireland Ltd.

[Chronic reactive depression. Disorders following imprisonment and persecution].

PubMed

Faust, V

1983-03-10

Ever since mankind exists, ethnic minorities, political adversaries etc. have been discriminated, pursued, tortured and killed. The twentieth century shows such examples too, also in post-war Europe of our days. But nothing exceeds the disastrous extent of the destruction machinery of the "3rd Reich". Still today, 50 years after the "Machtergreifung" delayed symptoms in the victims must be cared for. This and the realization that in future, too, terror of any variety will demand its victims make it necessary to deal directly with the consequences in order to ensure victims of greatest possible care and alleviation of their fate.

The Tortured History of Gauss's Law

NASA Astrophysics Data System (ADS)

Spencer, Ross

2009-10-01

American physics textbooks contain the following equation, which is called Gauss's law: E .d S = qenclosed ɛ0 It is odd, however, that biographies of Karl Friedrich Gauss (1777-1855) contain no mention of this law. A brief history of this important result will be presented in which it will be shown that what we call Gauss's law today was originally guessed at by Joseph Priestly (1733-1804) after he read a letter from Benjamin Franklin (1706-1790), then was derived, forgotten, and re-derived several times in two different contexts by many of the luminaries of physics in the eighteenth and nineteenth centuries.

Medical Evidence of Human Rights Violations against Non-Arabic-Speaking Civilians in Darfur: A Cross-Sectional Study

PubMed Central

Crosby, Sondra S.; Sirkin, Susannah; Heisler, Michele; Leaning, Jennifer; Iacopino, Vincent

2012-01-01

Background Ongoing conflict in the Darfur region of Sudan has resulted in a severe humanitarian crisis. We sought to characterize the nature and geographic scope of allegations of human rights violations perpetrated against civilians in Darfur and to evaluate their consistency with medical examinations documented in patients' medical records. Methods and Findings This was a retrospective review and analysis of medical records from all 325 patients seen for treatment from September 28, 2004, through December 31, 2006, at the Nyala-based Amel Centre for Treatment and Rehabilitation of Victims of Torture, the only dedicated local provider of free clinical and legal services to civilian victims of torture and other human rights violations in Darfur during this time period. Among 325 medical records identified and examined, 292 (89.8%) patients from 12 different non-Arabic-speaking tribes disclosed in the medical notes that they had been attacked by Government of Sudan (GoS) and/or Janjaweed forces. Attacks were reported in 23 different rural council areas throughout Darfur. Nearly all attacks (321 [98.8%]) were described as having occurred in the absence of active armed conflict between Janjaweed/GoS forces and rebel groups. The most common alleged abuses were beatings (161 [49.5%]), gunshot wounds (140 [43.1%]), destruction or theft of property (121 [37.2%]), involuntary detainment (97 [29.9%]), and being bound (64 [19.7%]). Approximately one-half (36 [49.3%]) of all women disclosed that they had been sexually assaulted, and one-half of sexual assaults were described as having occurred in close proximity to a camp for internally displaced persons. Among the 198 (60.9%) medical records that contained sufficient detail to enable the forensic medical reviewers to render an informed judgment, the signs and symptoms in all of the medical records were assessed to be consistent with, highly consistent with, or virtually diagnostic of the alleged abuses. Conclusions Allegations of widespread and sustained torture and other human rights violations by GoS and/or Janjaweed forces against non-Arabic-speaking civilians were corroborated by medical forensic review of medical records of patients seen at a local non-governmental provider of free clinical and legal services in Darfur. Limitations of this study were that patients seen in this clinic may not have been a representative sample of persons alleging abuse by Janjaweed/GoS forces, and that most delayed presenting for care. The quality of documentation was similar to that available in other conflict/post-conflict, resource-limited settings. Please see later in the article for the Editors' Summary PMID:22509136

Beyond where it started: a look at the "Healing Images" experience.

PubMed

Goodsmith, Lauren

2007-01-01

In March 2004, the Baltimore-based nonprofit organization Advocates for Survivors of Torture and Trauma (ASTT) initiated a photography-based therapeutic programme for clients. Developed by a professional photographer/teacher in collaboration with a psychologist, the programme has the goal of enabling clients to engage in creative self-exploration within a supportive, group setting. Since its inception, thirty survivors of conflict-related trauma and torture from five different countries have taken part in the programme, known as "Healing Images", using digital cameras to gather individually-chosen images that are subsequently shared and discussed within the group. These images include depictions of the natural and manmade environments in which clients find themselves; people, places and objects that offer comfort; and self-portraits that reflect the reality of the life of a refugee in the United States. This description of the "Healing Images" programme is based on comments gathered through discussion with participants and through interviews. Additional information was gathered from observation of early workshop sessions, review of numerous client photographs and captions, and pertinent organizational materials. A fundamental benefit of the programme was that it offered a mutually supportive group environment that diminished clients' feelings of psychological and physical isolation. Participants gained deep satisfaction from learning the technical skills related to use of the cameras, from the empowering experience of framing and creating specific images, and from exploring the personal significance of these images. Programme activities sparked a process of self-expression that participants valued on the level of personal discovery and growth. Some clients also welcomed opportunities to share their work publicly, as a means of raising awareness of the experience of survivors.

Does multidisciplinary rehabilitation of tortured refugees represent 'value-for-money'? A follow-up of a Danish case-study.

PubMed

Bager, Line; Hansen, Kristian Schultz; Andersen, Carit Jacques; Wang, Shr-Jie

2018-05-18

The recent surge of asylum seekers in the European Union (EU) is raising questions about the EU's ability to integrate newcomers into the economy and into society; particularly those who need specialized services for the treatment of severe trauma. This study investigated whether rehabilitating traumatised refugees represents 'value-for-money' (VfM) in terms of intervention cost per health gain and in a long-term and societal perspective. The economic evaluation comprised a cost-utility analysis (CUA) and a partial cost-benefit analysis (CBA). The CUA incorporated data on Quality Adjusted Life Years (QALY) for 45 patients who were treated at the Rehabilitation and Research Centre for Torture Victims, Copenhagen, Denmark, in 2001-2004 and followed for up to 2 years, to determine the incremental cost effectiveness ratio (ICER). For the CBA, data was collected for 44 patients who completed treatment between 2001 and 2004 and 44 matched controls on the waiting list, for the patients' primary health care utilisation, and personal and family labour income from 2001 to 2014. This was analysed to evaluate the Net Social Benefit (NSB) of the programme. The average cost of treatment was found to be about 32,000 USD per patient (2016 prices) with an average gain in QALY of 0.82. The treatment was cost effective according to the ICER threshold suggested by the National Institute of Health and Care Excellence (UK). At the individual level, the NSB remained negative throughout the study period. However, at the family income level the intervention proved to have been beneficial after 3 years. The implication of the study is, that providing rehabilitation to severely traumatised refugee families can be an economically viable strategy, considering the economic effects observed at the family level.

Adaptation of community health worker-delivered behavioral activation for torture survivors in Kurdistan, Iraq.

PubMed

Magidson, J F; Lejuez, C W; Kamal, T; Blevins, E J; Murray, L K; Bass, J K; Bolton, P; Pagoto, S

2015-12-01

Growing evidence supports the use of Western therapies for the treatment of depression, trauma, and stress delivered by community health workers (CHWs) in conflict-affected, resource-limited countries. A recent randomized controlled trial (Bolton et al . 2014 a ) supported the efficacy of two CHW-delivered interventions, cognitive processing therapy (CPT) and brief behavioral activation treatment for depression (BATD), for reducing depressive symptoms and functional impairment among torture survivors in the Kurdish region of Iraq. This study describes the adaptation of the CHW-delivered BATD approach delivered in this trial (Bolton et al .2014 a ), informed by the Assessment-Decision-Administration-Production-Topical experts-Integration-Training-Testing (ADAPT-ITT) framework for intervention adaptation (Wingood & DiClemente, 2008). Cultural modifications, adaptations for low-literacy, and tailored training and supervision for non-specialist CHWs are presented, along with two clinical case examples to illustrate delivery of the adapted intervention in this setting. Eleven CHWs, a study psychiatrist, and the CHW clinical supervisor were trained in BATD. The adaptation process followed the ADAPT-ITT framework and was iterative with significant input from the on-site supervisor and CHWs. Modifications were made to fit Kurdish culture, including culturally relevant analogies, use of stickers for behavior monitoring, cultural modifications to behavioral contracts, and including telephone-delivered sessions to enhance feasibility. BATD was delivered by CHWs in a resource-poor, conflict-affected area in Kurdistan, Iraq, with some important modifications, including low-literacy adaptations, increased cultural relevancy of clinical materials, and tailored training and supervision for CHWs. Barriers to implementation, lessons learned, and recommendations for future efforts to adapt behavioral therapies for resource-limited, conflict-affected areas are discussed.

[Fetal and early trauma syndrome-FETS].

PubMed

Zoroastro, Gastón A

2006-01-01

This is a new clinical description for cases of children whose parents are among those who have disappeared and were given birth by women held prisoners and subjected to torture, humiliation and abuses. This description is considered a special case of early, and in many cases fetal distress. These children felt horror when they were violently separated from their parents immediately after being born in captivity or in early infancy during the last military dictatorship (1976-1983). Afterwards they were sold by their captors and raised as adoptive or as their own children by the purchasers. The fact that these cases be included in the existing WHO categories contained in CIE-10: Posttraumatic stress disorder, F43.1, is discussed as they show late responses on the part of the victims to situations of torture, terrorism and rape. However, it is clarified that cases in which the aftereffects of severe stress become evident after decades will have to be classified as Persistent personality disorders, after catastrophic experience, F62.0. It is concluded that it is necessary to consider FETS as a new combination of manifestations of the Persistent Personality Disorders due to its specific idiosyncratic characteristics that go beyond the available clinical descriptions, to its own etiophatic equation and to its recognizable pathognomonic identification. Its pathognomonic identification in some cases was useful to detect children with these alienated identity problems (understood as legally neglected and clinically alienated). Propedeutic and treatment aspects are mentioned in conjunction with the peculiarities of a therapy that restores the illegally deprived personality of these children, who nowadays are adults of approximately 25 to 29 years of age. Finally, a metapsychologic discussion is presented, which is about the resilience of the truth and the fact that when it is rejected it returns, thus constituting ethics of the truth.

The path to extreme violence: nazism and serial killers.

PubMed

Cotter, Philippe

2010-01-01

In people's minds, extreme violence is an enigma. The tortures inflicted on defenceless victims seem to defy reason. Yet, the fact that these incidents keep recurring is proof that there are rules governing them. It is these rules that I have attempted to isolate. We shall see that they are clearly defined and that they are to be found in individual as well as collective violence. To categorise them is the first step towards implementing preventative measures which would help to protect the rational majority from a dangerous minority. Practice and theory are inextricably linked in the analysis of "organised insanity" that is extreme violence.

The Path to Extreme Violence: Nazism and Serial Killers

PubMed Central

Cotter, Philippe

2009-01-01

In people's minds, extreme violence is an enigma. The tortures inflicted on defenceless victims seem to defy reason. Yet, the fact that these incidents keep recurring is proof that there are rules governing them. It is these rules that I have attempted to isolate. We shall see that they are clearly defined and that they are to be found in individual as well as collective violence. To categorise them is the first step towards implementing preventative measures which would help to protect the rational majority from a dangerous minority. Practice and theory are inextricably linked in the analysis of “organised insanity” that is extreme violence. PMID:20126638

Annual report of Council, 1985-1986: medical ethics.

PubMed

1986-03-29

Recent activities of the Council of the British Medical Association related to ethical and public policy issues are described. The Council has been working to improve the network of local research ethics committees and favors the establishment of a national committee to review research proposals. It has been engaged in efforts to shape the Data Protection Act to safeguard the confidentiality of personal health records and to protect the confidentiality of minors who seek contraceptive advice without their parents' knowledge. Other Council concerns include advertising by the medical profession and the physician's role in law enforcement in Great Britain and in investigations of torture on the international scene.

On the Effectiveness of Military Institutions: Historical Case Studies from World War I, The Interwar Period, and World War II. Volume 3. World War II

DTIC Science & Technology

1986-04-01

ting the claims of U the tortured economy against those et the reeling military organization. I I I_ I I I I I I U I U 21. i II. S.rateqic...1 25. Henry I. Shaw, et . 41., History of u. S. Marine operaCions in World I war r (5 vols., Washington, DC, 1958-2971); Jeter A. Zsley and Philip A...Combat Troops, Bruce Jacobs, Soldiers (New 3 York, 1958), pp. 169-560; Stouffer, et al., The American Soldier: Combat and Its Afternath (New York, 1965

[Disintegration of the prison system, public security and social exclusion].

PubMed

Freixo, Marcelo

2016-06-01

The defense of human rights, namely one of the most important duties of the legislature, is a considerable challenge in the day-to-day business of parliament. The opinions and practices of elected representatives reflect the security concerns and fears of society that engender a vast process of social exclusion. In this context, the defense of the right to health of persons deprived of liberty seems an especially difficult task, as shown in the interview of State Congressman Marcelo Freixo, the Coordinator of the Human Rights Commission of the Legislative Assembly in Rio de Janeiro and creator of the State Mechanism for Preventing and Combating Torture.

Witchcraft, genealogy, Foucault.

PubMed

Russell, S

2001-03-01

This paper is a genealogical reflection on both the historiography of European witchcraft and the dynamics of witchcraft trials. I argue that traditional scholarly assumptions about the 'unsophisticated' nature of early modern European mentalities result in inadequate representations of accused witches and of the social contexts and processes of the trials. Genealogy, by contrast, problematizes fundamental notions such as reason, order, power and progress in ways that not only provide a different range of effective tools for the analysis of belief in witchcraft, but also underline its crucial significance for social theory. In the final section, an analysis of a typical trial is undertaken employing key genealogical insights into confession, torture, truth, governmentality, power, pleasure and pain.

Injuries and Illnesses of Vietnam War POWs Revisited. 5. Combined Service Group Risk Factors

DTIC Science & Technology

2017-11-08

provide the decision was made report both the standard F test using the Tukey post-hoc test, as well as the Welch test using the Games -Howell test for...USAF USN - USA USAF - USA Torture Mann-Whitney U < 0.001 < 0.001 0.170 Tukey HSD < 0.001 < 0.001 0.325 Games -Howell < 0.001 < 0.001 0.270 LOC months...Mann-Whitney U 0.185 < 0.001 < 0.001 Tukey HSD 0.015 0.013 0.578 Games -Howell 0.013 < 0.001 0.390 LOS weeks Mann-Whitney U < 0.001 < 0.001 0.541 Tukey

Scientific Freedom and Human Rights

NASA Astrophysics Data System (ADS)

Munoz, Elisa

2000-03-01

As part of her ongoing work monitoring issues at the intersection of science and human rights, Ms. Munoz has highlighted violations of academic freedom in Serbia and Iran, the denial of visas and travel licenses to U.S. and Cuban scientists, interference with scientific freedom in Brazil, Mexico, Russia, and the Ukraine, the use of organs from executed prisoners in China, legislation jeopardizing women's health in Iran, and the closure of centers for the treatment of torture survivors in Turkey. Such violations contravene international human rights principles listed in the Universal Declaration of Human Rights and other international human rights covenants. Ms. Munoz will describe current violations of scientific freedom and the relevant international principles on which these freedoms rest.

Apartheid medicine. Health and human rights in South Africa.

PubMed

Nightingale, E O; Hannibal, K; Geiger, H J; Hartmann, L; Lawrence, R; Spurlock, J

Human rights and health care under apartheid in South Africa were studied. Human rights violations, such as detention without charge or trial, assault and torture in police custody, and restriction orders, have had devastating effects on the health of persons experiencing them. These violations have occurred in the context of a deliberate policy of discriminatory health care favoring the white minority over the black majority. South Africa's medical societies have had mixed responses to the health problems raised by human rights violations and inequities in the health care system. The amelioration of health care for all and prevention of human rights violations depend on ending apartheid and discrimination and greater government attention to these problems.

Violence, health, and the 2030 agenda: Merging evidence and implementation.

PubMed

Lee, Bandy X; Donnelly, Peter D; Cohen, Larry; Garg, Shikha

2016-09-01

The Guest Editors introduce the Special Issue for the Journal of Public Health Policy on violence, health, and the 2030 Agenda. Emphasizing the importance of collaboration between scholars and practitioners, they outline the process of jointly imagining and designing the next generation of violence prevention strategies. They include representative works of members of the World Health Organization (WHO) Violence Prevention Alliance (VPA), including the World Bank, the United States Centers for Disease Control and Prevention, Prevention Institute, the Danish Institute Against Torture, the University of Cambridge Institute of Criminology, the London School of Hygiene and Tropical Medicine Gender Violence and Health Centre, and the Yale University Law and Psychiatry Division, among others.

The death of distinctions: From 9/11 to Abu Ghraib.

PubMed

Moon, John Ellis van Courtland

2004-09-01

War, the great simplifier, is the inevitable enemy of distinctions, especially when conflicts evoke survival fears, sounding echoes from humanity's environment of evolutionary adaptation. Throughout the twentieth century, attackers and targets grew more distant, weaponry grew more destructive, and distinctions -- between combatants and civilians, between legitimate and protected targets, between defensive and offensive strategies, between the innocent and the guilty -- faded. In the twenty-first century's first major conflict, "the war against terror," distinctions have faded still further, making nearly indistinguishable the frontier between preemption and prevention and between interrogation and torture. Proclaimed a "new type of war" in which old rules and customary safeguards would often be inapplicable, this conflict quickly came to be characterized by political embarrassment and operational scandal.

The use of pre-natal diagnostic techniques for sex selection: the Indian scene.

PubMed

Kusum

1993-04-01

The use of pre-natal diagnostic techniques only for sex determination followed by termination of pregnancy on a finding of female foetus, is an atrocious and unethical practice. The bias against a female has been stretched further back: from cradle to grave, it is now from womb to the grave. One cannot however ignore the conditions of the society which breed and encourage such practices. A girl suffers neglect and discrimination right from childhood; she is tortured, harassed and maltreated after marriage. At the work place she is exploited. A widow or a divorcee is looked down upon by the family and the society. All these things make her life miserable and not worth existence....

Representations of ECT in English-Language Film and Television in the New Millennium.

PubMed

Matthews, Avery Madeleine; Rosenquist, Peter B; McCall, William Vaughn

2016-09-01

The aim of the study was to survey the media landscape to determine whether visual depictions of electroconvulsive therapy (ECT) are becoming more or less medically accurate in the new millennium. English-language film and television shows depicting ECT were analyzed for patient demographics, administrator roles, indication, consent, anesthesia, paralytics, bite block, lead placement, electroencephalogram, and outcome. Thirty-nine ECT scenes were viewed, and just 3 included all 5 essential tools of modern ECT: anesthesia, paralytic, electrodes, electroencephalogram, and a bite block. Media depictions of ECT do not reflect current practice. Too often, ECT is portrayed as a torture technique rather than an evidenced-based therapy, and even in a therapeutic setting, it is too often shown with outdated techniques.

Physical punishment, abuse, torture or revenge? A case report.

PubMed

Gharib, Behdad; Esmaeili, Sara; Mazloomi Nobandegani, Narges; Shariati, Golnaz

2012-01-01

Child maltreatment happens in all countries and cultures. Children as the vulnerable part of the societies are subject to rage, abuse and maltreatment and need special multidisciplinary attention to get proper protection and care. Appropriate legislation, community education, advocacy in media and attention of care givers and children health providers may alter the trend of child abuse in communities. In order to raise awareness about child abuse for healthcare professionals, in this report we introduce a disastrous case of 4 years old boy who was attacked by his father which presented to Children's Medical Center in Tehran. The living environment of the victim was a dysfunctional family and an addict father as the risk factors of dangerous circumstances for a child.

From Nuremberg to Guantanamo Bay: Uses of Physicians in the War on Terror.

PubMed

Crosby, Sondra S; Benavidez, Gilbert

2018-01-01

Seventy years after the Nuremberg Doctors' Trial, health professionals and lawyers working together after 9/11 played a critical role in designing, justifying, and carrying out the US state-sponsored torture program in the CIA "Black Sites" and US military detention centers, including Abu Ghraib, Bagram, and Guantanamo Bay, Cuba. We analyze the similarities between the Nazi doctors and health professionals in the War on Terror and address the question of how it happened that health professionals, including doctors, psychologists, physician assistants, and nurses, acted as agents of the state to utilize their medical and healing skills to cause harm and sanitize barbarous acts, similar to (though not on the scale of) how Nazi doctors were used by the Third Reich.

American Doctors at the Nuremberg Medical Trial.

PubMed

Shuster, Evelyne

2018-01-01

Three Hippocratic physicians played critical roles in the prosecution of 23 Nazi doctors charged with murder and torture for conducting lethal medical experiments on concentration camp prisoners. Two of the physicians, Leopold Alexander and Andrew C. Ivy, were Americans, and the other, Werner Leibbrandt, was German. At the 70th anniversary of the Doctors' Trial it is fitting to recall the three's influences and contributions to the formulation of strict research ethics rules, known as the Nuremberg Code. Their contributions help us better understand why they insisted on strict research rules and yet ultimately were unable to apply these rules to their own research. Exploring their contributions at Nuremberg may help us appreciate the continuing difficulty physician-researchers have with accepting public regulation of research.

Diabetic artefacts in forensic practice.

PubMed

Murty, O P

2009-05-01

A case is presented where confusion arose about skin lesions and whether they were diabetic or electrical in origin. The deceased was a known diabetic and hypertensive man. A middle-aged person in early fifties was found unconscious in the cell and judicial autopsy was performed. He was facing trial for capital punishment of being allegedly involved in drug trafficking and money laundering. He had few marks over his fingers and foot which were considered to be electric marks produced in electric torture. also had fracture of skull and ischemic necrosis of right side of cerebrum; and contrecoup lesions. Findings are documented with photographs of the lesions. The article also depicts photographs of the scene where the victim had fallen and sustained skull fracture.

Human dignity as a component of a long-lasting and widespread conceptual construct.

PubMed

Baertschi, Bernard

2014-06-01

For some decades, the concept of human dignity has been widely discussed in bioethical literature. Some authors think that this concept is central to questions of respect for human beings, whereas others are very critical of it. It should be noted that, in these debates, dignity is one component of a long-lasting and widespread conceptual construct used to support a stance on the ethical question of the moral status of an action or being. This construct has been used from Modernity onward to condemn slavery and torture as violations of human dignity. In spelling it out, we can come to a better understanding of what "dignity" means and become aware that there exists a quite useful place for this notion in our ethical thought, albeit a modest one.

Child slavery in Hong Kong: case report and historical review.

PubMed

Lee, A C W; So, K T

2006-12-01

An 11-year-old girl was admitted with multiple injuries sustained during a 1-year servitude of domestic labour. She was acquired from her parents in Mainland China by a relative in Hong Kong. The child's parents received a sum of money that the child had to repay with work. Her hardship was characterised by long hours of incessant labour and physical torture when she failed to meet the demands of her mistress or her mistress' children. This case resembles Mui Tsai, a form of child slavery and exploitative domestic labour that was rife in Hong Kong a century ago, and illustrates the new challenges to child rights and protection consequent to the increasing social and economic integration between the Hong Kong Special Administrative Region and Mainland China.

Dismemberment: cause of death in the Colombian armed conflict.

PubMed

Morcillo-Méndez, Maria Dolores; Campos, Isla Yolima

2012-01-01

The purpose of this paper is to illustrate major findings in the recovery and analysis of victims, where dismemberment is the cause of death, but also a manner of torture within the context of the armed conflict in Colombia. It is intended to provide useful analytical information and to contribute to the correct interpretation of forensic analyses in cases of dismemberment and/or in the examination of human remains within the context of the Colombian armed conflict. The importance of including dismemberment as an opinion in the forensic report by correlating the findings on the body, the grave and context of the information available, and the accounts on the facts is encouraged. Otherwise these cases will be recorded as undetermined cause of death, which does not reflect the brutality of the war.

Social Ecology of Child Soldiers: Child, Family, and Community Determinants of Mental Health, Psychosocial Wellbeing, and Reintegration in Nepal

PubMed Central

Kohrt, Brandon A.; Jordans, Mark J.D.; Tol, Wietse A.; Perera, Em; Karki, Rohit; Koirala, Suraj; Upadhaya, Nawaraj

2013-01-01

This study employs social ecology to evaluate psychosocial wellbeing in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Scale (CPSS), and locally developed measures of function impairment and reintegration. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted fewer reintegration supports. Ultimately, social ecology is well-suited to identify intervention foci across ecological levels, based on community differences in vulnerability and protective factors. PMID:21088102

[Civilian massacre in Banija: Kraljevcani and Pecki, 14-16 March 1991].

PubMed

Kovacević, S; Judas, M; Marusić, A

1991-01-01

On 14 and 16 August 1991, Serbian terrorists attacked two villages near Petrinja in the Banija region. The village of Kraljevcani was attacked on 14 August, when the terrorists killed five older villagers, 3 women and 2 men who stayed in the village to watch the livestock and the houses. The women were killed by automatic rifle fire and grenades, and the bodies of the two men were blown up by a hand rocket-launcher projectiles. On 16 August 1991, Serbian terrorists captured four villagers from Pecki, who came to the deserted village to feed the livestock left after the inhabitants fled from the terrorists. The forensic medical expertise revealed that they were first wounded by rifle fire, then tortured and finally executed by hand axes and bayonets.

Palliative care and human rights in patient care: an Armenia case study.

PubMed

Barros de Luca, Gabriela; Zopunyan, Violeta; Burke-Shyne, Naomi; Papikyan, Anahit; Amiryan, Davit

2017-01-01

This paper examines palliative care within the human rights in patient care framework, which clarifies state obligations and addresses the rights of both patients and providers. In the context of palliative care, these rights extend beyond the right to health and include patient rights to freedom from torture, cruel and inhuman treatment, non-discrimination and equality, bodily integrity, privacy and confidentiality, information, and right to a remedy. They also encompass provider rights to decent working conditions, freedom of association, and due process. The paper then looks at a case study of Armenia, acknowledging how the government's commitment to palliative care, combined with awareness raising and advocacy by human rights organizations, created an enabling environment for the realization of human rights in patient care in the context of palliative care.

How was the Turin Shroud Man crucified?

PubMed

Bevilacqua, M; Fanti, G; D'Arienzo, M; Porzionato, A; Macchi, V; De Caro, R

2014-12-01

As the literature is not exhaustive with reference to the way the Turin Shroud (TS) Man was crucified, and it is not easy to draw significant information from only a "photograph" of a man on a linen sheet, this study tries to add some detail on this issue based on both image processing of high resolution photos of the TS and on experimental tests on arms and legs of human cadavers. With regard to the TS Man hands, a first hypothesis states that the left hand of the TS Man was nailed twice at two different anatomical sites: the midcarpal joint medially to the pisiform between the lunate/pyramidal and capitate/uncinate bones (Destot's space) and the radiocarpal joint between the radio, lunate and scaphoid; also the right hand would have been nailed twice. A second hypothesis, preferred by the authors, states that the hands were nailed only once in the Destot's space with partial lesion of the ulnar nerve and flexion of the metacarpophalangeal joint of the thumbs. With regard to the TS Man feet, the imprint of the sole of the right foot leads to the conclusion that TS Man suffered a dislocation at the ankle just before the nailing. The entrance hole of the nail on the right foot is a few inches from the ankle, and excludes a double nailing. The nail has been driven between the tarsal bones. The TS Man suffered the following tortures during crucifixion: a very serious and widespread causalgia due to total paralysis of the upper right limb (paradoxical causalgia); a nailing of the left wrist with damage to the ulnar nerve; a similar nailing of the right wrist; and a nailing to both feet using one only nail that injured the plantaris medialis nerves. The respiratory limitation was probably not sufficient to cause death by asphyxiation. Also considering the hypovolemia produced by scourging and the many other tortures detectable on the TS, the principal cause of death can be attributed to a myocardial infarction. Copyright © 2014 Elsevier Ltd. All rights reserved.

St. René: the Patron Saint of Anaesthetists and a Patron Saint of Canada.

PubMed

Calverley, R K

1980-01-01

René Goupil, the Patron Saint of Anaesthetists, and a Patron Saint of Canada, was born in Angers, France in 1608 and studied surgery. He joined the Jesuits as a donné or volunteer worker in 1640 and served in the then tiny colony of Quebec as one of the first medical workers of Canada. After earning meritorious praise for his skills, he again volunteered to attend the Hurons at Sainte Marie, a mission far beyond the frontiers. René's canoe party was ambushed. He was captured by the Mohawks and endured eight weeks of cruel torture before being killed on September 29, 1642. René was the first of eight North American martyrs whose dedication was recognized by canonization in 1930. St. René was appointed Patron Saint of Anaesthetists in 1951.

Medicolegal investigation of political killings in El Salvador.

PubMed

Thomsen, J L; Gruschow, J; Stover, E

1989-06-17

An axiom of Thomas Hobbes states that "people are never more helpless than when the force meant to protect their rights turns against them." Hobbes' axiom holds true today, with Amnesty International reporting that hundreds of thousands have been murdered by their governments. This article examines the medicolegal aspects of an investigation into the deaths of two Salvadoran peasants who were reportedly tortured and executed by soldiers in February 1988. One of the authors, Thomsen, participated in the investigation as a court-ordered expert, and as a representative of the American Association for the Advancement of Science and of a Salvadoran legal aid organization. His necropsy findings are reported with observations and comments. The article concludes with suggestions for initiatives that might be undertaken by individual physicians and institutions to improve the quality and impartiality of medicolegal investigations into political killings.

Whither prometheus' liver? Greek myth and the science of regeneration.

PubMed

Power, Carl; Rasko, John E J

2008-09-16

Stem-cell biologists and those involved in regenerative medicine are fascinated by the story of Prometheus, the Greek god whose immortal liver was feasted on day after day by Zeus' eagle. This myth invariably provokes the question: Did the ancient Greeks know about the liver's amazing capacity for self-repair? The authors address this question by exploring the origins of Greek myth and medicine, adopting a 2-fold strategy. First, the authors consider what opportunities the ancient Greeks had to learn about the liver's structure and function. This involves a discussion of early battlefield surgery, the beginnings of anatomical research, and the ancient art of liver augury. In addition, the authors consider how the Greeks understood Prometheus' immortal liver. Not only do the authors examine the general theme of regeneration in Greek mythology, they survey several scholarly interpretations of Prometheus' torture.

Risk, suffering and competing narratives in the psychiatric assessment of an Iraqi refugee.

PubMed

Savy, Pauline; Sawyer, Anne-Maree

2008-03-01

This paper highlights the problem of "place" for an Iraqi refugee who, for years, had been tortured and imprisoned in his home country. Specifically, the paper presents a case study of a clinical encounter with this refugee, who had come to the attention of an Australian Crisis Assessment and Treatment Team. Drawing from narrative theory, the paper describes the chaotic nature of the encounter to show how the diverse motives, claims and actions of those present expose the struggle involved in the emplotment of an emerging narrative. The case study is constructed and analysed to illustrate the interpretive machinery of "clinical reasoning" and, in particular, the tension and play between "paradigmatic thinking" and "narrative thinking." More generally, this analysis follows the work of social scientists who seek to expand methodologies for writing about human suffering.

[Culture-Sensitive Aspects in Diagnostics of Mental Distress in Refugees - Two Commented Case Reports].

PubMed

Nesterko, Yuriy; Kaiser, Marie; Glaesmer, Heide

2017-04-01

High levels of mental disorders, especially PTSD, are commonly known among groups of people forced to leave their homeland as a consequence of war-related experiences (e. g. armed conflict, torture or persecution). Depending on the cultural background the perceptions of illnesses vary, different symptom presentation and thereupon different coping strategies respectively expectations towards health care services exist. To minimize the danger of misdiagnosis by different experts working with refugees in the host countries, a culture-sensitive diagnostic approach is needed from the beginning. This article describes important aspects of culture-sensitive diagnostics by means of 2 commented case reports. Special focus is set on the aspect of linguistic and in a broader sense cultural comprehension between therapist, client and if necessary language mediator. © Georg Thieme Verlag KG Stuttgart · New York.

A question of conscience. Physicians in defense of human rights.

PubMed

Nightingale, E O; Stover, E

The vital role physicians can play in documenting physical and mental abuse of political prisoners, treating and rehabilitating victims, and preventing the punitive use of medicine is exemplified by the actions of three physicians whose stories are told here. Wendy Orr, a South African prison physician, took her complaint about police torture of political detainees to court after her superiors ignored her reports of prisoner abuse. An internationally known Chilean surgeon, Pedro Castillo, has been arrested twice for his work against the human rights violations of his country's military government. Soviet psychiatrist Anatoly Koryagin is reported to be near death after several years' imprisonment for his activities against involuntary psychiatric commitment of dissidents. Nightingale and Stover remind physicians of their obligation to protest the misuse of medical skills and urge support for professional organizations actively engaged in human rights issues.

Holistic medicine not "torture": performing acupuncture in Galway, Ireland.

PubMed

Anderson, Kevin Taylor

2010-07-01

This article examines how the aesthetic design of clinics and interactive discourse and rituals construct the social reality of acupuncture sessions as a form of holistic medical therapy. Verbal and nonverbal interactions create an appealing medical environment but also help prevent the emergence of undesired counter-realities (e.g., pain, biomedical intervention). Based on observations of acupuncture sessions conducted in Galway, Ireland, I illustrate how ambiance and aesthetic elements of clinics create a complex medico-cultural environment that balances oppositional associations (Western/non-Western, exoticism/convention, medical alterity/medical professionalism). Patients interviewed continually referred to acupuncture as a natural and non-invasive form of medical treatment. This suggests that interpersonal discourse and aesthetic design play key roles in how patients define acupuncture treatment, and that these ephemeral agents may also influence how patients come to define efficacy.

A systematic review of questionnaires measuring the health of resettling refugee women.

PubMed

Gagnon, Anita J; Tuck, Jodi; Barkun, Laurie

2004-02-01

Because many ethnically diverse refugee women resettle in industrialized countries, several biopsychosocial factors need to be considered in caring for them. This systematic review of studies conducted with female refugees, asylum-seekers, or "unspecified" immigrants based on six electronic databases was conducted to determine which questionnaires best measure relevant variables. Questionnaires were reviewed for measurement properties, application of translation theory, and quality of representation. Studies must have included > or = 1 measure of the following: general health; torture, abuse, sex-and-gender-based violence (SGBV); depression; stress; posttraumatic stress disorder (PTSD); anxiety; somatization; migration history; social support; socioeconomic status; discrimination; or mother-child interactions. Fifty-six studies using 47 questionnaires were identified; only five had strong evidence for use with resettling refugee women. Thus, few high-quality tools are available to measure concepts relevant to resettling refugee women's health.

Rendering justice in witch trials: the case of the val de Lièpvre.

PubMed

Simon, Maryse

2011-01-01

The borderland of the val de Lièpvre, with lands in Alsace and in the Duchy of Lorraine, and divided by religion and language, offers a rich collection of sources for the history of witchcraft persecution. The territory sharply reveals what was undoubtedly characteristic of witchcraft trials more widely. The crime of witchcraft was considered abominable before the Christian community and God, and its prosecution justified abandoning many of the safeguards and constraints in legal procedure, whether restrictions on the use of torture, the reliance on dubious testimony or even denial of advocacy to the witches. The action of the judges was nonetheless, as they understood it, the rendering of true justice, by punishing the culprits with a harshness that would expiate their crimes before the community and preserve them from damnation in the face of God's judgment.

Nepal's War on Human Rights: A summit higher than Everest

PubMed Central

Singh, Sonal; Dahal, Khagendra; Mills, Edward

2005-01-01

Nepal has witnessed serious human rights violations including arbitrary arrests, detentions, "disappearances", extra judicial executions, abductions and torture carried out by both the Royal Nepalese Army and the Maoist rebels in the 10 years of the "peoples war". Women and children have borne the brunt of the conflict. Massive displacement has led to adverse social and psychological consequences. While the reasons for the conflict are mainly indigenous and rooted in the social and economic in-equities, remedies for health inequities must come not only from the health sector but also from broad social policies and adopting a participatory and conflict-sensitive approach to development. Meanwhile the international community needs to use its leverage to urge both sides to accept a human rights accord and honor international human rights and humanitarian laws, while investigating allegations of abuse and prosecute those responsible. PMID:15985165

Neurofeedback as an adjunct therapy for treatment of chronic posttraumatic stress disorder related to refugee trauma and torture experiences: two case studies.

PubMed

Askovic, Mirjana; Watters, Anna J; Aroche, Jorge; Harris, Anthony W F

2017-08-01

The objective of this study was to describe the use of neurofeedback for refugee-related chronic posttraumatic stress disorder (PTSD) in two case studies. We describe the assessment and application of neurofeedback integrated into the treatment of two clients with chronic PTSD. We include details of our treatment schedule, symptoms and quantitative electrophysiological data for each case. Results All clients achieved significant reduction in symptoms of PTSD and improvement in daily functioning post-neurofeedback therapy. Quantitative electroencephalogric (EEG) measures indicate a normalisation of EEG markers relating to trauma, including overarousal at rest and working memory function. Conclusions Neurofeedback as an adjunct to trauma-informed therapy may help to remediate chronic PTSD relating to refugee experiences. If replicated then improvements demonstrated in this population would be generalisable to all chronic PTSD.

The relation of appraisal, coping efforts, and acuteness of trauma to PTS symptoms among former political prisoners.

PubMed

Kanninen, Katri; Punamäki, Raija-Leena; Qouta, Samir

2002-06-01

We examined how trauma-specific appraisals and coping efforts mediate between traumatic experiences, acuteness of trauma, and length of imprisonment and posttraumatic stress symptoms (PTS) among 103 Palestinian former political prisoners. The findings provide support for both direct and mediated models of trauma. The acuteness of trauma (time since release), appraisal of prison experience as harmful and involving loss, and use of both emotion- and problem-focused coping efforts were associated with high levels of PTS symptoms. Torture and ill-treatment had a direct association with intrusion, and recent release from prison with avoidance symptoms. Acuteness of trauma turned out to be important in the coping and symptom association: emotion-focused coping was associated with a low level of PTS symptoms in the long run, whereas problem-focused coping was associated with a low level of PTS symptoms in the short run.

Psychologists and detainee interrogations: key decisions, opportunities lost, and lessons learned.

PubMed

Pope, Kenneth S

2011-01-01

After the 9-11 terrorist attacks, U.S. psychologists faced hard choices about what roles, if any, were appropriate for psychologists in the detainee interrogations conducted in settings such as the Bagram Airbase, the Abu Ghraib Prison, and the Guantanamo Bay Detention Camps. The American Psychological Association (APA) sparked intense controversy with its policies and public statements. This article reviews APA decisions, documents, and public statements in this area, in the context of major criticisms and responses to those criticisms. The review focuses on key issues: how the APA created and reported policies in the areas of ethics and national security; transparency; psychologists' professional identities; psychologists' qualifications; ethical-legal conflicts; policies opposing torture; interpretations of avoiding harm; and effective interrogations. It suggests lessons learned, missed opportunities, and questions in need of a fresh approach. © 2011 by Annual Reviews. All rights reserved

World War II never ended in my house: interviews of 12 Office of Strategic Services veterans of wartime espionage on the 50th anniversary of WW II.

PubMed

Cavin, Susan

2006-07-01

The author conducted sociological interviews of 12 OSS spies (7 male, 5 female) who were operatives in France during World War II (WW II). The Office of Strategic Services (OSS) existed from 1941 to 1945 and was later renamed the CIA in 1947. This paper includes family studies of six close relatives of OSS vets and observation of 400 OSS veterans at the 50th anniversary of WW II. Three of the 12 OSS veterans who had been tortured by the Gestapo still suffered from PTSD-startle symptoms after 50 years; those three also suffered massive strokes in later life. The majority of OSS vets, regardless of gender, exhibited "war excitement" when talking about the war 50 years later. Most saw the war as the highpoint of their lives. War excitement needs more careful study within PTSD circles.

Scandinavian neuroscience during the Nazi era.

PubMed

Kondziella, Daniel; Hansen, Klaus; Zeidman, Lawrence A

2013-07-01

Although Scandinavian neuroscience has a proud history, its status during the Nazi era has been overlooked. In fact, prominent neuroscientists in German-occupied Denmark and Norway, as well as in neutral Sweden, were directly affected. Mogens Fog, Poul Thygesen (Denmark) and Haakon Sæthre (Norway) were resistance fighters, tortured by the Gestapo: Thygesen was imprisoned in concentration camps and Sæthre executed. Jan Jansen (Norway), another neuroscientist resistor, escaped to Sweden, returning under disguise to continue fighting. Fritz Buchthal (Denmark) was one of almost 8000 Jews escaping deportation by fleeing from Copenhagen to Sweden. In contrast, Carl Værnet (Denmark) became a collaborator, conducting inhuman experiments in Buchenwald concentration camp, and Herman Lundborg (Sweden) and Thorleif Østrem (Norway) advanced racial hygiene in order to maintain the "superior genetic pool of the Nordic race." Compared to other Nazi-occupied countries, there was a high ratio of resistance fighters to collaborators and victims among the neuroscientists in Scandinavia.

Exploring the mental health effects of political trauma with newly arrived refugees.

PubMed

Shannon, Patricia J; Wieling, Elizabeth; McCleary, Jennifer Simmelink; Becher, Emily

2015-04-01

We explored the mental health effects of war trauma and torture as described by 111 refugees newly arrived in the United States. We used ethnocultural methodologies to inform 13 culture-specific focus groups with refugees from Bhutan (34), Burma (23), Ethiopia (27), and Somalia (27). Contrary to the belief that stigma prevents refugees from discussing mental health distress, participants readily described complex conceptualizations of degrees of mental health distress informed by political context, observation of symptoms, cultural idioms, and functional impairment. Recommendations for health care providers include assessment processes that inquire about symptoms in their political context, the degree of distress as it is culturally conceptualized, and its effect on functioning. Findings confirm the cross-cultural recognition of symptoms associated with posttraumatic stress disorder; however, refugees described significant cultural variation in expressions of distress, indicating the need for more research on culture-bound disorders and idioms of distress. © The Author(s) 2014.

Gender, human rights and cultural diversity: reflections on a career in transcultural psychiatry.

PubMed

Kastrup, Marianne C

2011-04-01

The three issues of gender equality, human rights and cultural diversity have dominated my organizational commitments, research, and clinical practice in transcultural psychiatry. These issues are intertwined in many ways and have broad implications for transcultural psychiatry. With increasing globalization, psychiatrists in many countries are likely to be treating patients who have migrated from different cultures and who may have been exposed to a variety of traumatic experiences that have a profound impact on their mental health. Of particular concern is the group of torture survivors and the elucidation of their symptom manifestations, as well as effective therapeutic interventions, which clearly show how human rights issues are linked to research and clinical psychiatry. The analyses of how different ethnic groups use psychiatric services, epitomize how important it is to pay attention to gender aspects in the interpretation of the findings and their therapeutic, as well as policy, implications.

Social ecology of child soldiers: child, family, and community determinants of mental health, psychosocial well-being, and reintegration in Nepal.

PubMed

Kohrt, Brandon A; Jordans, Mark J D; Tol, Wietse A; Perera, Em; Karki, Rohit; Koirala, Suraj; Upadhaya, Nawaraj

2010-11-01

This study employed a social ecology framework to evaluate psychosocial well-being in a cross-sectional sample of 142 former child soldiers in Nepal. Outcome measures included the Depression Self Rating Scale (DSRS), Child Posttraumatic Stress Disorder Symptom Scale (CPSS), and locally developed measures of functional impairment and reintegration. Hierarchical linear modeling was used to examine the contribution of factors at multiple levels. At the child level, traumatic exposures, especially torture, predicted poor outcomes, while education improved outcomes. At the family level, conflict-related death of a relative, physical abuse in the household, and loss of wealth during the conflict predicted poor outcomes. At the community level, living in high caste Hindu communities predicted lack of reintegration supports. Ultimately, social ecology is well suited to identify intervention foci across ecological levels based on community differences in vulnerability and protective factors.

Torture by Cieng: ethical theory meets social practice among the Dinka Agaar of south Sudan.

PubMed

Deal, Jeffery L

2010-01-01

Here I detail violence in South Sudan by first discussing a specific Dinka Agaar practice alongside existing discourses on the social aspects of violence and universal human rights, then I show how these acts had meaning and purpose using data from personal accounts of violence. I posit that the violence described was consistent with Dinka Agaar concepts of justice and basic human rights and that it cannot be judged against any universal human rights standard, devoid of local context or of an overarching metanarrative. These events highlight conflicting subjectivities, ethical norms, and the painful difficulties inherent to advocacy in areas of conflict. Viewed from the perspective of the larger social unit, it is easy to see how violence was required to end violence. However, witnessing punitive violence purposefully enacted on innocent individuals to achieve peace has the potential to create conflicting positions that modern anthropological discourse cannot reconcile.

Experimental results on current-driven turbulence in plasmas - a survey

NASA Astrophysics Data System (ADS)

de Kluiver, H.; Perepelkin, N. F.; Hirose, A.

1991-01-01

The experimental consequences of plasma turbulence driven by a current parallel to a magnetic field and concurrent anomalous plasma heating are reviewed, with an attempt to deduce universalities in key parameters such as the anomalous electrical conductivities observed in diverse devices. It has been found that the nature of plasma turbulence and turbulent heating depends on several parameters including the electric field, current and magnetic fields. A classification of turbulence regimes based on these parameters has been made. Experimental observations of the anomalous electrical conductivity, plasma heating, skin effect, runaway electron braking and turbulent fluctuations are surveyed, and current theoretical understanding is briefly reviewed. Experimental results recently obtained in stellarators (SIRIUS, URAGAN at Kharkov), and in tokamaks (TORTUR at Nieuwegein, STOR-1M at Saskatoon) are presented in some detail in the light of investigating the feasibility of using turbulent heating as a means of injecting a large power into toroidal devices.

a Fractal Permeability Model Coupling Boundary-Layer Effect for Tight Oil Reservoirs

NASA Astrophysics Data System (ADS)

Wang, Fuyong; Liu, Zhichao; Jiao, Liang; Wang, Congle; Guo, Hu

A fractal permeability model coupling non-flowing boundary-layer effect for tight oil reservoirs was proposed. Firstly, pore structures of tight formations were characterized with fractal theory. Then, with the empirical equation of boundary-layer thickness, Hagen-Poiseuille equation and fractal theory, a fractal torturous capillary tube model coupled with boundary-layer effect was developed, and verified with experimental data. Finally, the parameters influencing effective liquid permeability were quantitatively investigated. The research results show that effective liquid permeability of tight formations is not only decided by pore structures, but also affected by boundary-layer distributions, and effective liquid permeability is the function of fluid type, fluid viscosity, pressure gradient, fractal dimension, tortuosity fractal dimension, minimum pore radius and maximum pore radius. For the tight formations dominated with nanoscale pores, boundary-layer effect can significantly reduce effective liquid permeability, especially under low pressure gradient.

The ethics of trauma: re-traumatization in society's approach to the traumatized subject.

PubMed

Nguyen, Leanh

2011-01-01

The paper starts from a question about the subconscious needs and anxieties which may underlie society's current responses to trauma. In particular, the author argues that the interest in the trauma of torture and man-made violence is a reaction to the increasingly dehumanizing and death-denying culture we live in. After proposing that the various categories of societal responses-the author focuses on evaluation, treatment, and advocacy-to traumatized subjects hide defenses of denial, distortion, refusal, with respect to the challenge of mortality, meaning-making, and mourning, the author then makes the thesis that they can derail and corrupt the project of post-traumatic repair. The paper proceeds with an examination of the ethics and politics that are implicit in contemporary North American society's current approach to trauma. The central argument is that the current approach may contain a collective acting out that often ends up being re-traumatizing to the traumatized subjects.

Crime and memory.

PubMed

Herman, J L

1995-01-01

The conflict between knowing and not knowing, speech and silence, remembering and forgetting, is the central dialectic of psychological trauma. This conflict is manifest in the individual disturbances of memory, the amnesias and hypermnesias, of traumatized people. It is manifest also on a social level, in persisting debates over the historical reality of atrocities that have been documented beyond any reasonable doubt. Social controversy becomes particularly acute at moments in history when perpetrators face the prospect of being publicly exposed or held legally accountable for crimes long hidden or condoned. This situation obtains in many countries emerging from dictatorship, with respect to political crimes such as murder and torture. It obtains in this country with regard to the private crimes of sexual and domestic violence. This article examines a current public controversy, regarding the credibility of adult recall of childhood abuse, as a classic example of the dialectic of trauma.

Persecution Experiences and Mental Health of LGBT Asylum Seekers.

PubMed

Hopkinson, Rebecca A; Keatley, Eva; Glaeser, Elizabeth; Erickson-Schroth, Laura; Fattal, Omar; Nicholson Sullivan, Melba

2017-01-01

Asylum seekers are a unique population, particularly those who have endured persecution for their sexual orientation or gender identity. Little data exist about the specific experiences and needs of asylum seekers persecuted due to lesbian, gay, bisexual, or transgender (LGBT) identity. Quantitative data were gathered regarding demographics, persecution histories, and mental health of 61 clients from a torture survivors program in New York City who reported persecution due to LGBT identity. Thirty-five clients persecuted due to their LGBT identity were matched by country of origin and sex with clients persecuted for other reasons to explore how persecution and symptoms may differ for LGBT clients. LGBT asylum seekers have a higher incidence of sexual violence, persecution occurring during childhood, persecution by family members, and suicidal ideation. Understanding the type of persecution experiences and how these influence mental health outcomes is an essential step toward designing and delivering effective treatments.

Arms trade and its impact on global health.

PubMed

Mahmudi-Azer, Salahaddin

2006-01-01

The most obvious adverse impact of the arms trade on health is loss of life and maiming from the use of weapons in conflicts. Wealthy countries suffer damage to their health and human services when considerable resources are diverted to military expenditure. However, the relative impact of military expenditures and conflict on third world countries is much greater, and often devastating, by depriving a significant portion of the population of essential food, medicine, shelter, education, and economic opportunities. Further, the physical and psychological damage inflicted specifically on children is debilitating - through loss of (or separation from) families, loss of education, destruction of homes, exposure to murder and other violence, sexual abuse, abduction, torture, slavery, and forcible conscription as soldiers. This article outlines the socio-economic impact of the global arms trade in general and the damage done to human health and the environment, specifically.

Atmospheric pressure: Russian drug policy as a driver for violations of the UN Convention against Torture and the International Covenant on Economic, Social and Cultural Rights.

PubMed

Golichenko, Mikhail; Sarang, Anya

2013-06-14

Responding to problematic drug use in Russia, the government promotes a policy of "zero tolerance" for drug use and "social pressure" against people who use drugs (PWUD), rejecting effective drug treatment and harm reduction measures. In order to assess Russian drug policy against the UN Convention Against Torture and the International Covenant on Economic, Social, and Cultural Rights, we reviewed published data from government and non-governmental organizations, scientific publications, media reports, and interviews with PWUD. Drug-dependent people (DDP) are the most vulnerable group of PWUD. The state strictly controls all aspects of drug dependence. Against this background, the state promotes hatred towards PWUD via state-controlled media, corroding public perception of PWUD and of their entitlement to human rights. This vilification of PWUD is accompanied by their widespread ill-treatment in health care facilities, police detention, and prisons. In practice, zero tolerance for drug use translates to zero tolerance for PWUD. Through drug policy, the government deliberately amplifies harms associated with drug use by causing PWUD (especially DDP) additional pain and suffering. It exploits the particular vulnerability of DDP, subjecting them to unscientific and ideologically driven methods of drug prevention and treatment and denying access to essential medicines and services. State policy is to legitimize and encourage societal ill-treatment of PWUD. The government intentionally subjects approximately 1.7 million people to pain, suffering, and humiliation. Aimed at punishing people for using drugs and coercing people into abstinence, the official drug policy disregards the chronic nature of drug dependence. It also ignores the ineffectiveness of punitive measures in achieving the purposes for which they are officially used, that is, public safety and public health. Simultaneously, the government impedes measures that would eliminate the pain and suffering of DDP, prevent infectious diseases, and lower mortality, which amount to systematic violations of Russia's human rights obligations. Copyright © 2013 Golichenko and Sarang. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Household exposure to violence and human rights violations in western Bangladesh (I): prevalence, risk factors and consequences

PubMed Central

2009-01-01

Background The ruling parties in Bangladesh have systematically used violence against political opponents and criminals. It is essential to 1) determine the magnitude and burden of organised crime and political violence (OPV) and human rights violations in the affected community, and to 2) identify the risk factors and key indicators for developing effective health intervention and prevention measures. Methods The population-based study consisted of two parts: a household survey and OPV screening at mobile clinics (presented in Part II). A cross-sectional, multistage cluster household survey was conducted in the Meherpur district in February-March 2008; 22 clusters with a sample size of 1,101 households (population of 4,870) were selected. Results Around 83% of households reported being exposed to at least two categories of OPV or human rights violations: 29% reported that the family members had been arrested or detained; 31% reported torture or other cruel, inhuman or degrading treatment or punishment. Crude mortality rate was 17.9/1,000 and under 5 mortality rate was 75/1,000. The annual injury rate was 36%, lifetime experience of violence-related injury was 50%, and pain experience within 2 weeks was reported by 57%. Over 80% of the population over 35 years old complained of pain. High prevalence of injury, lifetime experience of OPV-related injury and pain complaints are related to the level of exposure to OPV and human rights violations. A financial burden was imposed on families with an injured person. A geographical variation was revealed regarding reports of torture and lifetime experience of violence-related injury. A combination of individual, relational, community and societal factors, including variables such as political party affiliation, conflict with other families, household income and residential area, affected the risk of victimisation in the household. The odds ratio for reporting extrajudicial execution of a family member was 9.22 for Awami League supporters, 9.15 for Bangladesh Nationalist Party supporters; and 3.97 for Jamaat-e-Islami Party supporters compared with families with no political involvement. Conclusion The level of violence and human rights violations is high. The affected population suffers from violence-related injuries and traumas, which could be a factor contributing to poverty. Victimisation is not random. PMID:19930589

Survivors of the war in the Northern Kosovo: violence exposure, risk factors and public health effects of an ethnic conflict

PubMed Central

2010-01-01

Background The aim of this population-based study was to assess the long-lasting effects of ethnic conflict on health and well-being (with a focus on injury and persistent pain) at family and community level. We have also investigated possible risk factors for victimisation during the conflict and factors contributing to healing. Methods We conducted a district-level cross-sectional cluster survey of 1,115 households with a population of 6,845. Interviews were carried out in Mitrovicë district in Northern Kosovo from September to October 2008, using standardised questionnaire to collect lifetime violence exposure, lifestyle factors and health information on individual and household. Results Ethnic Albanians made up 95% of the sample population. Crude mortality and under-five mortality rate was not high in 2008. Over 90% of families had been exposed to at least two categories of violence and human rights violations, and 493 individuals from 341 families reported torture experiences. During the two weeks before the survey, 20% of individuals had suffered physical or mental pain. There were differences in pain complaints according to gender and age, and whether people had been injured within 12 months, had lifetime exposure to violence-related injury, or had been tortured. Patterns of social and political participation in a family could affect the proportion of family members complaining of pain. The proportion of family members with pain complaints was related to a decline in the household income (coef = 9.31, 95% CI = 6.16-12.46, P < 0.001) and the fact of borrowing money (coef = 6.11, 95% CI = 2.91-9.30, P < 0.001) because of an injured person in the household. Families that were affiliated with the Kosovo Liberation Army, or had participated in a protest before or during the war, were likely to be targeted by Serbian paramilitary and law enforcement agencies. Conclusions Mitrovicë district is currently characterised by a low level of violence, but the effects of ethnic conflict on health and well-being have not gone. The level of lifetime exposure to violence, the proportion of family members reporting pain and lifetime violence-related injury, and family's financial burden were found to be inter-correlated. The sample confined to one ethnic group in one district limits the generalizability of the findings. PMID:20509915

Household exposure to violence and human rights violations in western Bangladesh (II): history of torture and other traumatic experience of violence and functional assessment of victims

PubMed Central

2009-01-01

Background Organised crime and political violence (OPV) and human rights violations have marred Bangladesh history since 1971. Little is known about the consequences for the oppressed population. This study describes the patterns of OPV and human rights violations in a disturbed area of Bangladesh and assesses the physical, emotional and social functioning of victims. Methods A total of 236 of selected participants in a household survey in Meherpur district were recruited for a detailed study. Interviews and physical examinations were used to obtain information about history of torture and other cruel, inhuman or degrading treatment or punishment (TCIDTP), and about injuries, pain frequency and intensity. Handgrip strength and standing balance performance were measured. The "WHO-5 Well-being" scale was used to assess the subjective emotional well-being of study participants. Results The majority of the reported cases of TCIDTP occurred in 2000-2008, 51% of incidents occurred during winter; 32.0% between 20:00 and midnight. Police involvement was reported in 75% of cases. Incidents took place at victims' homes (46.7%), or at the police station, military camp, in custody or in prison (21.9%). Participants experienced 1-10 TCIDTP methods and reported 0-6 injury locations on their bodies; 77.5% reported having at least two injuries. Less than half of the participants were able to stand on one leg for 30 seconds. Only 7.5% of males aged 25-44 had handgrip strength in both hands exceeding average values for healthy people at the same age. Over 85% of participants scored low (<13) on the 25-point "WHO-5 Well-being" scale. The number of years since the TCIDTP event, pain frequency, the need to quit a job to take care of an injured family member, political involvement, personal conflicts and the fear of neighbourhood violence strongly affected emotional well-being. Good emotional well-being correlated with increased political and social participation. Conclusion A detailed picture of characteristics of the victimisation is presented. The participants showed poor emotional well-being and reduced physical capacity. The results indicated that the simple and rapid method of assessment used here is a promising tool that could be used to monitor the quality and outcome of rehabilitation. PMID:19943932

[Preventive human rights monitoring in child and adolescent psychiatry and welfare institutions].

PubMed

Berger, Ernst; Paar, Caroline

2017-09-01

Since 1 July 2012 the Austrian Ombudsman Board (AOB) together with its six regional expert commissions form the so called "National Prevention Mechanism" implementing the UN Optional Protocol to the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (OPCAT). The commissions are mandated to conduct regular, unrestricted and unannounced visits to all types of places in which there is or can be a deprivation or restriction of personal liberty, such as prisons, police stations, but also psychiatric hospitals or residential homes/groups for children and juveniles supervised by youth welfare services. 20 monitoring visits have been held in departments for Child- and Adolescent Psychiatry between 2012 and 2016. In the field of residential groups for young people 40 visiting protocols (out of a total of 176 between 2015 and 2016) have been chosen for this analysis. The following article overviews the legal sources and key issues of the monitoring process in this field as well as the commissions' findings and recommendations.

Dangerous journey: documenting the experience of Tibetan refugees.

PubMed

Dolma, Sonam; Singh, Sonal; Lohfeld, Lynne; Orbinski, James J; Mills, Edward J

2006-11-01

Since the 1950 invasion of Tibet by China, Tibetan refugees have attempted to flee into Nepal over the Himalayan mountains. We documented the experiences of a group of refugees making this journey. We conducted semistructured interviews with 50 recent refugees at the Tibetan Refugee Transit Centre in Kathmandu, Nepal. Participants ranged in age from 8 to 56 years, and 21 were female. The average length of their journey from Tibet to Nepal was 34 days. During their journey, a majority of the refugees encountered authorities or became involved in altercations with Nepali Maoist groups. Most of these interactions resulted in extortion and threats of expulsion. Several Tibetans were tortured, beaten with weapons, threatened with being shot, and robbed. Three women were sexually assaulted at gunpoint. The refugees who took part in this study experienced physical and mental hardships and, often, human rights abuses on their journey to Nepal. International pressure is needed to prevent human rights violations and reduce potential long-term physical and mental health effects associated with this dangerous crossing.

The moral ties that bind . . . Even to out-groups: the interactive effect of moral identity and the binding moral foundations.

PubMed

Smith, Isaac H; Aquino, Karl; Koleva, Spassena; Graham, Jesse

2014-08-01

Throughout history, principles such as obedience, loyalty, and purity have been instrumental in binding people together and helping them thrive as groups, tribes, and nations. However, these same principles have also led to in-group favoritism, war, and even genocide. Does adhering to the binding moral foundations that underlie such principles unavoidably lead to the derogation of out-group members? We demonstrated that for people with a strong moral identity, the answer is "no," because they are more likely than those with a weak moral identity to extend moral concern to people belonging to a perceived out-group. Across three studies, strongly endorsing the binding moral foundations indeed predicted support for the torture of out-group members (Studies 1a and 1b) and withholding of necessary help from out-group members (Study 2), but this relationship was attenuated among participants who also had a strong moral identity. © The Author(s) 2014.

Self-hypnosis training and captivity survival.

PubMed

Wood, D P; Sexton, J L

1997-01-01

In February and March, 1973, 566 U.S. military prisoners (POWs) were released from North Vietnam. These men had been POWs for a period of time between 2 months and 9 years, with a mean incarceration of 4.44 years. They had faced physical and psychological stress similar to that experienced by POWs from previous wars: starvation, disease, inadequate shelter, lack of medical care, interrogations and torture (Deaton, Burge, Richlin & Latrownik, 1977; Mitchell, 1991). By definition, such prison conditions constituted a traumatic experience (Deaton et al., 1977). However, a unique stress for our POWs in North Vietnam was the additional trauma of solitary confinement. This paper reviews the coping and "time killing" activities of U.S. Navy Vietnam POWs who experienced solitary confinement and tortuous interrogation. This paper also reports the physical and psychological adjustment of our POWs following their release from captivity. Suggestions are made regarding the revision of the curriculum for captivity survival training programs such as Survival, Evasion, Resistance, and Escape (SERE) school.

Satanism, ritual abuse, and multiple personality disorder: a sociohistorical perspective.

PubMed

Mulhern, S

1994-10-01

During the past decade in North America, a growing number of mental health professionals have reported that between 25% and 50% of their patients in treatment for multiple personality disorder (MPD) have recovered early childhood traumatic memories of ritual torture, incestuous rape, sexual debauchery, sacrificial murder, infanticide, and cannibalism perpetrated by members of clandestine satanic cults. Although hundreds of local and federal police investigations have failed to corroborate patients' therapeutically constructed accounts, because the satanic etiology of MPD is logically coherent with the neodissociative, traumatic theory of psychopathology, conspiracy theory has emerged as the nucleus of a consistent pattern of contemporary clinical interpretation. Resolutely logical and thoroughly operational, ultrascientific psychodemonology remains paradoxically oblivious to its own irrational premises. When the hermetic logic of conspiracy theory is stripped away by historical and socio/psychological analysis, however, the hypothetical perpetrators of satanic ritual abuse simply disappear, leaving in their wake the very real human suffering of all those who have been caught up in the social delusion.

Insects as weapons of war, terror, and torture.

PubMed

Lockwood, Jeffrey A

2012-01-01

For thousands of years insects have been incorporated into human conflict, with the goals of inflicting pain, destroying food, and transmitting pathogens. Early methods used insects as "found" weapons, functioning as tactical arms (e.g., hurled nests) or in strategic habitats (e.g., mosquito-infested swamps). In the twentieth century the relationship between insects and disease was exploited; vectors were mass-produced to efficiently deliver pathogens to an enemy. The two most sophisticated programs were those of the Japanese in World War II with plague-infected fleas and cholera-coated flies and of the Americans during the Cold War with yellow fever-infected mosquitoes. With continued advances, defenses in the form of insecticides and vaccines meant that insects were no longer considered as battlefield weapons. However, in recent times sociopolitical changes have put insects back into the realm of human conflict through asymmetrical conflicts pitting combatants from nonindustrialized regions against forces from militarily and economically superior nations. Copyright © 2012 by Annual Reviews. All rights reserved.

Narrative constructions of historical realities in testimony with Bosnian survivors of "ethnic cleansing".

PubMed

Weine, S; Laub, D

1995-08-01

Mental health care for traumatized refugees includes practices common to mainstream mental health care but also modifications and innovations in technique and approach. One such innovation, the testimony method, was first described by a group of Chilean psychiatrists working with Chilean survivors of torture from political repression (Cienfuego and Monelli 1983). The testimony method has been used as a time-limited psychotherapeutic intervention, often within the context of an extended, supportive psychotherapy. This method consists of asking individuals to tell in detail the story of their experiences of victimization from state-sponsored violence and recording their narrative accounts verbatim. Agger and Jensen's account of this method depicts testimony as a universal practice, appearing in multiple cultures and at different points in history (Agger and Jensen 1990). They also note that testimony simultaneously functions in both the private and public domains; and as confession embodying the person's spiritual, ethical, aesthetic, and philosophical values, and as evidence documenting the occurrence of evil events to the world.

Angels and demons are among us: assessing individual differences in belief in pure evil and belief in pure good.

PubMed

Webster, Russell J; Saucier, Donald A

2013-11-01

We conducted five studies to demonstrate that individuals' beliefs in pure evil (BPE) and in pure good (BPG) are valid and important psychological constructs. First, these studies together demonstrated that BPE and BPG are reliable, unitary, and stable constructs each composed of eight theoretically interdependent dimensions. Second, these studies showed that across a wide variety of different measures, higher BPE consistently related to greater intergroup aggression (e.g., supporting the death penalty and preemptive military aggression) and less intergroup prosociality (e.g., opposing criminal rehabilitation, proracial policies, and beneficial social programs), while higher BPG consistently related to less intergroup aggression (e.g., opposing proviolent foreign relations and torture) and greater intergroup prosociality (e.g., supporting criminal rehabilitation and support for diplomacy). In sum, these studies evidence that BPE and BPG relate to aggressive and prosocial orientations toward others and have strong potential to advance current theories on prejudice, aggression, and prosociality.

Later life disability status following incarceration as a prisoner of war.

PubMed

Hunt, Stephen C; Orsborn, Mack; Checkoway, Harvey; Biggs, Mary L; McFall, Miles; Takaro, Tim K

2008-07-01

Incarceration-related predictors of later life disability in former prisoners of war (POWs) have not been previously described. The objective of this project was to identify aspects of POW incarceration which are associated with later life disability status. Cross-sectional retrospective study of 328 former U.S. military personnel held as POWs (World War II and Korean and Vietnam Wars) who presented for evaluations at a Veterans Affairs medical center between January 1, 1997 and December 31, 2004 outcome measures were: (1) total number of later life disability conditions attributable to incarceration and (2) cumulative percentage later life disability attributable to these conditions. We found significant associations between later life disability and POW experiences, including experiencing or witnessing torture, solitary confinement, forced marches, dysentry, pellagra, vitamin deficiencies, scabies, depression, and suicidal thoughts. Conditions of captivity and health concerns or emotional distress during captivity may contribute to long-term adverse health outcomes as measured by later life disabilities in individuals incarcerated as POWs.

Representations of nurses and individuals in psychological distress in the photographic exhibit USAnatomy, by Steven Klein.

PubMed

Carvalho, Evanilda Souza de Santana; Araújo, Edna Maria de; Santos, Silvone Santa Bárbara da Silva; Santos, Alexandro Gesner Gomes Dos

2016-06-01

Objectives To analyze the representations of the nurse and individual in mental suffering portrayed in the photographic work by Steven Klein, in the USAnatomy exhibit held at the Museum of Sculpture (Museu da escultura) in São Paulo, in 2011. Methods Qualitative study carried out in 2012. Three photographs were submitted to iconographic analysis. The interpretation of the findings was based on theoretical frameworks of Foucault and Bourdieu on power relations. Results The nurse is represented as a sensual, insensitive person, with the power to control and torture while the person in psychological distress is represented as dirty, imprisoned and subjected to an asymmetrical relationship of power with the nurse. Final considerations Relationships of submission and symbolic dominance, in which the person in psychological distress has their body molded by discipline imposed by the nurse. Stereotypes of the image of the nurse oppose the ideology of the profession, which is to ensure the integrity of those being cared for.

Childhood lead poisoning: the torturous path from science to policy

PubMed Central

Bellinger, David C.; Bellinger, Andrew M.

2006-01-01

The long history of lead poisoning provides many lessons about the process by which scientific knowledge is translated into public health policy. In the United States, lead was added to paint and to gasoline in enormous quantities long after medical evidence clearly showed that excessive lead exposure caused considerable morbidity in the population. This article discusses some of the factors that contributed to the slow pace of efforts to address this problem, including the ubiquity and magnitude of lead exposure during much of the twentieth century, which produced a distorted notion about the blood lead level that can be considered “normal”; the prevailing model of disease during this period, notably the novelty of the concept of subclinical disease; the fact that childhood lead poisoning affected mostly families that were politically and economically disenfranchised, fostering a “blame the victim” attitude; and that controlling lead exposure would have impeded efforts to achieve other desirable goals, illustrating the role that value trade-offs often play in policy decisions. PMID:16585952

Caring for Refugee Youth in the School Setting.

PubMed

Johnson, Jennifer Leigh; Beard, Joyce; Evans, Dena

2017-03-01

Annually, over 80,000 refugees enter the United States as a result of political or religious persecution. Of these, approximately 35% to 40% are children and adolescents. Refugees are faced with challenges associated with living conditions, cultural and social norms, and socioeconomic status due to problems occurring in their homelands. These challenges include but are not limited to malnutrition, communicable disease, questionable immunization status, lack of formal education, sexual abuse, violence, torture, human trafficking, homelessness, poverty, and a lack of access to health care. Moreover, the psychological impact of relocation and the stress of acculturation may perpetuate many of these existing challenges, particularly for refugee youth, with limited or underdeveloped coping skills. School nurses are uniquely poised to support refugee youth in the transition process, improve overall health, and facilitate access to primary health services. The purpose of this article is to provide an overview of the unique refugee experience, examine the key health care needs of the population, and present school nurses with timely and relevant resources to assist in caring for refugee youth.

[A range of mobbing among female and male nurses employed in the Szczecin hospitals].

PubMed

Kunecka, Danuta; Kamińska, Magdalena; Karakiewicz, Beata

2008-01-01

Workplace mobbing, a particular type of conflict, has recently been recognized as one of the factors of occupational hazard, resulting from the social environment. Health service workers belong to occupational groups, which are particularly exposed to mobbing. Moreover, changes in the structure of medical labor market make that nurses often work under strong pressure and thus the phenomenon of mobbing becomes even more intensified. The aim of this study was to analyze the incidence of mobbing in the nursing stuff employed in the Szczecin hospitals. The method of diagnostic poll was based on a questionnaire, developed and distributed among 1578 respondents employed in hospitals in Szczecin. Of this number, 1261 correctly completed questionnaires were statistically analyzed. The results showed that the phenomenon of mobbing is actually common in the nursing occupational group (18.6%). The majority (40%) of respondents indicated a superior as a mobber (torturer). The high incidence of mobbing observed in the nursing occupational group may evidence that Human Resource Management (HRM) processes are not perfect.

Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies.

PubMed

Schuklenk, Udo; Smalling, Ricardo

2017-04-01

We describe a number of conscientious objection cases in a liberal Western democracy. These cases strongly suggest that the typical conscientious objector does not object to unreasonable, controversial professional services-involving torture, for instance-but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive. We analyse the conflict between these patients' access rights and the conscientious objection accommodation demanded by monopoly providers of such healthcare services. It is implausible that professionals who voluntarily join a profession should be endowed with a legal claim not to provide services that are within the scope of the profession's practice and that society expects them to provide. We discuss common counterarguments to this view and reject all of them. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Gross human rights violations and reparation under international law: approaching rehabilitation as a form of reparation.

PubMed

Sveaass, Nora

2013-01-01

The strengthening of international criminal law through an increased focus on the right to reparation and rehabilitation for victims of crimes against humanity represents an important challenge to health professionals, particularly to those in the field of trauma research and treatment. A brief outline of some developments in the field of international law and justice for victims of gross human rights violations is presented, with a focus on the right to reparation including the means for rehabilitation. The fulfillment of this right is a complex endeavor which raises many questions. The road to justice and reparation for those whose rights have been brutally violated is long and burdensome. The active presence of trauma-informed health professionals in this process is a priority. Some of the issues raised within the context of states' obligations to provide and ensure redress and rehabilitation to those subjected to torture and gross human rights violations are discussed, and in particular how rehabilitation can be understood and responded to by health professionals.

Deliberate Rumination and Positive Reappraisal as Serial Mediators Between Life Impact and Posttraumatic Growth in Victims of State Terrorism in Chile (1973-1990).

PubMed

Cárdenas Castro, Manuel; Arnoso Martínez, Maitane; Faúndez Abarca, Ximena

2016-04-06

This study examines the role of coping strategies related to positive reappraisal versus other cognitive strategies (deliberate rumination) as mediators between life impact and posttraumatic growth in survivors of the military dictatorship in Chile between 1973 and 1990 (tortured political prisoners and family members of political prisoners executed and missing). Survey data from 251 political violence survivors were analyzed using the SPSS PROCESS macro for bootstrapping indirect effects (Hayes, 2013). Results indicated that positive reappraisal (or reframing) coping mediated the relationship between life impact and posttraumatic growth. A serial multiple mediation model indicates that in the life impact to growth moderation process, rumination must be followed by positive reappraisal to drive this growth. These findings suggest that positive reappraisal of the traumatic experience is essential to achieve growth reports. Implications of these more complex relations are discussed for both counseling interventions and further research. © The Author(s) 2016.

Developing Market Opportunities for Flexible Rooftop Applications of PV Using Flexible CIGS Technology: Market Considerations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sabnani, L.; Skumanich, A.; Ryabova, E.

There has been a recent upsurge in developments for building-integrated phototovoltaics (BiPV) roof top materials based on CIGS. Several new companies have increased their presence and are looking to bring products to market for this application in 2011. For roof-top application, there are significant key requirements beyond just having good conversion efficiency. Other attributes include lightweight, as well as moisture-proof, and fully functionally reliable. The companies bringing these new BIPV/BAPV products need to ensure functionality with a rigorous series of tests, and have an extensive set of 'torture' tests to validate the capability. There is a convergence of form, aesthetics,more » and physics to ensure that the CIGS BiPV deliver on their promises. This article will cover the developments in this segment of the BiPV market and delve into the specific tests and measurements needed to characterize the products. The potential market sizes are evaluated and the technical considerations developed.« less

"In the Sport I Am Here": Therapeutic Processes and Health Effects of Sport and Exercise on PTSD.

PubMed

Ley, Clemens; Rato Barrio, María; Koch, Andreas

2018-02-01

Current evidence suggests positive effects of exercise on posttraumatic stress symptoms; however, knowledge about how these effects are achieved is limited. Thus, this study aims to contribute to a more holistic understanding of these effects. We performed a single case study of a war and torture survivor, who was diagnosed with posttraumatic stress disorder (PTSD) and depression, and who was participant of the sport and exercise therapy program Movi Kune. Participant observation was conducted as well as semi-structured interviews with the participant and his psychotherapist. Data analysis resulted in the proposal of different processes: The focus on bodily sensations related to an exposure effect, contributing to improvements in body awareness, coping behavior, and affect regulation, whereas the focus on playing related to an improved performance, presence, enjoyment, and mastery experiences, pointing toward distraction and motivational-restorative effects. The findings also advice to be cautious as participants may be exposed to negative sensations and trauma-related triggers.

“In the Sport I Am Here”: Therapeutic Processes and Health Effects of Sport and Exercise on PTSD

PubMed Central

Rato Barrio, María; Koch, Andreas

2017-01-01

Current evidence suggests positive effects of exercise on posttraumatic stress symptoms; however, knowledge about how these effects are achieved is limited. Thus, this study aims to contribute to a more holistic understanding of these effects. We performed a single case study of a war and torture survivor, who was diagnosed with posttraumatic stress disorder (PTSD) and depression, and who was participant of the sport and exercise therapy program Movi Kune. Participant observation was conducted as well as semi-structured interviews with the participant and his psychotherapist. Data analysis resulted in the proposal of different processes: The focus on bodily sensations related to an exposure effect, contributing to improvements in body awareness, coping behavior, and affect regulation, whereas the focus on playing related to an improved performance, presence, enjoyment, and mastery experiences, pointing toward distraction and motivational-restorative effects. The findings also advice to be cautious as participants may be exposed to negative sensations and trauma-related triggers. PMID:29199529

Epidermal changes in heat and electrically injured pig skin: a light microscopic study of the sequences in morphology.

PubMed

Thomsen, H K; Danielsen, L; Nielsen, O; Aalund, O; Nielsen, K G; Karlsmark, T; Genefke, I K

1982-09-01

Biopsies were obtained from heat and electrically exposed pig skin at different at different times after exposure, in order to describe the morphological sequences in heat and electrically injured skin. The work is part of a series of studies in which it is investigated whether morphological methods can be used in disclosing electrical torture. Epidermal changes in heat lesions differed from those of electrical lesions in all experiments. Heat lesions typically showed a detached epidermis with fibrillar or granular cytoplasm. In older lesions the epidermis appeared concrete. Electrical lesions showed an attached epidermis with small defects, a white, homogeneous cytoplasm, vesicular nuclei and curled, clumped keratin. The electrical lesions were rejected at day 4 or 5. The number of characteristic morphological changes in epidermis decreased with the age of the lesions. It is concluded that epidermal electrical lesions differ in morphology from heat lesions and that it is possible to evaluate the age of the lesions.

Development of “-omics” research in Schistosoma spp. and -omics-based new diagnostic tools for schistosomiasis

PubMed Central

Wang, Shuqi; Hu, Wei

2014-01-01

Schistosomiasis, caused by dioecious flatworms in the genus Schistosoma, is torturing people from many developing countries nowadays and frequently leads to severe morbidity and mortality of the patients. Praziquantel based chemotherapy and morbidity control for this disease adopted currently necessitate viable and efficient diagnostic technologies. Fortunately, those “-omics” researches, which rely on high-throughput experimental technologies to produce massive amounts of informative data, have substantially contributed to the exploitation and innovation of diagnostic tools of schistosomiasis. In its first section, this review provides a concise conclusion on the progresses pertaining to schistosomal “-omics” researches to date, followed by a comprehensive section on the diagnostic methods of schistosomiasis, especially those innovative ones based on the detection of antibodies, antigens, nucleic acids, and metabolites with a focus on those achievements inspired by “-omics” researches. Finally, suggestions about the design of future diagnostic tools of schistosomiasis are proposed, in order to better harness those data produced by “-omics” studies. PMID:25018752

Sleep Deprivation Attack Detection in Wireless Sensor Network

NASA Astrophysics Data System (ADS)

Bhattasali, Tapalina; Chaki, Rituparna; Sanyal, Sugata

2012-02-01

Deployment of sensor network in hostile environment makes it mainly vulnerable to battery drainage attacks because it is impossible to recharge or replace the battery power of sensor nodes. Among different types of security threats, low power sensor nodes are immensely affected by the attacks which cause random drainage of the energy level of sensors, leading to death of the nodes. The most dangerous type of attack in this category is sleep deprivation, where target of the intruder is to maximize the power consumption of sensor nodes, so that their lifetime is minimized. Most of the existing works on sleep deprivation attack detection involve a lot of overhead, leading to poor throughput. The need of the day is to design a model for detecting intrusions accurately in an energy efficient manner. This paper proposes a hierarchical framework based on distributed collaborative mechanism for detecting sleep deprivation torture in wireless sensor network efficiently. Proposed model uses anomaly detection technique in two steps to reduce the probability of false intrusion.

Data-driven methods towards learning the highly nonlinear inverse kinematics of tendon-driven surgical manipulators.

PubMed

Xu, Wenjun; Chen, Jie; Lau, Henry Y K; Ren, Hongliang

2017-09-01

Accurate motion control of flexible surgical manipulators is crucial in tissue manipulation tasks. The tendon-driven serpentine manipulator (TSM) is one of the most widely adopted flexible mechanisms in minimally invasive surgery because of its enhanced maneuverability in torturous environments. TSM, however, exhibits high nonlinearities and conventional analytical kinematics model is insufficient to achieve high accuracy. To account for the system nonlinearities, we applied a data driven approach to encode the system inverse kinematics. Three regression methods: extreme learning machine (ELM), Gaussian mixture regression (GMR) and K-nearest neighbors regression (KNNR) were implemented to learn a nonlinear mapping from the robot 3D position states to the control inputs. The performance of the three algorithms was evaluated both in simulation and physical trajectory tracking experiments. KNNR performed the best in the tracking experiments, with the lowest RMSE of 2.1275 mm. The proposed inverse kinematics learning methods provide an alternative and efficient way to accurately model the tendon driven flexible manipulator. Copyright © 2016 John Wiley & Sons, Ltd.

Medical Approach to the Management of Traumatized Refugees.

PubMed

Kinzie, J David

2016-03-01

Refugees are a highly traumatized and culturally diverse group of patients who present many clinical challenges. Refugees have a high prevalence of traumas from torture, ethnic cleansing, and the effects of long civil wars. The most common diagnoses associated with the effects of such traumas are posttraumatic stress disorder (PTSD) or PTSD with comorbid depression; however, psychosis and neurocognitive disorders are also common. For those with PTSD, a suggested treatment approach is long-term supportive psychotherapy with drug treatment directed at reducing the most disruptive symptoms, such as insomnia, nightmares, and irritability or psychosis. The author recommends a sedative tricyclic antidepressant, clonidine or prazosin, and aripiprazole as a useful combination of medications to provide rapid relief. In addition to PTSD, long-term studies indicate a high prevalence of diabetes and hypertension in traumatized refugees. It is therefore important to perform a thorough evaluation for these disorders that includes the measurement of blood pressure and a blood test for diabetes. When managed with such a medical approach, refugees are generally accepting of psychiatric treatment and can obtain relief from the symptoms associated with the massive trauma and losses they have experienced.

"A day in my life" photography project: the silent voice of pediatric bone marrow transplant patients.

PubMed

Breitwieser, Carrie L; Vaughn, Lisa M

2014-01-01

A photovoice project was conducted with pediatric bone marrow transplant (BMT) patients to examine their coping skills and interpretation of their experience during a BMT, especially when hospitalized. We also wanted to determine how photovoice could be used within a pediatric BMT unit. Sixteen children (ages 4-14) and 2 young adults (ages 22 and 25) from a pediatric BMT unit participated in the project. Six BMT outpatients participated in the data analysis and evaluation phase. Fourteen clinical staff evaluated the impact of the project on their practice. Three primary themes emerged from the pre- and post-BMT photos, accompanying detailed notes, and BMT outpatient analysis of the photos: (a) BMT is "torture," (b) BMT is "time slipping away," and (c) BMT requires normalization, comfort, distraction, and support. BMT patients and staff concluded that photovoice helped express and release emotions regarding the challenges of BMT. BMT staff noted that the results of this project reminded them of the importance of being patient-centered and mindful of patient experience and the therapeutic relationship. © 2014 by Association of Pediatric Hematology/Oncology Nurses.

Primary Care for Refugees: Challenges and Opportunities.

PubMed

Mishori, Ranit; Aleinikoff, Shoshana; Davis, Dawn

2017-07-15

Since 1975, more than 3 million refugees have settled in the United States, fleeing unrest, conflict, and persecution. Refugees represent diverse ethnic, cultural, religious, socioeconomic, and educational backgrounds. Despite this heterogeneity, there are commonalities in the refugee experience. Before resettlement, all refugees must undergo an overseas medical screening to detect conditions that pose a potential health threat in the United States. On arrival, they should undergo an examination to detect diseases with high prevalence in their country of origin or departure. Refugees have higher rates of chronic pain compared with the general population, and their mental health and wellbeing are strongly influenced by their migration history. Refugees have higher rates of mood disorders, posttraumatic stress disorder, and anxiety than the general population. Some refugees have been tortured, which contributes to poorer health. Chronic noncommunicable diseases, such as diabetes mellitus and hypertension, are also prevalent among refugees. Many refugees may be missing routine immunizations and screenings for cancer and chronic diseases. Attention to reproductive health, oral health, and vision care will help identify and address previously unmet needs. Refugees face barriers to care as a result of cultural, language, and socioeconomic factors.

Elusive retributive justice in post-Khmer Rouge Cambodia: Challenges of using ECCC Victim Information Forms as a victim participatory rights mechanism.

PubMed

Nou, Leakhena

2015-01-01

This paper focuses on the procedural challenges of using the Victim Information Forms (VIFs) to analyze survivors' experiences with the Extraordinary Chambers in the Courts of Cambodia (ECCC), commonly known as the Khmer Rouge Tribunal. The paper takes a systematic public/medical sociology approach to examining the VIF as a participatory rights mechanism for victims wishing to pursue justice for themselves and their loved ones who experienced the Khmer Rouge atrocities, torture, forced relocation, starvation, forced labor, rape, robbery, and other physical and psychological torment, firsthand. It provides the first comparative, critical analysis of both the original VIF and the revised form issued midway through the submission period; both forms appear as appendices to the paper. Conclusions are drawn and suggestions made by the researcher based on the firsthand collection and submission of the largest group of VIFs from any single source around the world (outside of Cambodia itself), as well as on support work with victims/survivors during the ECCC proceedings in Phnom Penh, Cambodia in 2013.

Reducing involuntary memory by interfering consolidation of stressful auditory information: A pilot study.

PubMed

Tabrizi, Fara; Jansson, Billy

2016-03-01

Intrusive emotional memories were induced by aversive auditory stimuli and modulated with cognitive tasks performed post-encoding (i.e., during consolidation). A between-subjects design was used with four conditions; three consolidation-interference tasks (a visuospatial and two verbal interference tasks) and a no-task control condition. Forty-one participants listened to a soundtrack depicting traumatic scenes (e.g., police brutality, torture and rape). Immediately after listening to the soundtrack, the subjects completed a randomly assigned task for 10 min. Intrusions from the soundtrack were reported in a diary during the following seven-day period. In line with a modality-specific approach to intrusion modulation, auditory intrusions were reduced by verbal tasks compared to both a no-task and a visuospatial interference task.. The study did not control for individual differences in imagery ability which may be a feature in intrusion development. The results provide an increased understanding of how intrusive mental images can be modulated which may have implications for preventive treatment.. Copyright © 2015 Elsevier Ltd. All rights reserved.

A Population-Based Assessment of Human Rights Abuses Committed Against Ethnic Albanian Refugees From Kosovo

PubMed Central

Iacopino, Vincent; Frank, Martina W.; Bauer, Heidi M.; Keller, Allen S.; Fink, Sheri L.; Ford, Doug; Pallin, Daniel J.; Waldman, Ronald

2001-01-01

Objectives. This study assessed patterns of displacement and human rights abuses among Kosovar refugees in Macedonia and Albania. Methods. Between April 19 and May 3, 1999, 1180 ethnic Albanian refugees living in 31 refugee camps and collective centers in Macedonia and Albania were interviewed. Results. The majority (68%) of participants reported that their families were directly expelled from their homes by Serb forces. Overall, 50% of participants saw Serb police or soldiers burning the houses of others, 16% saw Serb police or soldiers burn their own home, and 14% witnessed Serb police or soldiers killing someone. Large percentages of participants saw destroyed mosques, schools, or medical facilities. Thirty-one percent of respondents reported human rights abuses committed against their household members, including beatings, killings, torture, forced separation and disappearances, gunshot wounds, and sexual assault. Conclusions. The present findings confirm that Serb forces engaged in a systematic and brutal campaign to forcibly expel the ethnic Albanian population of Kosovo. In the course of these mass deportations, Serb forces committed widespread abuses of human rights against ethnic Albanians. PMID:11726386

The violence of poverty victimizes children.

PubMed

Jailer, T

1999-01-01

While war, torture, and sexual violence threaten children's health, poverty is the most dangerous and widespread threat to children. However, while societies may react strongly to the most apparent forms and instances of violence against children, they fail to take the measures needed to effectively reduce the prevailing levels of poverty afflicting the world's children. For example, in 1998, the global starvation rate among children reached its 600-year peak; in Africa, 15% of children die before reaching age 5 years; and 200 million children under age 5 years are malnourished, with half of all deaths in that age group due to malnutrition. Lack of water, clothing, shelter, food, or medicine causes about 16.5 million deaths annually. Furthermore, current global military spending has reached $781 billion/year, more than the total income of the poorest 45% of the global population, while current annual world spending on education is only $80 billion. The world is becoming an increasingly hostile place for most people, but especially for children. Yet, as global economic and political conditions increasingly endanger children and their families, young people seem to be noticed only as certain kinds of problems.

Anxiety, depression and PTSD in asylum-seekers: assocations with pre-migration trauma and post-migration stressors.

PubMed

Silove, D; Sinnerbrink, I; Field, A; Manicavasagar, V; Steel, Z

1997-04-01

Research into the mental health of refugees has burgeoned in recent times, but there is a dearth of studies focusing specifically on the factors associated with psychiatric distress in asylum-seekers who have not been accorded residency status. Forty consecutive asylum-seekers attending a community resource centre in Sydney, Australia, were interviewed using structured instruments and questionnaires. Anxiety scores were associated with female gender, poverty, and conflict with immigration officials, while loneliness and boredom were linked with both anxiety and depression. Thirty subjects (79%) had experienced a traumatic event such as witnessing killings, being assaulted, or suffering torture and captivity, and 14 subjects (37%) met full criteria for PTSD. A diagnosis of PTSD was associated with greater exposure to pre-migration trauma, delays in processing refugee applications, difficulties in dealing with immigration officials, obstacles to employment, racial discrimination, and loneliness and boredom. Although based on correlational data derived from'a convenient' sample, our findings raise the possibility that current procedures for dealing with asylum-seekers may contribute to high levels of stress and psychiatric symptoms in those who have been previously traumatised.

Music and 're-education' in Greek prison camps: from Makronisos (1947-1955) to Giaros (1967-1968).

PubMed

Papaeti, Anna

2013-01-01

This paper examines the policy of 're-education' for left-wing political prisoners in Greece during the military Junta (1967-1974) at the prison camp on the island of Giaros from 1967 to November 1968. Taking as its starting point the ways folk culture was used to substantiate the Colonels' ideological discourse and to give their rule aesthetic roots as a strategy of legitimization, the paper investigates how this kind of music was instrumentalized as a way of breaking political prisoners in exile. Music from loudspeakers was part of an attempt to make detainees sign Declarations of Loyalty, renouncing their values and their comrades. The 're-education' programme of Giaros is examined here as a remainder of the Greek Civil-War legacy (1946-1949), and particularly of the institutionalized 're-education' and 'rehabilitation' programme of the infamous prison camps on the island of Makronisos (1947-1955). Interviews with former detainees from both historical periods underline the damaging effects of the use of music, highlighting the need to understand music's capacity to degrade, but also torture, individuals instead of uplift and ennoble the soul.

Genocide Rape Trauma: A Conceptual Framework for Understanding the Psychological Suffering of Rwandan Survivors.

PubMed

Mukamana, Donatilla; Collins, Anthony; Rosa, William E

2018-05-01

In 1994, the Rwandan genocide claimed the lives of approximately 1 million Tutsi and moderate Hutu citizens. Systematic rape was a strategic component of the Hutu extremist plan to eradicate the Tutsi minority population. This involved collective and repeated sexual assaults with brutal violence, public humiliation, and torture. This article maps the ongoing psychological impact on Rwandan genocide rape survivors and identifies implications for international nursing practice. The research formalizes their narratives, identifying a number of interconnected elements that combine to produce myriad forms of chronic psychological suffering in the Rwandan context. This work in turn reveals the specific needs of these survivors that may be addressed by nursing. It allows nurses, as experts in managing the human responses to health and illness, to develop a more complete understanding of psychological suffering as it pertains to vulnerable populations during and in the wake of extreme social conflict. This clarifies the roles of nurse educators, clinicians, and policy advocates as key agents in providing genocide rape survivors with the resources and expertise needed to effectively manage their ongoing trauma.

From Hohenschönhausen to Guantanamo Bay: Psychology's role in the secret services of the GDR and the United States.

PubMed

Michels, Moritz; Wieser, Martin

2018-01-01

This paper presents a historical analysis of the genesis, context, and function of "Operative Psychology," a little-known branch of applied psychology developed by employees of the Ministry of State Security in the German Democratic Republic. For 25 years, theories and practices of Operative Psychology were taught to elite agents at the Juridical Academy in Potsdam, introducing them to various "silent" psychological techniques of persuasion, interrogation, and repression. After highlighting the economic and political context that increased the need for "silent" techniques of observation and repression, an overview of the topics that were taught and researched at the chair for Operative Psychology is given. Examples of how these techniques were put into practice are provided and the consequences for the victims of Operative Psychology are discussed. Furthermore, commonalities and differences between Operative Psychology and the use of psychological torture by the CIA during the "war on terror" are discussed and questions regarding the relation between methodological and moral strategies of justification are addressed. © 2017 Wiley Periodicals, Inc.

Gross human rights violations and reparation under international law: approaching rehabilitation as a form of reparation

PubMed Central

Sveaass, Nora

2013-01-01

The strengthening of international criminal law through an increased focus on the right to reparation and rehabilitation for victims of crimes against humanity represents an important challenge to health professionals, particularly to those in the field of trauma research and treatment. A brief outline of some developments in the field of international law and justice for victims of gross human rights violations is presented, with a focus on the right to reparation including the means for rehabilitation. The fulfillment of this right is a complex endeavor which raises many questions. The road to justice and reparation for those whose rights have been brutally violated is long and burdensome. The active presence of trauma-informed health professionals in this process is a priority. Some of the issues raised within the context of states’ obligations to provide and ensure redress and rehabilitation to those subjected to torture and gross human rights violations are discussed, and in particular how rehabilitation can be understood and responded to by health professionals. PMID:23671765

Correlates of violence in Guinea's Maison Centrale Prison: a statistical approach to documenting human rights abuses.

PubMed

Osborn, Ronald E

2010-12-15

Les Mêmes Droits Pour Tous (MDT) is a human rights NGO in Guinea, West Africa that focuses on the rights of prisoners in Maison Centrale, the country's largest prison located in the capital city of Conakry. In 2007, MDT completed a survey of the prison population to assess basic legal and human rights conditions. This article uses statistical tools to explore MDT's survey results in greater depth, shedding light on human rights violations in Guinea. It contributes to human rights literature that argues for greater use of econometric tools in rights reporting, and demonstrates how human rights practitioners and academics can work together to construct an etiology of violence and torture by state actors, as physical violence is perhaps the most extreme violation of the individual's right to health. Copyright © 2010 Osborn. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

The molecular physiology of liver regeneration following partial hepatectomy.

PubMed

Mangnall, David; Bird, Nigel C; Majeed, Ali W

2003-04-01

The ability of the liver to regenerate after resection has been known for many years. Two reports from Germany in the late 1800s probably mark the introduction of the phenomenon into the scientific literature, but in the early 1900s the first reviews of this subject had appeared in the English literature. Predating these early scientific reports the legends from the Greek mythology described the fate of Prometheus. As punishment for defying Zeus and revealing the secret of fire to man, Prometheus was chained to a rock and each day had part of his liver ripped out by an eagle which, returning the following day, repeated the torture because his liver regenerated itself overnight. Although the speed of regeneration in the Greek legend is somewhat greater than that observed either clinically or in the laboratory, the myth does serve to emphasise the remarkable ability of the liver to repeatedly regenerate following repeated resections. This review aims to summarise the more recent literature concerning the early molecular events accompanying liver regeneration and to integrate this with the existing knowledge of this subject.

The application of the forensic sciences to human rights investigations.

PubMed

Kirschner, R H; Hannibal, K E

1994-01-01

Prior to the mid-1980's, human rights abuses were documented almost entirely through witness and victim testimony. In 1984-85, forensic scientists from the United States, working under the auspices of the American Association for the Advancement of Science, exhumed skeletal remains of disappeared persons in Argentina. They provided physical evidence for the trial of members of the deposed military junta and trained an Argentine forensic anthropology team. It became apparent that medical and forensic verification of torture and extrajudicial executions could provide irrefutable evidence that such activities had, in fact, taken place. Requests for assistance came from human rights groups throughout the world, and led to the development of an international protocol for the investigation of government sponsored murders. The United States based Physicians for Human Rights has now conducted missions to nearly 30 countries. The recent documentation of mass graves in El Salvador, Guatemala, Iraqi Kurdistan and the former Yugoslavia demonstrates how forensic scientists expose such crimes to international scrutiny, and the necessity of scientific evidence when confronting human rights violations.

[Criminology and victimology of rape in context with war-like conflicts using the example of the former Yugoslavia and Rwanda].

PubMed

Nittmann, Christian; Franke, Barbara; Augustin, Christa; Püschel, Klaus

2012-01-01

The topic of this article is sexual violence in context with war-like conflicts in the former Yugoslavia and Rwanda. The fundamental categories of sexual violence in war-like conflicts are described. The authors discuss the types of sexual violence as defined in the report of the UN Commission of Experts on the war-like conflicts in the former Yugoslavia. Four criminal trials were evaluated: three held before the International Criminal Tribunal for the Former Yugoslavia (ICTY) in The Hague/Netherlands and one before the International Criminal Tribunal for Rwanda (ICTR) in Arusha/Tansania. The defendants were found guilty of torture, crime against humanity and genocide. Potential procedures with respect to similar crimes in current or prospective conflicts are discussed. An alternative may be the assignment of medical personnel (for example of the German Federal Armed Forces). Finally, the post-war cooperation between the Institute of Legal Medicine at the University Medical Centre of Hamburg-Eppendorf as well as the medical and government institutions in Rwanda is presented, which has been going on since 2005.

Structural Competency in the U.S. Healthcare Crisis: Putting Social and Policy Interventions Into Clinical Practice.

PubMed

Hansen, H; Metzl, J

2016-06-01

This symposium of the Journal of Bioethical Inquiry illustrates structural competency: how clinical practitioners can intervene on social and institutional determinants of health. It will require training clinicians to see and act on structural barriers to health, to adapt imaginative structural approaches from fields outside of medicine, and to collaborate with disciplines and institutions outside of medicine. Case studies of effective work on all of these levels are presented in this volume. The contributors exemplify structural competency from many angles, from the implications of epigenetics for environmental intervention in personalized medicine to the ways clinicians can act on fundamental causes of disease, address abuses of power in clinical training, racially desegregate cities to reduce health disparities, address the systemic causes of torture by police, and implement harm-reduction programs for addiction in the face of punitive drug laws. Together, these contributors demonstrate the unique roles that clinicians can play in breaking systemic barriers to health and the benefit to the U.S. healthcare system of adopting innovations from outside of the United States and outside of clinical medicine.

Towards an epidemiology of political violence in the Third World.

PubMed

Zwi, A; Ugalde, A

1989-01-01

Political violence is distressingly widespread in many parts of the world. This paper reviews the forms and effects of political violence and devotes particular attention to experiences from Central America and Southern Africa. The forms of violence vary from those which are extensive such as civil unrest and war, to those which are intensive, such as assassinations, disappearances and torture. The effects of violence on health may be direct, such as deaths, disabilities, psychological stress and the destruction of health services, or indirect such as the erosion of innovative health policies in favour of increased military expenditure. Health workers have a role to play in opposing political violence, providing care for those affected by violence, and documenting and analysing its impact on health. Research needs include documenting the impact of different forms of violence on health, and analysing the social and political factors which promote and support political violence. It is hoped that increasing recognition of political violence and man-made violence as being of major public health concern will play a part in promoting a more peaceful world.

Sulphur and skin: from Satan to Saddam!

PubMed

Leslie, K S; Millington, G W M; Levell, N J

2004-04-01

Since the dawn of time, Beelzebub has been showering fire and brimstone (sulphur) on tortured souls, but the cutaneous effects of this have been poorly described. Sulphur has also been used for centuries as a treatment for many skin conditions, such as fungal infections, scabies, psoriasis, eczema and acne. It has also been used extensively in cosmetic preparations and by cosmetic dermatologists treating conditions such as seborrhoeic eczema. Many natural bathing spas have high levels of sulphur; such balneology has been advocated by medical and cosmetic dermatologists as an effective treatment for cutaneous disorders for more than 500 years. Sulphur was often the active agent in many of the so-called 'patent medicines' that became popular in the mid-nineteenth century. Time has not withered medical practitioners' enthusiasm for sulphur. There are various reports in the medical literature of its current use. However sulphur treatment is not without its risks; a sulphur spring dermatitis has been described from a spa bath in Taiwan. With the satanic threat of bio-terrorism, some dermatologists may be treating the effects of contact with sulphur mustard all too soon.

Attachment style and interpersonal trauma in refugees.

PubMed

Morina, Naser; Schnyder, Ulrich; Schick, Matthis; Nickerson, Angela; Bryant, Richard A

2016-12-01

Refugees can suffer many experiences that threaten their trust in others. Although models of refugee mental health have postulated that attachment securities may be damaged by refugee experiences, this has yet to be empirically tested. This study aimed to understand the relationship between the nature of traumatic experiences sustained by refugees and attachment styles. In a cross-sectional study, treatment-seeking refugees (N = 134) were assessed for traumatic exposure using the Harvard Trauma Questionnaire and Posttraumatic Diagnostic Scale. Attachment style was assessed using the Experiences in Close Relationship Scale. Whereas gender and severity of interpersonal traumatic events predicted avoidant attachment style (accounting for 11% of the variance), neither these factors nor non-interpersonal trauma predicted anxious attachment. Exposure to interpersonal traumatic events, including torture, is associated with enduring avoidant attachment tendencies in refugees. This finding accords with attachment theories that prior adverse interpersonal experiences can undermine secure attachment systems, and may promote avoidance of attachment seeking. This finding may point to an important process maintaining poor psychological health in refugees affected by interpersonal trauma. © The Royal Australian and New Zealand College of Psychiatrists 2016.

'It's time she stopped torturing herself': structural constraints to decision-making about life-sustaining treatment by medical trainees.

PubMed

Jenkins, Tania M

2015-05-01

This article explores how structural factors associated with the profession and organization of medicine can constrain internal medicine residents, leading them to sometimes limit or terminate treatment in end-of-life care in ways that do not always embrace patient autonomy. Specifically, it examines the opportunities and motivations that explain why residents sometimes arrogate decision-making for themselves about life-sustaining treatment. Using ethnographic data drawn from over two years at an American community hospital, I contend that unlike previous studies which aggregate junior and senior physicians' perspectives, medical trainees face unique constraints that can lead them to intentionally or unintentionally overlook patient preferences. This is especially salient in cases where they misunderstand their patients' wishes, disagree about what is in their best interest, and/or lack the standing to pursue alternative ethical approaches to resolving these tensions. The study concludes with recommendations that take into account the structural underpinnings of arrogance in decision-making about life-sustaining treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Current research in transcultural psychiatry in the Nordic countries.

PubMed

Ekblad, Solvig; Kastrup, Marianne Carisius

2013-12-01

This article discusses major themes in recent transcultural psychiatric research in the Nordic countries from 2008 to 2011: (a) epidemiological studies of migration, (b) indigenous populations, and (c) quality of psychiatric care for migrants. Over the past several decades, the populations of the Nordic countries, Denmark, Finland, Norway, and Sweden, which were relatively homogeneous, have become increasingly culturally diverse. Many migrants to Nordic countries have been exposed to extreme stress, such as threats of death and/or torture and other severe social adversities before, during, and after migration, with potential effects on their physical, mental, social, and spiritual health. Growing interest in transcultural issues is reflected in the level of scientific research and clinical activity in the field by Nordic physicians, psychologists, social scientists, demographers, medical anthropologists, as well as other clinicians and policy planners. Research includes work with migrants and indigenous minorities in the Nordic countries, as well as comparisons with mental health in postconflict countries. We conclude by suggesting future directions for transcultural psychiatry research and providing guidelines for the education and training of future clinicians in the Nordic countries.

Supporting Asylum Seekers: Clinician Experiences of Documenting Human Rights Violations Through Forensic Psychological Evaluation.

PubMed

Baranowski, Kim A; Moses, Melissa H; Sundri, Jasmine

2018-05-22

The United States permits foreign nationals to apply for asylum if they have experienced persecution or have a fear of future persecution. In order to meet the criteria for persecution, the harm inflicted upon the asylum seeker does not need to be or have been physical and can include psychological sequelae. In an effort to document persecution, lawyers seek the assistance of health professionals when preparing their clients' asylum applications. Mental health professionals work to corroborate psychological evidence of the asylum seeker's report of ill treatment through evaluation and presentation of their findings in the form of legal affidavits. This study gathered the experiences of 15 mental health clinicians who conduct forensic psychological evaluations and document the impact of torture and other human rights violations on asylum seekers. We analyzed the resulting interview transcripts using a consensual qualitative research (CQR) approach. The results of the study highlight challenges associated with this work, suggest recommendations for training, and encourage advocacy endeavors by mental health professionals who provide these services. Copyright © 2018 International Society for Traumatic Stress Studies.

Circumcision of male infants as a human rights violation.

PubMed

Svoboda, J Steven

2013-07-01

Every infant has a right to bodily integrity. Removing healthy tissue from an infant is only permissible if there is an immediate medical indication. In the case of infant male circumcision there is no evidence of an immediate need to perform the procedure. As a German court recently held, any benefit to circumcision can be obtained by delaying the procedure until the male is old enough to give his own fully informed consent. With the option of delaying circumcision providing all of the purported benefits, circumcising an infant is an unnecessary violation of his bodily integrity as well as an ethically invalid form of medical violence. Parental proxy 'consent' for newborn circumcision is invalid. Male circumcision also violates four core human rights documents-the Universal Declaration of Human Rights, the Convention on the Rights of the Child, the International Covenant on Civil and Political Rights, and the Convention Against Torture. Social norm theory predicts that once the circumcision rate falls below a critical value, the social norms that currently distort our perception of the practice will dissolve and rates will quickly fall.

"A hideous torture on himself": madness and self-mutilation in Victorian literature.

PubMed

Chaney, Sarah

2011-12-01

This paper suggests that late nineteenth-century definitions of self-mutilation, a new category of psychiatric symptomatology, were heavily influenced by the use of self-injury as a rhetorical device in the novel, for the literary text held a high status in Victorian psychology. In exploring Dimmesdale's "self-mutilation" in The Scarlet Letter in conjunction with psychiatric case histories, the paper indicates a number of common techniques and themes in literary and psychiatric texts. As well as illuminating key elements of nineteenth-century conceptions of the self, and the relation of mind and body through ideas of madness, this exploration also serves to highlight the social commentary implicit in many Victorian medical texts. Late nineteenth-century England, like mid-century New England, required the individual to help himself and, simultaneously, others; personal charity and individual philanthropy were encouraged, while state intervention was often presented as dubious. In both novel and psychiatric text, self-mutilation is thus presented as the ultimate act of selfish preoccupation, particularly in cases on the "borderlands" of insanity.

Delaware's first serial killer.

PubMed

Inguito, G B; Sekula-Perlman, A; Lynch, M J; Callery, R T

2000-11-01

The violent murder of Shirley Ellis on November 29, 1987, marked the beginning of the strange and terrible tale of Steven Bryan Pennell's reign as the state of Delaware's first convicted serial killer. Three more bodies followed the first victim, and all had been brutally beaten and sadistically tortured. The body of a fifth woman has never been found. State and county police collaborated with the FBI to identify and hunt down their suspect, forming a task force of over 100 officers and spending about one million dollars. Through their knowledge and experience with other serial killers, the FBI was able to make an amazingly accurate psychological profile of Delaware's serial killer. After months of around-the-clock surveillance, Steven Pennell was arrested on November 29, 1988, one year to the day after the first victim was found. Pennell was found guilty in the deaths of the first two victims on November 29, 1989, and plead no contest to the murder of two others on October 30, 1991. Still maintaining his innocence, he asked for the death penalty so that he could spare his family further agony. Steven Pennell was executed by lethal injection on March 15, 1992.

Health and human rights of women imprisoned in Zambia

PubMed Central

2011-01-01

Background The healthcare needs and general experience of women in detention in sub-Saharan Africa are rarely studied and poorly understood. Methods A mixed-methods study was conducted including in-depth interviews with 38 adult female prisoners and 21 prison officers in four Zambian prisons to assess the health and human rights concerns of female detainees. Key informant interviews with 46 officials from government and non-governmental organizations and a legal and policy review were also conducted. Results Despite special protection under international and regional law, incarcerated women's health needs–including prenatal care, prevention of mother-to-child transmission of HIV, and nutritional support during pregnancy and breastfeeding–are not being adequately met in Zambian prisons. Women are underserved by general healthcare programs including those offering tuberculosis and HIV testing, and reported physical and sexual abuse conducted by police and prison officers that could amount to torture under international law. Conclusions There is an urgent need for women's healthcare services to be expanded, and for general prison health campaigns, including HIV and tuberculosis testing and treatment, to ensure the inclusion of female inmates. Abuses against women in Zambian police and prison custody, which violate their rights and compromise their health, must be halted immediately. PMID:21696625

Dowry in 21st-century India: the sociocultural face of exploitation.

PubMed

Banerjee, Priya R

2014-01-01

The World Health Organization (2009) implicates deep-rooted cultural and social norms as influential contributing factors toward physical and intimate partner violence against women. The dowry system is a social practice that perpetuates the oppression, torture, and murder of women in India. The practice of dowry is an expected part of marriage in cultures where arranged marriages are the norm. Violence can occur when the dowry or bride-price is deemed unsatisfactory by the recipient. In India, in spite of laws prohibiting the practice, not much has changed over the last 30 years. The National Crime Records Bureau of India, recorded a total of 8,618 female deaths related to dowry disputes in 2011, and the Asian Women's Human Rights Council (2009) estimates that the practice of dowry is implicated in 25,000 deaths and maiming of women between the ages of 15-34 in India every year. The current review of literature reveals that despite efforts on the part of the Indian government, social activists and feminists organizations in India, not much has changed over the past decade, in fact, the problem has increased, resulting in an unprecedented amount of mortality and morbidity among women in India.

Posttraumatic Stress Disorder and Related Disorders among Female Yazidi Refugees following Islamic State of Iraq and Syria Attacks-A Case Series and Mini-Review.

PubMed

Gerdau, Inga; Kizilhan, Jan Ilhan; Noll-Hussong, Michael

2017-01-01

Following the severe attacks by the so-called "Islamic State of Iraq and Syria" on the Yazidi population, which started in summer 2014, the state government of Baden-Württemberg, Germany, funded a Special-Quota Project to bring 1,000 very ill or left-behind women and children who were being held hostage to 22 cities and towns in Baden-Württemberg to receive integrated care. Here, we report for the first time on the cases of four Yazidi women living in Ulm, Germany, focusing on the clinically observed and psychometrically assessed mental phenomena or disorders. Our primary aim was to explore what International Classification of Diseases, 10th Revision diagnoses are present in this population. Although highly traumatized, these women were suffering primarily from adjustment disorder rather than posttraumatic stress disorder according to official classification systems. Despite their symptoms of depression and anxiety, the women's responses to self-assessment questionnaires provided no evidence of compulsion, somatization, or eating disorders. The results suggest that further investigation of the individual-level effects of rape and torture, as well the historic, systemic, and collective effects, e.g., on families and societies, is required.

Hearing loss in former prisoners of war of the Japanese.

PubMed

Grossman, T W; Kerr, H D; Byrd, J C

1996-09-01

To describe the prevalence, degree, and types of hearing loss present in a group of older American veterans who had been prisoners of war of the Japanese. A descriptive study. A Veterans Affairs university hospital. Seventy-five male veterans, mean age 68 (+/- 3.6) years. Hearing aids were prescribed for eight veterans. Subjects were examined, and pure tone air and bone conduction, speech reception threshold, and speech discrimination were determined. Results were compared with age- and sex-matched controls from the largest recent American population study of hearing loss. 95% of subjects had been imprisoned longer than 33 months. Starvation conditions (100%), head trauma (85%), and trauma-related loss of consciousness (23%) were commonly reported. A total of 73% complained of hearing loss, and 29% (22/75) dated its onset to captivity. Most of those with the worst losses in hearing and speech discrimination were found in this subgroup. When the entire group was compared with published age- and sex-matched controls from the Framingham Study, no significant differences were found. We advocate screening examinations and long-term follow-up of populations with similar histories of starvation, head trauma, and torture.

Health and human rights of women imprisoned in Zambia.

PubMed

Todrys, Katherine W; Amon, Joseph J

2011-06-22

The healthcare needs and general experience of women in detention in sub-Saharan Africa are rarely studied and poorly understood. A mixed-methods study was conducted including in-depth interviews with 38 adult female prisoners and 21 prison officers in four Zambian prisons to assess the health and human rights concerns of female detainees. Key informant interviews with 46 officials from government and non-governmental organizations and a legal and policy review were also conducted. Despite special protection under international and regional law, incarcerated women's health needs-including prenatal care, prevention of mother-to-child transmission of HIV, and nutritional support during pregnancy and breastfeeding-are not being adequately met in Zambian prisons. Women are underserved by general healthcare programs including those offering tuberculosis and HIV testing, and reported physical and sexual abuse conducted by police and prison officers that could amount to torture under international law. There is an urgent need for women's healthcare services to be expanded, and for general prison health campaigns, including HIV and tuberculosis testing and treatment, to ensure the inclusion of female inmates. Abuses against women in Zambian police and prison custody, which violate their rights and compromise their health, must be halted immediately.

Roe v. Wade. Reflective compassion.

PubMed

Padovano, A T

1998-01-01

The US has arrived at the correct legal status for induced abortion by permitting it on constitutional grounds within limits. In addition, the general consensus among American Catholics is in favor of abortion rights while disapproving of abortion and wishing to discourage it. Concerns about the morality of abortion, however, arise out of our uncertainty about the personhood of a fetus before birth or before viability. Early church leaders taught that a fetus did not obtain personhood until it acquired a human form, and the Catholic church did not baptize aborted fetuses without human shape or hold formal funeral services for dead fetuses. While official church teaching is adamant about the immorality of abortion, official church teaching has changed in the past in regard to the salvation of non-Catholics, slavery, inquisitions and torture, ecumenism, worship in the vernacular, and divorce and remarriage. No one is forced to have an abortion in the US because the legal right exists, and Catholics are more likely to heed Church teachings that do not seek legal force and punishment though "infallible" pronouncements and insensitive condemnation of women. If the Catholic church expects compassion for its wrong decisions in the past, then it should extend compassion to women in difficult situations.

[Diabetic Ketoacidosis and Hyperosmolar Hyperglycemic State].

PubMed

Schumann, Christina; Faust, Michael

2018-03-01

 Diabetic ketoacidosis and the hyperosmolar hyperglycemic state are the most serious diabetic emergencies. Before the discovery of insulin in 1921 by Banting and Best the diagnosis of type 1 diabetes was fatal ending in diabetic ketoacidosis equivalent to a torturous death. Today, mortality from diabetic ketoacidosis is low at approximately 2 %. But each death from these two acute metabolic complications of diabetes is potentially avoidable by improved patient and healthcare professional education. Therefore, there is a need to raise awareness of hyperglycemic crisis and its management amongst physicians.  Insulin deficiency or resistence and increased concentrations of counterreulatory hormones (glucagon, catecholamines, cortisol and growth hormone) are responsible for the development of diabetic ketoacidosis and the hyperosmolar hyperglycemic state. Hyperglycemia develops as a result of increased gluconeogenesis and accelerated glyconeogenesis. In DKA, the absolute insulin deficiency additionally leads to increased lipolysis and production of ketone bodies and resulting metabolic acidosis.  Both DKA and HHS require prompt recognition and management. The diagnosis can be suspected by clinical features and confirmed by laboratory findings.  The treatment of DKA and HHS is similar, including correction of fluid and electrolyte abnormalities and the administration of insulin. © Georg Thieme Verlag KG Stuttgart · New York.

Personality disorders and criminal law: an international perspective.

PubMed

Sparr, Landy F

2009-01-01

At the International War Crimes Tribunal for the Former Yugoslavia (ICTY), a detention camp guard, charged with acts of murder and torture, advanced a plea of diminished responsibility. Defense psychiatrists testified that he had a personality disorder that influenced his ability to control his behavior, but a prosecution expert testified that the guard did not meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria. Thus, the unresolved question of how the law defines a mental disease or defect for purposes of mitigation or excuse was transposed to an international setting. It has been argued in a variety of jurisdictions and national legal systems that exculpatory mental disorders must be serious, and personality disorders should not qualify. In fact, it has been proposed that the volitional aspect of excuse defenses be eliminated, and definitions of mental disease or defect narrowed. Others have argued that such exclusions are too restrictive and arbitrary. This article examines the criminal defense at ICTY and traces its origin in national jurisdictions. Mental incapacity defenses based on personality disorders are more often used in The Netherlands, England, Germany and Belgium, but seldom in Canada and rarely in the United States and Sweden.

[Criminal psychology in Franco's police].

PubMed

Bandrés, Javier; Llavona, Rafael; Zubieta, Eva

2013-02-01

Francisco J. de Echalecu (1897-1957) was a Spanish psychiatrist who held important positions, such as Psychology Professor at the Academia General de Policía and Neuropsychiatrist at the Dirección General de Seguridad. This work provides a brief biography of Echalecu and analyzes the transcriptions of his classes on Criminal Psychology of 1942, his Criminal Psychology from 1947 as well as his involvement in the case of the torture of Communist leader Heriberto Quiñones. We describe his project of a totalitarian Psychology and his proposal of social intervention, including eugenic methodologies as well as forced reclusion for those labeled as asocial. The adaptation in Spain of the totalitarian psychological project to the new international reality after the Second World War is also described. In Spain a "final solution" for criminals and political dissidents has been prepared, which was inspired by the Nazi criminal policies and promoted by Dr. Echalecu from Spain's higher police body, the DGS. This project was frustrated by the German defeat in the world war and the only thing left from the original project was the arbitrary application of the Ley de Vagos y Maleantes [an antivagrancy law] to those individuals labeled as "asocial".

Refugee health and medical student training.

PubMed

Griswold, Kim S

2003-10-01

Cultural awareness training is an increasingly important priority within medical curricula. This article describes an academic family practice-community partnership focusing on health care needs of refugees that became the model for a medical school selective on cultural sensitivity training. The monthly Refugee Health Night program featured dinner with preceptors and patients, international sessions on special medical needs of refugees, and actual clinical encounters with patients. Students were not expected to become culturally competent experts but, rather, health care providers sensitive to and appreciative of cultural context, experience, and expectations. We worked with students to develop sensitive methods of inquiry about mental health, especially around issues of war and torture. We used problem-based cases to emphasize primary care continuity and the benefit of establishing trust over time. Over 2 years, 50 students and nearly 300 refugees (more than 73 families) participated. Students reported that their interactions with the refugees provided positive learning experiences, including expanded knowledge of diverse cultures and enhanced skills for overcoming communication barriers. Patients of refugee status were able to have emergent health care needs met in a timely fashion. Providing health care for refugee individuals and families presents many challenges as well as extraordinary opportunities for patients and practitioners to learn from one another.

Failing ethics 101: psychologists, the U.S. military establishment, and human rights.

PubMed

Boyd, J Wesley; LoCicero, Alice; Malowney, Monica; Aldis, Rajendra; Marlin, Robert P

2014-01-01

The American Psychological Association (APA) has long maintained a close, even symbiotic, relationship with the Department of Defense (DOD) and the Veterans Administration (VA). Herein we highlight these close ties and describe psychologists' participation in interrogations by U.S. military and intelligence entities. We then review the APA's statements about the permissibility of psychologist participation in the interrogation and torture of suspected terrorists. These issues are significant in and of themselves and because the VA and DOD have been described as "growth careers" for psychologists of the future (1). Additionally, the Health Care Personnel Delivery System allows the drafting of civilian clinical psychologists into military service even in the absence of a general draft. In light of psychologists' extensive involvement in the interrogation process of suspected terrorists, and the possibility that psychologists without prior military experience may be drafted, we wondered how much psychologists have been taught about their ethical duties should they find themselves in military settings. The results of our pilot study of U.S. psychology graduate students, which assessed their knowledge of military ethics, raise concerns that psychologists receive inadequate formal training in these matters. This may leave psychologists vulnerable to misinformation about proper ethical conduct in their future work.

Challenges to parenting in a new culture: Implications for child and family welfare.

PubMed

Lewig, Kerry; Arney, Fiona; Salveron, Mary

2010-08-01

Increasing numbers of families arriving through Australia's humanitarian settlement scheme are coming into contact with Australian child protection systems. A large number of these families come from African and Middle Eastern countries and have common experiences of trauma, dislocation, loss and many are victims of genocide, war, and torture. Pre-migration experiences together with the considerable challenges of settling into a new country can significantly affect family well-being and parenting practices. It is therefore important that child and family welfare service planners are well informed about how best to support refugee families using culturally competent family intervention and community development practices. This paper draws on the findings of a research project designed to examine why recently arrived families from refugee backgrounds are presenting in the South Australian child protection system and to identify culturally appropriate strategies for intervention. The paper presents findings from the project that relate to (1) refugee parents', community members' and child protection practitioners' perspectives on the challenges to being a refugee parent in Australia and (2) strategies and resources relevant to prevention and early intervention in refugee families before statutory child protection intervention becomes necessary. Copyright (c)2009 Elsevier Ltd. All rights reserved.

Effects on asylum seekers of ill treatment in Zaïre.

PubMed Central

Peel, M. R.

1996-01-01

To describe the health effects of the political system in Zaïre on asylum seekers seen at the Medical Foundation for the Care of Victims of Torture a retrospective study was performed of the records of 92 asylum seekers from Zaïre who were seen for medical reports at the medical foundation in 1993 and 1994. Eighty one had been imprisoned; the others had been severely treated at home by the security services. Sixty six had been detained for up to one year. Prison conditions were invariably unsanitary, and food of poor quality when provided. All had been beaten on arrest, and all but two had been beaten repeatedly in prison. Nearly all the women and some of the men described sexual abuse. Almost all left prison through bribery or because a guard had a similar background. Seventy two asylum seekers had scarring, consider to be consistent with the history, and 70 were considered to have suffered persistent psychological damage. Asylum seekers from Zaïre will have health effects from experiences unimaginable to the ordinary Briton. An understanding of the background will help clinicians manage them. PMID:8611788

Burmese political dissidents in Thailand: trauma and survival among young adults in exile.

PubMed Central

Allden, K; Poole, C; Chantavanich, S; Ohmar, K; Aung, N N; Mollica, R F

1996-01-01

OBJECTIVES: This study assessed the self-reported mental health, physical health, and social functioning of young adult political exiles and relates their psychiatric symptoms to their trauma and survival strategies. METHODS: A 1992/93 survey of Burmese who fled to Bangkok, Thailand, after participating in a 1988 uprising against Burma's government elicited information on employment, education, disability, trauma, survival strategies, and depressive and posttraumatic stress symptoms. RESULTS: The 104 participants reported a mean of 30 trauma events, including interrogation (89%), imprisonment (78%), threats of deportation (70%), and torture (38%). Many reported poor health and lack of social supports, but few reported substantial social disability. The prevalence of elevated symptom scores was 38% for depressive symptoms and 23% for criterion symptoms of posttraumatic stress disorder. Symptoms of avoidance and of increased arousal were the most strongly related to cumulative trauma. Two survival strategies, camaraderie and a Buddhist concept of self-confidence (weria), were associated with somewhat reduced levels of both classes of symptoms. CONCLUSIONS: Burmese political exiles in Thailand are young adults adversely affected by severe trauma. Their psychosocial well-being may deteriorate further without legal protections to reduce the continuing stress and violence. PMID:8916521

Human rights and correctional health policy: a view from Europe.

PubMed

Rogan, Mary

2017-03-13

Purpose Correctional healthcare should promote the protection of human rights. The purpose of this paper is to bring a discussion of human rights into debates on how such policy should be best organized. Design/methodology/approach The paper achieves its aim by providing an analysis of European prison law and policy in the area of prison health, through assessing decisions of the European Court of Human Rights, as well as policies created by the European Committee for the Prevention of Torture. Findings The paper describes the position of the European Court of Human Rights on the topics of access to healthcare, ill health and release from prison, mental illness in prison, and the duty to provide rehabilitative programming for those seeking to reduce their level of "risk." It also argues that human rights law can be a source of practical reform, and that legal frameworks have much to offer healthcare leaders seeking to uphold the dignity of those in their care. Originality/value This paper will provide a rare example of the engagement of human rights law with correctional health policy. It provides practical recommendations arising out of an analysis of European human rights law in the area of prisons.

Moral harassment at work model and inability.

PubMed

Campos, Izabel C Martins; da Silva, Lizandra; Trevisan, Rafaela Luiza; Cruz, Roberto Moraes

2012-01-01

Moral Harassment at Work (MHW) is considered a recurrent practice of humiliation, mockery, isolation, persecution and psychological torture. Its results go beyond the worker private life: represent financial loss, affects the work, the organization, the productivity and the society. This article aims to develop a model of MHW, which characterizes the main components of the phenomenon and their nexus with the inability to work. For this, the Literature field is consulted, in order to identify systematically, the MHW components and their risky factors. The results showed a multifaceted model which demonstrates: the aggressor/victim and the configuration of the Moral Harassment at Work causes. The management of the degraded work. The characteristic features of the inability to work, caused on the victim. The MHW modalities and as a final product, the integration among these components. It is expected that this model can help the Ergonomist comprehending this phenomenon and contribute on the creation of some strategies of prevention on the workplace. It is concluded that the removal or minimization of this occupational risks requires some changes on the job organization, on the people`s behaviour, the leadership styles, on the humanization of the social labor relationship and on the coping this problem.

Effects on asylum seekers of ill treatment in Zaïre.

PubMed

Peel, M R

1996-02-03

To describe the health effects of the political system in Zaïre on asylum seekers seen at the Medical Foundation for the Care of Victims of Torture a retrospective study was performed of the records of 92 asylum seekers from Zaïre who were seen for medical reports at the medical foundation in 1993 and 1994. Eighty one had been imprisoned; the others had been severely treated at home by the security services. Sixty six had been detained for up to one year. Prison conditions were invariably unsanitary, and food of poor quality when provided. All had been beaten on arrest, and all but two had been beaten repeatedly in prison. Nearly all the women and some of the men described sexual abuse. Almost all left prison through bribery or because a guard had a similar background. Seventy two asylum seekers had scarring, consider to be consistent with the history, and 70 were considered to have suffered persistent psychological damage. Asylum seekers from Zaïre will have health effects from experiences unimaginable to the ordinary Briton. An understanding of the background will help clinicians manage them.

Genetic identification of children of the disappeared in Argentina.

PubMed

Penchaszadeh, V B

1997-01-01

During the military dictatorship that ruled Argentina between 1976 and 1983, the security forces engaged in well-planned repression that included the abduction, torture, and disappearance of thousands of dissidents. Repression spared neither children nor pregnant women. Approximately 220 babies and children of the disappeared victims were abducted and kept mostly by families with connections with the military. After the restoration of democracy, attempts to find and identify the missing children were made, with the goal of restoring their personal and familial identities and returning them to their surviving relatives. The Association of Grandmothers of Plaza de Mayo and a number of geneticists who developed and applied methods of genetic identification to this human rights cause were instrumental in this quest. Initial use of histocompatibility (HLA) typing for genetic identification was later followed by nuclear DNA typing and mitochondrial DNA sequencing. Of 56 children found and identified, 30 were returned to their legitimate families, 13 remained with the families who had adopted them in good faith, 6 are still the subject of custody litigation in the courts, and 7 were found dead. Psychological and ethical guidelines protecting the best interests of the children were followed in all proceedings.

Gout: modern management of an ancient malady.

PubMed

Boyd, R E

1993-05-01

If Dr. Sydenham could have benefited from today's therapy, he likely would not have had to endure thirty years of "violent ... torture" that gave birth to his most elegant and classic description of acute gout. The five key points to remember in management of the gouty spectrum are: (1) Establish the diagnosis as clearly as possible or as clearly as seems necessary under the clinical circumstances (i.e. arthrocentesis with crystal analysis to establish diagnosis is not always necessary with reliable patients when septic joint seems highly unlikely). (2) Treat acute attacks with NSAIDs alone or perhaps steroids--or rarely IV colchicine under special circumstances. (3) DO NOT START ALLOPURINOL OR PROBENECID DURING AN ACUTE FLARE OF GOUT--IT MAY MAKE THE EPISODE WORSE. (4) The pattern of disease over time (frequency and severity of attacks) determines whether or not one decides to use an agent such as allopurinol, probenecid, or prophylactic colchicine chronically once a patient is over the acute attack--the mere presence of increased uric acid and a single or rare gouty attack would not usually require any other than the appropriate acute therapy. (5) The presence of visible tophi, uric acid renal calculi and destructive gouty arthritis nearly always warrant uric acid lowering therapy.

Arctigenin, a Potent Ingredient of Arctium lappa L., Induces Endothelial Nitric Oxide Synthase and Attenuates Subarachnoid Hemorrhage-Induced Vasospasm through PI3K/Akt Pathway in a Rat Model

PubMed Central

Chang, Chih-Zen; Wu, Shu-Chuan; Chang, Chia-Mao; Kwan, Aij-Lie

2015-01-01

Upregulation of protein kinase B (PKB, also known as Akt) is observed within the cerebral arteries of subarachnoid hemorrhage (SAH) animals. This study is of interest to examine Arctigenin, a potent antioxidant, on endothelial nitric oxide synthase (eNOS) and Akt pathways in a SAH in vitro study. Basilar arteries (BAs) were obtained to examine phosphatidylinositol-3-kinase (PI3K), phospho-PI3K, Akt, phospho-Akt (Western blot) and morphological examination. Endothelins (ETs) and eNOS evaluation (Western blot and immunostaining) were also determined. Arctigenin treatment significantly alleviates disrupted endothelial cells and tortured internal elastic layer observed in the SAH groups (p < 0.01). The reduced eNOS protein and phospho-Akt expression in the SAH groups were relieved by the treatment of Arctigenin (p < 0.01). This result confirmed that Arctigenin might exert dural effects in preventing SAH-induced vasospasm through upregulating eNOS expression via the PI3K/Akt signaling pathway and attenuate endothelins after SAH. Arctigenin shows therapeutic promise in the treatment of cerebral vasospasm following SAH. PMID:26539501

Arctigenin, a Potent Ingredient of Arctium lappa L., Induces Endothelial Nitric Oxide Synthase and Attenuates Subarachnoid Hemorrhage-Induced Vasospasm through PI3K/Akt Pathway in a Rat Model.

PubMed

Chang, Chih-Zen; Wu, Shu-Chuan; Chang, Chia-Mao; Lin, Chih-Lung; Kwan, Aij-Lie

2015-01-01

Upregulation of protein kinase B (PKB, also known as Akt) is observed within the cerebral arteries of subarachnoid hemorrhage (SAH) animals. This study is of interest to examine Arctigenin, a potent antioxidant, on endothelial nitric oxide synthase (eNOS) and Akt pathways in a SAH in vitro study. Basilar arteries (BAs) were obtained to examine phosphatidylinositol-3-kinase (PI3K), phospho-PI3K, Akt, phospho-Akt (Western blot) and morphological examination. Endothelins (ETs) and eNOS evaluation (Western blot and immunostaining) were also determined. Arctigenin treatment significantly alleviates disrupted endothelial cells and tortured internal elastic layer observed in the SAH groups (p < 0.01). The reduced eNOS protein and phospho-Akt expression in the SAH groups were relieved by the treatment of Arctigenin (p < 0.01). This result confirmed that Arctigenin might exert dural effects in preventing SAH-induced vasospasm through upregulating eNOS expression via the PI3K/Akt signaling pathway and attenuate endothelins after SAH. Arctigenin shows therapeutic promise in the treatment of cerebral vasospasm following SAH.

[Education and the rights of man. Press review: Mauritania].

PubMed

1999-12-01

We are now poised at the brink of a revolution in education, based upon a broadened and renewed concept of what defines education and apprenticeship. We have come to this point because of our realization during the 1990s that human rights are a key element of human development. Humanity recognizes today that human rights are indivisible and that the realization of one right leads to the reinforcement and promotion of another. Man has the right to education, freedom of speech and thought, and protection from torture. This is a very important concept for the developing world, where approximately 130 million children grow up without being properly educated. Governments are obligated to take the necessary measures to ensure that children receive a quality, basic education. Countries deficient in this domain often argue that they do not have enough resources to educate all of their populations, despite 30 years of evidence demonstrating how much developing countries can achieve in education with only limited means. Countries least advanced in achieving education for all have often inequitably invested more funds into higher education than into basic education. They have also failed to contain costs as scholastic coverage expanded. Efforts must be made to minimize the financial cost to parents of educating their children.

Barcelona 2002: law, ethics, and human rights. Global battle cry: health is a right, not a commodity.

PubMed

Fernandez, Irene

2002-12-01

Health is a fundamental right, not a commodity to be sold at a profit, argues Irene Fernandez in the second Jonathan Mann Memorial Lecture delivered on 8 July 2002 to the XIV International AIDS Conference in Barcelona. Ms Fernandez had to obtain a special permit from the Malaysian government to attend the Conference because she is on trial for having publicly released information about abuse, torture, illness, corruption, and death in Malaysian detention camps for migrants. This article, based on Ms Fernandez' presentation, describes how the policies of the rich world have failed the poor world. According to Ms Fernandez, the policies of globalization and privatization of health care have hindered the ability of developing countries to respond to the HIV/AIDS epidemic. The article decries the hypocrisy of the industrialized nations in increasing subsidies to farmers while demanding that the developing world open its doors to Western goods. It points out that the rich nations have failed to live up their foreign aid commitments. The article concludes that these commitments--and the other promises made in the last few years, such as those in the United Nations' Declaration of Commitment on HIV/AIDS--can only become a reality if they are translated into action.

Revenge versus rapport: Interrogation, terrorism, and torture.

PubMed

Alison, Laurence; Alison, Emily

2017-04-01

This review begins with the historical context of harsh interrogation methods that have been used repeatedly since the Second World War. This is despite the legal, ethical and moral sanctions against them and the lack of evidence for their efficacy. Revenge-motivated interrogations (Carlsmith & Sood, 2009) regularly occur in high conflict, high uncertainty situations and where there is dehumanization of the enemy. These methods are diametrically opposed to the humanization process required for adopting rapport-based methods-for which there is an increasing corpus of studies evidencing their efficacy. We review this emerging field of study and show how rapport-based methods rely on building alliances and involve a specific set of interpersonal skills on the part of the interrogator. We conclude with 2 key propositions: (a) for psychologists to firmly maintain the Hippocratic Oath of "first do no harm," irrespective of perceived threat and uncertainty, and (b) for wider recognition of the empirical evidence that rapport-based approaches work and revenge tactics do not. Proposition (a) is directly in line with fundamental ethical principles of practice for anyone in a caring profession. Proposition (b) is based on the requirement for psychology to protect and promote human welfare and to base conclusions on objective evidence. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Nacre-mimetic bulk lamellar composites reinforced with high aspect ratio glass flakes.

PubMed

Guner, Selen N Gurbuz; Dericioglu, Arcan F

2016-12-05

Nacre-mimetic epoxy matrix composites reinforced with readily available micron-sized high aspect ratio C-glass flakes were fabricated by a relatively simple, single-step, scalable, time, cost and man-power effective processing strategy: hot-press assisted slip casting (HASC). HASC enables the fabrication of preferentially oriented two-dimensional inorganic reinforcement-polymer matrix bulk lamellar composites with a micro-scale structure resembling the brick-and-mortar architecture of nacre. By applying the micro-scale design guideline found in nacre and optimizing the relative volume fractions of the reinforcement and the matrix as well as by anchoring the brick-and-mortar architecture, and tailoring the interface between reinforcements and the matrix via silane coupling agents, strong, stiff and tough bio-inspired nacre-mimetic bulk composites were fabricated. As a result of high shear stress transfer lengths and effective stress transfer at the interface achieved through surface functionalization of the reinforcements, fabricated bulk composites exhibited enhanced mechanical performance as compared to neat epoxy. Furthermore, governed flake pull-out mode along with a highly torturous crack path, which resulted from extensive deflection and meandering of the advancing crack around well-aligned high aspect ratio C-glass flakes, have led to high work-of-fracture values similar to nacre.

Graduate public health training in healthcare of refugee asylum seekers and clinical human rights: evaluation of an innovative curriculum.

PubMed

Asgary, Ramin

2016-04-01

An innovative curriculum was developed to equip public health students with appropriate attitude and skills to address healthcare of asylum seekers. Implemented in 2005 the curriculum included: (1) didactic sessions covering epidemiology and health sequelae of torture, asylum laws, and approaches to identify survivors' healthcare needs; (2) panel discussions with survivors and advocates; and (3) participating in medico-legal process of asylum seeking. Complementary mixed methods evaluations included pre- and post-curriculum questionnaires, formal curriculum evaluations, final papers and oral presentations. 125 students participated. Students showed improved knowledge regrading sequelae of abuse and survivors' healthcare needs (P < 0.01), improved attitudes towards working with survivors (P < 0.05) and self-efficacy in identifying at-risk populations and addressing healthcare of survivors (P < 0.05). Students reported increased desire to pursue global health and human rights careers. As an advocacy and cultural competency training in public health practice addressing healthcare of refugees domestically, this curriculum was well received and effective, and will also help students better serve other similar populations. Population case-based domestic opportunities to teach global health and health and human rights should be effectively utilized to develop a well-equipped global health corps.

Neuropsychological assessment of refugees: Methodological and cross-cultural barriers.

PubMed

Veliu, Bahrie; Leathem, Janet

2017-01-01

Cross-cultural research in neuropsychological assessment has primarily focused on Hispanic and African American populations. Less is known about the impact of language, culture, education, socioeconomic factors, and life experiences on assessment for other cultural groups. We highlight the methodological and cross-cultural barriers encountered at each stage of the neuropsychological assessment of Arabic- and Burmese-speaking refugees, who were culturally and linguistically diverse (CALD). A total of 18 refugees (13 men/five women; in their 20-50s) who were victims of torture in their countries of origin, some with post-traumatic stress disorder (PTSD) and now residents in New Zealand, were seen for neuropsychological assessment. Measures were officially translated, back translated, and administered with the assistance of professional interpreters. Multiple challenges arose in terms of administration (e.g., use of interpreters, interactions with the tester, assessment environment, assessment experience, and motivation), scoring, and interpretation (e.g., age appropriate scoring, estimation of prior function, estimation of brain injury severity, obtaining collateral information), the tests themselves, and ecological validity. There are more challenges in the neuropsychological assessment of people who are CALD than can be managed by adhering to current guidelines. The best approach is to find a balance between maintaining assessment integrity and working creatively and sensitively with this group.

Human rights violations among sexual and gender minorities in Kathmandu, Nepal: a qualitative investigation.

PubMed

Singh, Sonal; Pant, Sunil Babu; Dhakal, Suben; Pokhrel, Subash; Mullany, Luke C

2012-05-16

Nepal has experienced sporadic reports of human rights violations among sexual and gender minorities. Our objective was to identify a range of human rights that are enshrined in international law and/or are commonly reported by sexual and gender minority participants in Kathmandu, to be nonprotected or violated. In September 2009 three focus group discussions were conducted by trained interviewers among a convenience sample of sexual and gender minority participants in Kathmandu Nepal. The modified Delphi technique was utilized to elicit and rank participant-generated definitions of human rights and their subsequent violations. Data was analyzed independently and cross checked by another investigator. Participants (n = 29) reported experiencing a range of human rights violations at home, work, educational, health care settings and in public places. Lack of adequate legal protection, physical and mental abuse and torture were commonly reported. Access to adequate legal protection and improvements in the family and healthcare environment were ranked as the most important priority areas. Sexual and gender minorities in Nepal experienced a range of human rights violations. Future efforts should enroll a larger and more systematic sample of participants to determine frequency, timing, and/or intensity of exposure to rights violations, and estimate the population-based impact of these rights violations on specific health outcomes.

Analyzing the microfoundations of human violence in the DRC - intrinsic and extrinsic rewards and the prediction of appetitive aggression.

PubMed

Haer, Roos; Banholzer, Lilli; Elbert, Thomas; Weierstall, Roland

2013-05-17

Civil wars are characterized by intense forms of violence, such as torture, maiming and rape. Political scientists suggest that this form of political violence is fostered through the provision of particular intrinsic and extrinsic rewards to combatants. In the field of psychology, the perpetration of this kind of cruelty is observed to be positively linked to appetitive aggression. Over time, combatants start to enjoy the fights and even the perpetration of atrocities. In this study, we examine how receiving rewards (intrinsic versus extrinsic) influence the level of appetitive aggression exhibited by former combatants. We surveyed 95 former combatants in the eastern provinces of the Democratic Republic of the Congo. Linear regression analyses reveal that intrinsic as well as extrinsic rewards are linked to the former combatants' Appetitive Aggression score. However, this relationship is partly determined by the way in which combatants are recruited: While abducted combatants seem to react more strongly to extrinsic rewards, the score of those that joined voluntarily is primarily determined by intrinsic rewards. We conclude that receiving rewards influence the level of appetitive aggression. However, which type of rewards (intrinsic versus extrinsic) is of most importance is determined by the way combatants are recruited.

Long-term consequences of traumatic experiences: an assessment of former political detainees in romania

PubMed Central

2005-01-01

Background Research has suggested that organized violence and torture have long-term psychological effects that persist throughout the lifespan. The present survey aimed at examining the prevalence of posttraumatic stress disorder (PTSD), and other disorders and symptoms, all present in old age, as long-term consequences of politically motivated violence in a comparison design. Methods A group of former political detainees (N = 59, mean age 73.5 years) who had been arrested by the Romanian communist regime were compared to an age- and gender-matched control group (N = 39). PTSD was assessed using a structured clinical interview (CIDI). The investigation of the clinical profile was further accomplished by self-rating measures for anxiety, depression, and health-related functioning, as well as by clinician-administrated interviews for substance abuse, dissociation, and somatization symptoms. Results Lifetime prevalence of PTSD was 54%. In the case of participants left untreated, PTSD persisted, often over four decades, such that current PTSD was diagnosed still in a third of the survivors. Other clinical conditions such as somatization, substance abuse, dissociative disorders, and major depression were also common among the former political detainees and often associated with current PTSD. Conclusion Our findings suggest that political detention may have long-term psychological consequences that outlast the changes in the political system. PMID:16185364

Violence and health: preliminary elements for thought and action.

PubMed

Franco Agudelo, S

1992-01-01

Violence is one of the most serious problems that society, and the public health sector in particular, has to deal with today. This article begins with a discussion of the concept of violence itself, bringing out its historical and cultural dimensions and emphasizing its essential relationship to the exercise of force in the interest of power under conditions of inequality. Violence must be seen as a process that includes its origins, the conditions that allow it to happen, its different forms of expression, and its individual and collective consequences. The violence-health relationship is seen as having different levels: violence threatens or denies not only health but the entire vital human process. The author analyzes the different forms of violence: violence that impairs health (torture, disappearances, rape, child abuse, elderly abuse) and violence that kills (suicide, homicide, war). Recent data show that the problem is on the increase and pervades everyday life. The author then examines the mechanisms by which violence impinges on health care institutions, especially the health services, training institutions, and agencies responsible for orienting and financing the sector. Finally, the health sector is revealed as not only a victim or patient of violence, but, unfortunately, sometimes an agent of violence, which means that changes are needed in approaches, attitudes, and behavior.

Analyzing the microfoundations of human violence in the DRC - intrinsic and extrinsic rewards and the prediction of appetitive aggression

PubMed Central

2013-01-01

Background Civil wars are characterized by intense forms of violence, such as torture, maiming and rape. Political scientists suggest that this form of political violence is fostered through the provision of particular intrinsic and extrinsic rewards to combatants. In the field of psychology, the perpetration of this kind of cruelty is observed to be positively linked to appetitive aggression. Over time, combatants start to enjoy the fights and even the perpetration of atrocities. In this study, we examine how receiving rewards (intrinsic versus extrinsic) influence the level of appetitive aggression exhibited by former combatants. Method We surveyed 95 former combatants in the eastern provinces of the Democratic Republic of the Congo. Results Linear regression analyses reveal that intrinsic as well as extrinsic rewards are linked to the former combatants’ Appetitive Aggression score. However, this relationship is partly determined by the way in which combatants are recruited: While abducted combatants seem to react more strongly to extrinsic rewards, the score of those that joined voluntarily is primarily determined by intrinsic rewards. Conclusions We conclude that receiving rewards influence the level of appetitive aggression. However, which type of rewards (intrinsic versus extrinsic) is of most importance is determined by the way combatants are recruited. PMID:23683122

When Care is a "Systematic Route of Torture": Conceptualizing the Violence of Medical Negligence in Resource-Poor Settings.

PubMed

Heckert, Carina

2016-12-01

Descriptions of patient mistreatment fill ethnographic accounts of healthcare in resource-poor settings. Often, anthropologists point to structural factors and the ways that the global political economy produces substandard care. This approach makes it difficult to hold parties accountable when there is blatant disregard for human life on the part of individuals providing care. In this article, I draw on the illness narrative of Magaly Chacón, the first HIV positive individual in Bolivia to file charges of medical negligence after failing to receive care to prevent mother-to-child transmission. Magaly's narrative demonstrates how structural conditions are often used to explain away poor patient outcomes, shifting attention away from and normalizing the symbolic violence that also perpetuates substandard care of marginalized patients. I use Magaly's accusations to interrogate how defining acts of mistreatment as medical negligence can be a productive exercise, even when it is difficult to disentangle structural constraints from blatant acts of negligence. Defining who is negligent in resource-poor settings is not easy, as Magaly's case demonstrates. However, Magaly's case also demonstrates that accusations of negligence themselves can demand accountability and force changes within the local structures that contribute to the systematic mistreatment of marginalized patients.

Intersections of Western biomedical ethics and world culture: problematic and possibility.

PubMed

Pellegrino, Edmund D

1992-01-01

... What emerges from the intersection of systems of medical ethics across cultural lines is a recognition of the need for and the possibility of some form of metacultural ethic that can ameliorate cultural relativism. In medical ethics, all ethical positions are not of equal moral status -- regardless of how tightly bound they may be to a particular culture; for example, consider the nearly universal approbation for cooperative efforts of physicians who oppose the use of nuclear weapons and the condemnation of physicians who torture or experiment with prisoners of war. Even if violations of patient rights are tolerated in certain social and cultural settings, they are not tolerable in any common ethic of medicine. Growing recognition of the moral rights of patients, their special vulnerability as sick persons, and their dependency on the physician's knowledge constitute the empirical foundation of a morally defensible ethic of medicine. Those cultural systems that violate such norms cannot be given equal moral standing with systems that respect these norms, not because the cultural systems that support human and patients' rights are per se superior but because the protection of human rights is grounded in something more fundamental than culture -- the deference owed to all human beings qua human beings. This is a norm by which every culture may be judged....

Is Tickling Torture? Assessing Welfare towards Slow Lorises (Nycticebus spp.) within Web 2.0 Videos.

PubMed

Nekaris, K Anne I; Musing, Louisa; Vazquez, Asier Gil; Donati, Giuseppe

2015-01-01

Videos, memes and images of pet slow lorises have become increasingly popular on the Internet. Although some video sites allow viewers to tag material as 'animal cruelty', no site has yet acknowledged the presence of cruelty in slow loris videos. We examined 100 online videos to assess whether they violated the 'five freedoms' of animal welfare and whether presence or absence of these conditions contributed to the number of thumbs up and views received by the videos. We found that all 100 videos showed at least 1 condition known as negative for lorises, indicating absence of the necessary freedom; 4% showed only 1 condition, but in nearly one third (31.3%) all 5 chosen criteria were present, including human contact (57%), daylight (87%), signs of stress/ill health (53%), unnatural environment (91%) and isolation from conspecifics (77%). The public were more likely to like videos where a slow loris was kept in the light or displayed signs of stress. Recent work on primates has shown that imagery of primates in a human context can cause viewers to perceive them as less threatened. Prevalence of a positive public opinion of such videos is a real threat towards awareness of the conservation crisis faced by slow lorises. © 2016 S. Karger AG, Basel.

The psychiatric profession and the Australian government: the debate over collective depression syndrome among asylum-seeking detainees

PubMed Central

Bostock, William W

2009-01-01

Psychiatrists have long had involvement with the political process, both individually and as a profession. They have made valuable contributions to debate over such issues as war, conflict, terrorism, torture, human rights abuse, drug abuse, suicide and other public health issues. However, they have also been complicit in some gross atrocities. Over several years there has been debate over the Australian Government’s treatment of asylum seekers, and the Royal Australian and New Zealand College of Psychiatrists took the unusual step of publicly criticizing the Australian Government’s policy on grounds of its toxicity leading to a diagnosis of collective depression syndrome, particularly among child detainees, but also adult detainees. The official Ministerial response was to deny that collective depression exists and to assert that the concept is meaningless. Can this intervention by psychiatrists be interpreted as a product of earlier political behaviors by psychiatrists? The willingness of psychiatrists to cooperate with other professions, notably psychologists, pediatricians, physicians and lawyers, is noted, as is presence of minority voices within the Australian psychiatric profession. The significance of the debate over the mental condition of asylum-seeking detainees is that its outcome has implications for how Australia sees itself and is seen by the rest of the world, that is, its national identity. PMID:22110326

Assessing reliability and validity of the Arabic language version of the Post-traumatic Diagnostic Scale (PDS) Symptom Items

PubMed Central

Norris, Anne E.; Aroian, Karen J.

2009-01-01

Arab immigrant women are vulnerable to posttraumatic stress disorder (PTSD) because of gender, higher probability of being exposed to war-related violence, traditional cultural values, and immigration stressors. A valid and reliable screen is needed to assess the incidence of PTSD in this population. This study evaluated the reliability and validity of an Arabic language version of the symptom items in the Posttraumatic Diagnostic Scale (PDS) in a sample of Arab immigrant women (n = 453). Reliability was supported by Cronbach’s alpha values for the Arabic language version (0.93) and its subscales (0.77-0.91). Results of group comparisons supported validity: Among women who had lived in a refugee camp and had emigrated from Iraq – a country where exposure to war and torture is common -- those who were exhibiting depressive symptoms (CES-D score above 16) or who reported moderate-to-severe impairment in functioning had significantly higher mean PDS total and symptom subscale scores than women who had not had these experiences or were not exhibiting depressive symptoms. Scores on the PDS and its subscales were also positively correlated with the Profile of Mood States (POMS) depression and anxiety subscales and negatively correlated with the POMS vigor subscale. PMID:18718671

Storytelling, sugar snacking, and toothbrushing rules: a proposed theoretical and developmental perspective on children's health and oral health literacy.

PubMed

Freeman, Ruth

2015-09-01

Health literacy has been conceptualised to explain how health information facilitates the maintenance of health. What are the clinical implications of children's health literacy? Children have language skills, numeracy, and reading skills that are in a state of flux - how do they decipher and encode adult health messages to make them their own? To explore children's health and oral health literacy and discover what processes they use to convert adult health messages into useable information. Observations and descriptive case study approach. A theoretical and developmental perspective on children's health and oral health literacy, based upon the ability of the adult to provide a health message with a common shared element, is proposed. It is this common element that the child uses to make adult words understandable and to generate health action. Children's health and oral health literacy development is achieved, through, a torturous path, supported by the way adults provide health messages to children. Taking time to identify this common element, helping children to encode and reflect upon the health message will help children convert adult oral health messages into their own oral health practices, and support their emerging health and oral health literacy. © 2015 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Psyche and culture: Perspectives based on the contributions and limits of ethnopsychiatry.

PubMed

Stitou, Rajaa

2016-12-01

The unconscious often appears in the form of a question or answer to the difficult relationship between the psyche and culture, a difficulty that becomes exacerbated when we are dealing with cultural difference. This difficulty, evidenced for example by Freud's thoughts on Islam, reappears, albeit in a very different way, in ethnopsychiatric theory. The author discusses the blind spots of the binary logic of the unconscious present in the work of George Devereux, a logic that eventually leads him into the same trap he had himself criticized. This discussion allows us to open up other perspectives, by moving away from the analogies, confusions and splits between the psyche and culture towards what binds them together. This link is sustained by language and its dialectics, at the crossroads of individual singularity and cultural codifications. The author's approach is supported by two clinical vignettes: one from a case of a young Turkish woman, the other concerning a male Iraqi patient, a survivor of torture. This approach distances itself from any psychocentric view that would see the psyche as closed upon itself and thus ultimately exclude any object-relations and inter-subjective relationships; likewise, it rejects the ethnocentric conflation of the subject with his culture. Copyright © 2016 Institute of Psychoanalysis.

Political Imprisonment and Adult Functioning: A Life Event History Analysis of Palestinians.

PubMed

McNeely, Clea; Barber, Brian K; Spellings, Carolyn; Belli, Robert; Giacaman, Rita; Arafat, Cairo; Daher, Mahmoud; El Sarraj, Eyad; Mallouh, Mohammed Abu

2015-06-01

Political imprisonment is a traumatic event, often accompanied by torture and deprivation. This study explores the association of political imprisonment between 1987 and 2011 with political, economic, community, psychological, physical, and family functioning in a population-based sample of Palestinian men ages 32-43 years (N = 884) derived from a dataset collected in 2011. Twenty-six percent (n = 233) had been politically imprisoned. Men imprisoned between 1987 and 2005 reported functioning as well as never-imprisoned men in most domains, suggesting that men imprisoned as youth have moved forward with their lives in ways similar to their nonimprisoned counterparts. In an exception to this pattern, men imprisoned during the Oslo Accords period (1994-1999) reported higher levels of trauma-related stress (B = 0.24, p = .027) compared to never-imprisoned men. Men imprisoned since 2006 reported lower functioning in multiple domains: human insecurity (B = 0.33, p = .023), freedom of public expression (B = -0.48, p = .017), perceived government stability (B = -0.38, p = .009), feeling broken or destroyed (B = 0.59, p = .001), physical limitations (B = 0.55, p = .002), and community belonging (B = -0.33, p = .048). Findings pointed to the value of examining the effects of imprisonment on functioning in multiple domains. © 2015 International Society for Traumatic Stress Studies.

[Impact of eating psychopathology, obsessive-compulsion and depression on self-harm behavior in patients with eating disorders].

PubMed

Kong, Seong Sook

2009-08-01

The purpose of the study was to investigate psychological factors such as eating psychopathology, depression, and obsessive-compulsion that might influence self-harm behavior in patients with eating disorders. Patients with eating disorders (n=135) who visited "M" clinic for eating disorders participated in the study. Data were collected from March to August 2007 using the Eating Disorder Inventory-2, Beck Depression Inventory, Maudsley Obsessional-Compulsive Inventory, and Self-Harm Inventory (SHI). The participants scored high on self-harm as well as on depression and obsessive-compulsion. On the SHI, a high frequency of self harm behavior such as 'torturing self with self-defeating thoughts', 'abused alcohol', 'hit self', and 'suicide attempt' were found for the participants. There were significant correlations between most eating psychopathology variables, depression, obsessive-compulsion, and self-harm behavior. 'Interoceptive awareness' (eating psychopathology), depression, and 'checking' (obsessive-compulsion) were significant predictors of self-harm behavior. Future interventions for patients with eating disorders should focus on assessing the possibility of self-harm and suicidal attempts, especially in those patients with high levels of eating psychopathology, depression, or obsessive-compulsion. Early intervention for depression and obsessive-compulsion could contribute to preventing self-harm and suicide in patients with eating disorders.

Investigations on human and animal remains from a medieval shaft well in Ayasuluk/Ephesos (Turkey).

PubMed

Kanz, Fabian; Pfeiffer-Taş, Şule; Forstenpointner, Gerhard; Galik, Alfred; Weissengruber, Gerald; Grossschmidt, Karl; Risser, Daniele U

2014-01-01

In course of the archaeological survey of Ayasuluk/Ephesos region (Turkey), a shaft well situated at the area of an extensive medieval bathing complex was excavated. In the stratum corresponding to the reign Mehmed II the well-preserved skeletons of two humans, an equine and a canine were recovered. Anthropological analysis of the human skeletons indentified two males aged 22 (± 3) and 36 (± 5) years. The skeleton of the younger individual showed signs of various antemortal conditions, including a well-healed fraction of right arc of the fifth lumbar vertebra, and a marked asymmetry of the shoulder joints. The older individual exhibited significant peri/postmortem injuries at the elbows, with evident signs of peeling and external burning. Also, the few elements of the cranium recovered showed also indications of burning. Archaeozoological characterization of the complete skeletons of the equine and canine established evidence of well cared-for animals of high value. The time of disposal of this group coincides with uprising of the formerly ruling Aydnoullar clan against the Ottomans in power. The human individuals recovered from the well may have been members of Aydnoullar tribe or men in service of the latter, suffering severe torture and/or mutilation for siding with the rebels after defeat.

The political abuse of medicine and the challenge of opposing it.

PubMed

Zwi, A B

1987-01-01

A fundamental aim of medicine is to protect and promote health. The practice of medicine has, however, been used to promote political aims which may be detrimental to health. The article attempts to isolate the ways in which political abuses may interfere with good medical practice: by allowing health policies to be influenced by undemocratic political considerations; by using health services to reward or punish political supporters or opponents; by direct medical involvement in political acts which contradict accepted medical ethics; and by the support which conventional medical practises give to perpetuating inequalities in health and social services. Each of these is examined with the use of a number of examples. The ways in which medical personnel have opposed the political abuse of medicine is explored by a brief review of the opposition of Chilean doctors to torture, the involvement of South African doctors in opposing the abuse of health services in perpetuating apartheid, and the growing medical movement in opposition to nuclear war. Some comments concerning the monitoring of a multitude of medical disciplines which are open to political abuse are made. The purpose of the paper is primarily to stimulate debate around this important issue and it does not attempt to provide a comprehensive review of the political abuse of medicine.

Forerunner of the Science of Psychoanalysis? An Essay on the Spanish and Portuguese Inquisition.

PubMed

Simms, Norman

2015-01-01

The inquisitions in Spain and Portugual were state organs, rather than church-run enterprises; their purpose to modernize disparate jurisdictions during the final stages of Reconquista (return of Moorish areas to Christian administration) to ensure security and loyalty. So many Jews converted (under duress or willingly for strategic reasons) and inter-married with middle-class and aristocratic families, that their sincerity and loyalty was suspected, This meant going beyond traditional monitoring of ritual acts and social behaviour; there was a need to look below the surface, to interpret ambiguity, and to break codes of duplicity. Inquisitors developed techniques of a form of psychoanalysis before the discoveries of Freud: methods of questioning to bring out repressed beliefs and motivations, unriddling equivocational performance and speech-acts, and integrating fragments of information from family members, business associates and neighbours collected over many years. Torture, more threatened than actual, and lengthy incarceration punctuated by periods of exile and re-arrest after years quiet, provoked desperate confessions and specious denunciations, all of which had to be subject to intense scrutiny and analysis. The assumption was modern: a person's self was no longer equivalent to their words and actions; instead, a deep dark and traumatized inner self to be revealed.

Active formation of `chaos terrain' over shallow subsurface water on Europa

NASA Astrophysics Data System (ADS)

Schmidt, B. E.; Blankenship, D. D.; Patterson, G. W.; Schenk, P. M.

2011-11-01

Europa, the innermost icy satellite of Jupiter, has a tortured young surface and sustains a liquid water ocean below an ice shell of highly debated thickness. Quasi-circular areas of ice disruption called chaos terrains are unique to Europa, and both their formation and the ice-shell thickness depend on Europa's thermal state. No model so far has been able to explain why features such as Conamara Chaos stand above surrounding terrain and contain matrix domes. Melt-through of a thin (few-kilometre) shell is thermodynamically improbable and cannot raise the ice. The buoyancy of material rising as either plumes of warm, pure ice called diapirs or convective cells in a thick (>10 kilometres) shell is insufficient to produce the observed chaos heights, and no single plume can create matrix domes. Here we report an analysis of archival data from Europa, guided by processes observed within Earth's subglacial volcanoes and ice shelves. The data suggest that chaos terrains form above liquid water lenses perched within the ice shell as shallow as 3kilometres. Our results suggest that ice-water interactions and freeze-out give rise to the diverse morphologies and topography of chaos terrains. The sunken topography of Thera Macula indicates that Europa is actively resurfacing over a lens comparable in volume to the Great Lakes in North America.

Psychiatric care in the German prison system.

PubMed

Lehmann, Marc

2012-01-01

The purpose of this paper is to describe the nature of medical care within the German penal system. German prison services provide health care for all inmates, including psychiatric care. The reached level of equivalence of care and ethical problems and resource limitations are discussed and the way of legislation in this field since 2006 reform on federal law is described. The article summarizes basic data on German prison health care for mentally ill inmates. The legislation process and factors of influence are pointed out. A description of how psychiatric care is organized in German prisons follows. It focuses on the actual legal situation including European standards of prison health care and prevention of torture, psychiatric care in German prisons themselves, self harm and addiction. Associated problems such as blood born diseases and tuberculosis are included. The interactions between prison staff and health care personal and ethic aspects are discussed. The legislation process is still going on and there is still a chance to improve psychiatric care. Mental health problems are the major challenge for prison health care. Factors such as special problems of migrants, shortage of professionals and pure statistic data are considered. The paper provides a general overview on psychiatric services in prison and names weak points and strengths of the system.

Audit of custodial deaths in Karachi--an autopsy-based study.

PubMed

Mirza, Farhat Hussain; Memon, Akhtar Amin; Adil, Syeda Ezz-e-Rukhshan; Paryar, Hamid Ali

2012-08-01

To assess the causes and manner of custodial deaths in Karachi, and to determine the factor of negligence on the part of the custodians behind such deaths. The cross-sectional study involved the deaths in custody undergoing autopsy at Civil Hospital, Karachi, from January 2005 to December 2010. Autopsy was followed by histological examination, X-ray or CT scan wherever required. A proforma was also filled as per the standard autopsy protocol. There were 61 custodial deaths in Karachi during the six-year study period which met the inclusion criterion. There were 58 (95.1%) males and 3 (9.4%) females. Natural causes accounted for a majority of deaths (n = 36; 59%), the most common disease being coronary artery disease (n = 13; 21.3%). Unnatural causes accounted for 25 (41%) deaths, comprising 13 (21.3%) homicidal, 7 (11.5%) suicidal and 5 (8.2%) accidental. Deaths were more frequent in the age group ranging from 30-39 years (34.4%), while the overall age-range was from 19 to 75 years. Measures need to be taken to provide a wholesome environment for the prisoners. Code of conduct for the prisoners should be followed and judicial procedures shall be conducted at a quick pace. Torture should be avoided under all circumstances, and proper vigilance shall be kept to prompt suicidal deaths.

Active formation of 'chaos terrain' over shallow subsurface water on Europa.

PubMed

Schmidt, B E; Blankenship, D D; Patterson, G W; Schenk, P M

2011-11-16

Europa, the innermost icy satellite of Jupiter, has a tortured young surface and sustains a liquid water ocean below an ice shell of highly debated thickness. Quasi-circular areas of ice disruption called chaos terrains are unique to Europa, and both their formation and the ice-shell thickness depend on Europa's thermal state. No model so far has been able to explain why features such as Conamara Chaos stand above surrounding terrain and contain matrix domes. Melt-through of a thin (few-kilometre) shell is thermodynamically improbable and cannot raise the ice. The buoyancy of material rising as either plumes of warm, pure ice called diapirs or convective cells in a thick (>10 kilometres) shell is insufficient to produce the observed chaos heights, and no single plume can create matrix domes. Here we report an analysis of archival data from Europa, guided by processes observed within Earth's subglacial volcanoes and ice shelves. The data suggest that chaos terrains form above liquid water lenses perched within the ice shell as shallow as 3 kilometres. Our results suggest that ice-water interactions and freeze-out give rise to the diverse morphologies and topography of chaos terrains. The sunken topography of Thera Macula indicates that Europa is actively resurfacing over a lens comparable in volume to the Great Lakes in North America. ©2011 Macmillan Publishers Limited. All rights reserved

Dua sakit (double sick): trauma and the settlement experiences of West Papuan refugees living in North Queensland.

PubMed

Rees, Susan; Silove, Derrick; Kareth, Moses

2009-08-01

There is mounting evidence of systematic abuses, including torture, rape and extrajudicial killings directed against independence activists as well as the civilian population in Indonesian occupied West Papua. Refugees from West Papua have sought safety in neighbouring Australia, experiencing hazardous journeys during their flight. We report early observations from a mental health study among West Papuan refugees living in North Queensland, Australia. The project includes qualitative methods aimed at gathering histories of trauma and human rights violations as well as standard mental health assessments and indices of acculturation and resettlement stresses. We consider the emerging data from the vantage point of the Adaptation and Development After Persecution and Trauma model that identifies five psychosocial domains that require repair following exposure to gross human rights violations and refugee trauma. The model emphasizes the inter-relatedness of key challenges, the compounding of adversity, and the bivalent effects of complex experiences, with both positive and negative elements shaping the adaptive trajectory of displaced persons. Refugee groups have their own approaches to conceptualizing the complexity of their problems, with the term dua sakit representing the expression used by West Papuans to identify the multiple challenges they face. The study highlights the importance of assessing each refugee group within its unique social and cultural context, taking into account such diverse factors as geographical location, employment, and ongoing conflict in the homeland in designing appropriate interventions.

Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System

PubMed Central

Carone, Marco; Al-Saedy, Huda; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Black, Robert E

2012-01-01

Abstract Objective To determine the range and burden of health services utilization among Iraqi refugees receiving health assistance in Jordan, a country of first asylum. Methods Medical conditions, diagnosed in accordance with the tenth revision of the International classification of diseases, were actively monitored from 1January to 31December 2010 using a pilot centralized database in Jordan called the Refugee Assistance Information System. Findings There were 27 166 medical visits by 7642 Iraqi refugees (mean age: 37.4 years; 49% male; 70% from Baghdad; 6% disabled; 3% with a history of torture). Chronic diseases were common, including essential hypertension (22% of refugees), visual disturbances (12%), joint disorders (11%) and type II diabetes mellitus (11%). The most common reasons for seeking acute care were upper respiratory tract infection (11%), supervision of normal pregnancy (4%) and urinary disorders (3%). The conditions requiring the highest number of visits per refugee were cerebrovascular disease (1.46 visits), senile cataract (1.46) and glaucoma (1.44). Sponsored care included 31 747 referrals or consultations to a specialty service, 18 432 drug dispensations, 2307 laboratory studies and 1090 X-rays. The specialties most commonly required were ophthalmology, dentistry, gynaecology and orthopaedic surgery. Conclusion Iraqi refugees in countries of first asylum and resettlement require targeted health services, health education and sustainable prevention and control strategies for predominantly chronic diseases. PMID:22690034

Surveillance of Ocular Parameters and Visual Function in Bed Rest Subjects

NASA Technical Reports Server (NTRS)

Cromwell, Ronita L.

2011-01-01

Recent visual changes in astronauts have raised concern about ocular health during long duration spaceflight. Seven cases have been documented in astronauts who spent 6 months aboard the International Space Station. These astronauts were male ranging in age from 45 to 55 years old. All astronauts exhibited pre- to post flight refractive changes. Decreased intraocular pressure (IOP) post flight was observed in 3 cases. Fundoscopic exams revealed post flight findings of choroidal folds in 4 cases, optic disc edema in 5 cases and the presence of cotton wool spots in 3 cases. Optical coherence tomography (OCT) confirmed findings of choroidal folds and disc edema, and also documented retinal nerve fiber layer thickening (5 cases). Findings from MRI examinations showed posterior globe flattening (5 cases), optic nerve sheath distention (6 cases) and torturous optic nerves (2 cases). Of the 7 cases, intracranial pressure was measured on 4 astronauts. These 4 showed elevated ICP post-flight that remained elevated for as long as 19 months in one case. While the etiology remains unknown, hypotheses speculate that venous insufficiency or hypertension in the brain caused by cephalad fluid shifts during spaceflight are possible mechanisms for ocular changes seen in astronauts. Head-down tilt bed rest is a spaceflight analog that induces cephalad fluid shifts. This study is designed to provide ocular monitoring of bed rest subjects and determine whether clinically relevant changes are found. Ocular Changes

From "Animal Machines" to "Happy Meat"? Foucault's Ideas of Disciplinary and Pastoral Power Applied to 'Animal-Centred' Welfare Discourse.

PubMed

Cole, Matthew

2011-01-11

Michel Foucault's work traces shifting techniques in the governance of humans, from the production of 'docile bodies' subjected to the knowledge formations of the human sciences (disciplinary power), to the facilitation of self-governing agents directed towards specified forms of self-knowledge by quasi-therapeutic authorities (pastoral power). While mindful of the important differences between the governance of human subjects and the oppression of nonhuman animals, exemplified in nonhuman animals' legal status as property, this paper explores parallel shifts from disciplinary to pastoral regimes of human-'farmed' animal relations. Recent innovations in 'animal-centred' welfare science represent a trend away from the 'disciplinary' techniques of confinement and torture associated with 'factory farms' and towards quasi-therapeutic ways of claiming to know 'farmed' animals, in which the animals themselves are co-opted into the processes by which knowledge about them is generated. The new pastoral turn in 'animal-centred' welfare finds popular expression in 'happy meat' discourses that invite 'consumers' to adopt a position of vicarious carer for the 'farmed' animals who they eat. The paper concludes that while 'animal-centred' welfare reform and 'happy meat' discourses promise a possibility of a somewhat less degraded life for some 'farmed' animals, they do so by perpetuating exploitation and oppression and entrenching speciesist privilege by making it less vulnerable to critical scrutiny.

British Muslims and the UK government's 'war on terror' within: evidence of a clash of civilizations or emergent de-civilizing processes?

PubMed

Vertigans, Stephen

2010-03-01

In the immediate aftermath of the September 2001 attacks on America, defending civilization was quickly established at the core of the 'war on terror'. Unintentionally or otherwise this incorporation of civilization connected with Samuel Huntington's 'Clash of Civilizations' thesis. Within the 'war on terror' the dark side of counterterrorism has become apparent through international practices like extrajudicial killing, extraordinary rendition and torture. The impact of Western governments' policies upon their indigenous Muslim populations has also been problematic but social and political analysis has been relatively limited. This paper seeks to help address the scarcity of sociological contributions. Hidden costs of the UK government's attempts to utilize violence and enhance social constraints within the nation-state are identified. It is argued that although counterterrorism strategies are contributing to a self-fulfilling spiral of hatred that could be considered evidence in support of the 'Clash of Civilizations', the thesis is unhelpful when trying to grasp the underlying processes. Instead the paper draws upon Norbert Elias's application of the concepts of 'civilizing' and 'de-civilizing' to help improve levels of understanding about the processes and consequences of particular Muslim communities being targeted by security forces. The paper concludes with an exploration of the majority of the population's acquiescence and willingness to accept restraints upon Muslims in order to safeguard their own security.

Constitution, 30 September 1987.

PubMed

1987-01-01

This document reprints provisions of Suriname's 1987 Constitution relating to freedom of movement, equality of the sexes, the right to life, the right to physical integrity, equal opportunity in employment, the family, children, maternity benefits, the right to health care, parental responsibilities, free and compulsory education, illiteracy, and housing. All citizens enjoy freedom of movement within the bounds of the law. All people within the territory may claim protection of their person and property, and discrimination is forbidden on the basis of birth, sex, race, language, religion, education, political beliefs, economic position, or other status. Torture or inhuman treatment and punishment is banned, and the right to life is protected by the law. The state guarantees the right to work, and all employees have the right to equal remuneration for equal work, safe working conditions, and sufficient rest and recreation. The family is protected, and husbands and wives are equal before the law. Children have the right to protection, and working women are entitled to paid maternity leave. The state promotes the right to good health by systematic improvements in living and working conditions and dissemination of health education. The right to education is protected by the provision of free general primary education and efforts of the state to enable all citizens to achieve the highest educational levels possible. The Constitution also calls for the institution of a plan to allow the state to create public housing.

Economic evaluation of a bio-psycho-social intervention for comorbid disorders in a traumatized population in post-war Kosovo.

PubMed

Chang, Wei-Lun; Andersen, Carit Jacques; Berisha, Besa Shatri; Estrup, Olena; Wang, Shr-Jie

2018-05-08

Post-hoc economic evaluation of a bio-psycho-social intervention in post-war Kosovo from a societal perspective. Cost-effectiveness analysis, cost-utility analysis, and partial cost-benefit analysis using data from a randomized controlled trial. Thirty-four torture/war victims with comorbid conditions enrolled in 2012-2013. Participants were randomly assigned to an "intervention" and a "waiting-list" group. Changes in mental, emotional and physical health and functional impairment were assessed before and after treatment, along with increase in labour income as a proxy for productivity gain. The cost of an extra unit of effectiveness and an additional quality-adjusted life year were calculated. The total cost per participant was €1,322 including, or €1,019 excluding, research costs. Wide variations in costs of changes in mental, emotional and physical effectiveness were demonstrated. Multidisciplinary intervention resulted in functional improvement at a cost of €10,508 per quality-adjusted life year gained. With a mean monthly income increase to €133 (18%) after intervention, the intervention cost per participant would be equal to the total increase in monthly income after 4-5 years, assuming the increased level is maintained. Socio-economic benefit associated with quality-adjusted life year gain is shown, although the cost of an additional quality-adjusted life year is above the World Health Organization cost-effectiveness threshold.

Music and 're-education' in the Soviet Gulag.

PubMed

Klause, Inna

2013-01-01

After the October Revolution, the Bolsheviks announced a new human dimension of penal policy whose goal should be the so-called 're-education' of prisoners. The desired 're-education' was to be realised using two kinds of measures: the physical work of the prisoners, and 'cultural education work'. A varied musical life in groups, 'agitation brigades', ensembles, orchestras and choirs developed within the framework of the 'cultural education work'. Two camps responsible for building canals in the 1930s particularly adopted this musical life: Belbaltlag and Dmitlag. In the latter, a composition competition took place in 1936 in which, among others, the arrested composer Sergey Protopopov took part. Since the 1930s, the Gulag administration had publicised that the measures taken for 're-education' concerned primarily criminal prisoners, as opposed to 'political prisoners', who were labelled as foreign to socialist society. Although the 'cultural education work' would not have functioned as well as it did without the cooperation of 'political prisoners', since their participation did not fit into the prescribed ideology, they were often underappreciated or even completely concealed. The following is a depiction of the officially organised musical life in the Gulag in the 1920s and 1930s as a grey zone. Music making and listening represented not only a source of strength for the prisoners, but also brought about situations that meant physical and psychological torture for them.

What Therapies are Favored in the Treatment of the Psychological Sequelae of Trauma in Human Trafficking Victims?

PubMed

Salami, Temilola; Gordon, Mollie; Coverdale, John; Nguyen, Phuong T

2018-03-01

Human trafficking is a major public health concern that brings about deleterious psychological consequences and sequelae. Although a number of risk and protective factors for the health consequences of human trafficking victims have been identified, there is a dearth of information in the area of treatment. Specifically, we found no articles comparing the different components of prevailing trauma treatment strategies, and the potential usefulness of these strategies in the treatment of human trafficking victims. To this end, we compared and contrasted the different therapeutic treatments typically implemented with victims of trauma (including domestic violence victims and torture victims), and discussed how the different components of these treatments may or may not be helpful for human trafficking victims. We assessed the impact of these treatments on the psychological consequences of trauma and, in particular on posttraumatic stress disorder. We also assessed the potential usefulness of these treatments with co-occurring problems such as substance use, psychosis, dissociation, and other mood and anxiety disorders. On the basis of the prevailing research, we highlighted cognitive therapies as being preferred in addressing the needs of human trafficking victims. Mental health providers who work with human trafficking victims should become aware of and practiced in the use of cognitive therapeutic approaches in treating this population. Efficacy and effectiveness studies are needed to validate our recommendations.

Feminism and nursing.

PubMed

Chinn, P L; Wheeler, C E

1985-01-01

Feminism provides a personal, philosophic and political means for analyzing the realities of women's lives as lived in patriarchal systems. It is not a single line of thought; multiple approaches have been developed that provide diverse avenues for confronting systematic injustices while learning to value ourselves as women. Jo Ann Ashley, recognizing that new realities must emerge from within nursing rather than from other groups, states: "For many years we have heard that nursing is at the crossroads. Nursing never seems to get over being at a crossroads. Indeed, nursing has been at a crossroads many times, but instead of taking a new road, leaders in the profession always choose to continue bearing the burden of continuing to live out the subservient role under the patriarchal system, rather than taking a new road that can lead beyond patriarchy. Nursing is no longer at a crossroads. It is at a turning point. It needs to turn away from being the "token torturer" of itself and other women. It needs to turn toward the health awaiting women in a woman-defined, woman-created world that lies beyond patriarchal ideas and institutions." Movement in this direction requires becoming familiar with feminist literature and the insights that women scholars have provided. In nursing, a feminist perspective requires an uncompromising questioning of the forces that divide us from one another, the ethics of our actions, and our co-optation into the unhealthy environment of the current health care system.

Systemic trauma.

PubMed

Goldsmith, Rachel E; Martin, Christina Gamache; Smith, Carly Parnitzke

2014-01-01

Substantial theoretical, empirical, and clinical work examines trauma as it relates to individual victims and perpetrators. As trauma professionals, it is necessary to acknowledge facets of institutions, cultures, and communities that contribute to trauma and subsequent outcomes. Systemic trauma-contextual features of environments and institutions that give rise to trauma, maintain it, and impact posttraumatic responses-provides a framework for considering the full range of traumatic phenomena. The current issue of the Journal of Trauma & Dissociation is composed of articles that incorporate systemic approaches to trauma. This perspective extends conceptualizations of trauma to consider the influence of environments such as schools and universities, churches and other religious institutions, the military, workplace settings, hospitals, jails, and prisons; agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media; conflicts involving war, torture, terrorism, and refugees; dynamics of racism, sexism, discrimination, bullying, and homophobia; and issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention. Although it may be challenging to expand psychological and psychiatric paradigms of trauma, a systemic trauma perspective is necessary on both scientific and ethical grounds. Furthermore, a systemic trauma perspective reflects current approaches in the fields of global health, nursing, social work, and human rights. Empirical investigations and intervention science informed by this paradigm have the potential to advance scientific inquiry, lower the incidence of a broader range of traumatic experiences, and help to alleviate personal and societal suffering.

Quantitative survey on health and violence endured by refugees during their journey and in Calais, France

PubMed Central

Bouhenia, Malika; Farhat, Jihane Ben; Coldiron, Matthew E; Abdallah, Saif; Visentin, Delphine; Neuman, Michaël; Berthelot, Mathilde; Porten, Klaudia; Cohuet, Sandra

2017-01-01

Abstract Background In 2015, more than 1 million refugees arrived in Europe. During their travels, refugees often face harsh conditions, violence and torture in transit countries, but there is a lack of quantitative evidence on their experiences. We present the results of a retrospective survey among refugees in the ‘Jungle’ of Calais, France, to document their health problems and the violence they endured during their journeys. Methods We conducted a cross-sectional population-based survey in November and December 2015. The sample size was set at 402 individuals, and geospatial simple random sampling was used. We collected data on demographics, routes travelled, health status, violence and future plans. Results Departures from the country of origin increased beginning in September 2015. Sixty-one percent of respondents reported having at least one health problem, especially while in Calais. Overall, 65.6% (95% CI 60.3–70.6) experienced at least one violent event en route; 81.5% of refugees wanted to go to the UK. Conclusions This first quantitative survey conducted among refugees in Europe provides important socio-demographic data on refugees living in Calais and describes the high rate of violence they encountered during their journeys. Similar documentation should be repeated throughout Europe in order to better respond to the needs of this vulnerable population. PMID:29325099

Restraining good practice: Reviewing evidence of the effects of restraint from the perspective of service users and mental health professionals in the United Kingdom (UK).

PubMed

Cusack, P; McAndrew, S; Cusack, F; Warne, T

2016-01-01

Safeguarding, balancing the concept of risk with the need for public protection and its implication for the lives of individuals, is an important facet of contemporary mental health care. Integral to safeguarding is the protection of human rights; the right to live free from torture, inhuman, or degrading treatment, and having the right to liberty, security, respect, and privacy. Professionals are required to recognise all of these rights when delivering care to vulnerable people. In the United Kingdom (UK) there has been growing public concern regarding abusive practices in institutions, with a number of unacceptable methods of restraint being identified as a feature of care, particularly in mental health care. In keeping with the service user movement, and following a review of the literature, this paper discusses the evidence regarding restraint from the perspectives of service users and professionals within mental health services and considers the implications for future practice and research. In reviewing the literature, findings revealed that restraint can be a form of abuse, it's inappropriate use often being a consequence of fear, neglect, and lack of using de-escalation techniques. Using restraint in this way can have negative implications for the well-being of service users and mental health professionals alike. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Does Wartime Captivity Affect Late-life Mental Health? A Study of Vietnam-era Repatriated Prisoners of War

PubMed Central

Park, Crystal L.; Kaiser, Anica Pless; Spiro, Avron; King, Daniel W.; King, Lynda A.

2012-01-01

Our earlier study of U.S. prisoners of war in Vietnam (King et al., 2011) examined personal and military demographics and aspects of the stressful experience of wartime imprisonment as they related to psychological well-being shortly after homecoming in 1973. Research with repatriated prisoners of war (RPWs) from other military eras suggests that the severity of captivity stressors might predict long-term distress. However, the extent to which effects of the captivity experience persisted for Vietnam-era RPWs is unknown. The present study extended our previous analyses by examining the associations of demographic factors, captivity stressors, and repatriation mental health with subsequent symptoms of posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms (measured nearly 30 years later) in a sample of 292 Vietnam-era RPWs. Results indicated that although most of the men in our sample were within normal limits on anxiety and depressive symptoms, a substantial minority reported experiencing clinically significant levels. Levels of PTSD symptoms were generally low, with only a modest proportion demonstrating elevations. Multiple regression analyses showed that age at capture and posttraumatic stress symptoms at repatriation predicted all three long-term mental health outcomes. In addition, physical torture predicted long-term PTSD symptoms. Findings highlight the potential long-term effects of wartime captivity, and also suggest that most Vietnam-era RPWs demonstrate remarkable resilience to extraordinarily stressful life experiences. PMID:22984347

Eloquent bodies: conflict and ritual in northern Sri Lanka.

PubMed

Derges, Jane

2009-04-01

It is increasingly apparent that hostilities continue in the aftermath of war and conflict, where presuppositions of peace and safety are rarely reflected on the ground. In Sri Lanka, the 2002 ceasefire agreement between the Sri Lankan government and the Liberation Tigers of Tamil Eelam (LTTE) has recently collapsed. This collapse developed slowly over a period of several years, beginning with cautious optimism before descending into deep pessimism with increasingly high levels of violence brought about by the absence of any real progress. Efforts to rebuild and reintegrate both rural and urban communities in the north of the country have had to take place within an atmosphere of silence, suspicion and a marked escalation towards the renewed outbreak of war. This article, following sixteen months of fieldwork in the northern Jaffna peninsula, examines how Tamil youths - many of whom were imprisoned and tortured during the war - have transformed a well-known ritual that has seen a dramatic increase since occupation of the far north by government troops in 1996. The ritual, previously an act of devotion to a popular Tamil god, Murugan, has transformed into a demonstration of strength and youthful challenge. This article examines how toleration of ritual pain can be contrasted with the pain and suffering of war, and articulated not only for the self, but also for the entire community.

Human rights violations among sexual and gender minorities in Kathmandu, Nepal: a qualitative investigation

PubMed Central

2012-01-01

Background Nepal has experienced sporadic reports of human rights violations among sexual and gender minorities. Our objective was to identify a range of human rights that are enshrined in international law and/or are commonly reported by sexual and gender minority participants in Kathmandu, to be nonprotected or violated. Methods In September 2009 three focus group discussions were conducted by trained interviewers among a convenience sample of sexual and gender minority participants in Kathmandu Nepal. The modified Delphi technique was utilized to elicit and rank participant-generated definitions of human rights and their subsequent violations. Data was analyzed independently and cross checked by another investigator. Results Participants (n = 29) reported experiencing a range of human rights violations at home, work, educational, health care settings and in public places. Lack of adequate legal protection, physical and mental abuse and torture were commonly reported. Access to adequate legal protection and improvements in the family and healthcare environment were ranked as the most important priority areas. Conclusions Sexual and gender minorities in Nepal experienced a range of human rights violations. Future efforts should enroll a larger and more systematic sample of participants to determine frequency, timing, and/or intensity of exposure to rights violations, and estimate the population-based impact of these rights violations on specific health outcomes PMID:22591775

MEDICAL AND LEGAL ISSUES OF THE DECISIONS RENDERED BY THE EUROPEAN COURT OF HUMAN RIGHTS.

PubMed

Chakhvadze, B; Chakhvadze, G

2017-01-01

The European Convention on Human rights is a document that protects human rights and fundamental freedoms of individuals, and the European Court of Human Rights and its case-law makes a convention a powerful instrument to meet the new challenges of modernity and protect the principles of rule of law and democracy. This is important, particularly for young democracies, including Georgia. The more that Georgia is a party to this convention. Article 3 of the convention deals with torture, inhuman and degrading treatment, while article 8 deals with private life, home and correspondence. At the same time, the international practice of the European court of human rights shows that these articles are often used with regard to medical rights. The paper highlights the most recent and interesting cases from the case-law of the ECHR, in which the courts conclusions are based solely on the European Convention on Human Rights. In most instances, the European Court of Human Rights uses the principle of democracy with regard to medical rights. The European court of human rights considers medical rights as moral underpinning rights. Particularly in every occasion, the European Court of Human Rights acknowledges an ethical dimension of these rights. In most instances, it does not matter whether a plaintiff is a free person or prisoner, the European court of human rights make decisions based on fundamental human rights and freedoms of individuals.

Nonmalignant chronic pain evaluation in the Turkish population as measured by the McGill Pain Questionnaire.

PubMed

Oksuz, Ergun; Mutlu, Esra Tuba; Malhan, Simten

2007-09-01

The purpose of this study was to explore how Turkish nonmalignant pain patients described their pain and how the language of pain used by Turkish patients compares to the language found in common pain assessment tools. Pain is influenced by a combination of ethnic, cultural, psychological, and social variants. In the Turkish language, six words are central to pain-like experiences: ağri (pain), aci (suffering), sizi (aching), sanci (colic), istirap (agony), and dert (torture). We assessed discriminant characteristics of the Turkish translation of the McGill Pain Questionnaire (MPQ). Chronic clinical nonmalignant pain patients (n = 319, 35.7% males, 64.3% females) were questioned with the Turkish translation of the MPQ. Pain symptoms were categorized as headache (33.5%), musculoskeletal pain (33.2%), visceral pain (18.8%), and low back pain (14.5%). The visceral pain group had the highest mean value in the evaluative subscale (2.6 +/- 1.9). Descriptions used for sensory subscale included throbbing, sharp, aching, and tingling, while affective subscale words included tiring, suffocating, sickening, cruel, and wretched. In all pain groups, frequently chosen words for the miscellaneous subscale were nagging and penetrating. Pain descriptors were identified for each type of pain. This is, to our knowledge, the first assessment of the Turkish translation of the MPQ in nonmalignant pain patients.

Head injury in asylum seekers and refugees referred with psychological trauma.

PubMed

Doherty, S M; Craig, R; Gardani, M; McMillan, T M

2016-01-01

Individuals who seek asylum are frequently fleeing violent persecution and may experience head injury (HI). However, little is known about the prevalence of HI in asylum seekers and refugees (ASR) despite the potential for HI to significantly affect cognitive and emotional functioning and to compromise asylum outcomes. This preliminary study investigates the prevalence of HI in ASR referred to a complex psychological trauma service. Participants were 115 adult ASR referred to a community psychological trauma service with moderate to severe mental health problems associated with psychological trauma. They were screened for a history of HI using a questionnaire developed for the study. Interpreters were used when required. The overall prevalence of HI was 51%. At least 38% of those with HI had a moderate-severe HI that could cause persisting disability. In 53% of those with HI, the cause was torture, human trafficking or domestic violence. Repeat HI can have cumulative effects on function; it was common, and was reported in 68% of those with HI. An injury to the head was not known to mental health clinicians prior to screening in 64% of cases. The emotional and cognitive consequences of HI in ASR may increase the vulnerability of this disadvantaged group, and can be associated with neurobehavioural problems affecting daily life and may compromise asylum outcomes. Routine screening for HI in ASR is needed, as are links to neuropsychology and brain injury services for advice, assessment and intervention.

Reconstruction following traumatic partial amputation of the ear.

PubMed

Pearl, Robert A; Sabbagh, Walid

2011-02-01

Reconstruction following traumatic amputation of the external ear remains a unique challenge to the plastic surgeon. The authors report a series of ear reconstructions with autologous costal cartilage in patients following traumatic partial amputation of the ear. Technical points regarding the carving of the cartilage framework and methods of skin coverage are discussed. Fifty partial ear reconstructions with autologous costal cartilage were performed over a 4-year period. All patients had suffered previous traumatic amputation of part of the external auricle due to bite injuries (n = 36), road traffic accidents (n = 6), burns (n = 5), or torture (n = 3). A two-stage technique of reconstruction with autologous cartilage graft was used based on Nagata's adaptations of Brent's original technique. In nine cases, skin shortage or extensive scarring required preoperative tissue expansion (n = 4) or a temporoparietal fascial flap (n = 5) to provide adequate coverage of the cartilage framework. Forty-seven patients had a successful surgical outcome without complication. Two patients developed small areas of skin necrosis resulting in exposure of the cartilage framework. These healed with conservative management with minor loss of definition. One case of wound infection resulted in significant loss of definition of the construct, which required a further surgical procedure with additional costal cartilage graft. Reconstruction of the external ear with autologous costal cartilage following traumatic amputation can produce high-quality auricles consistently and is becoming the treatment of choice for such injuries, given access to a specialist center with exposure to a high volume of cases.

The Arabic Scale of Death Anxiety (ASDA): its development, validation, and results in three Arab countries.

PubMed

Abdel-Khalek, Ahmed M

2004-06-01

The Arabic Scale of Death Anxiety (ASDA) was constructed and validated in a sample of undergraduates (17-33 yrs) in 3 Arab countries, Egypt (n = 418), Kuwait (n = 509), and Syria (n = 709). In its final form, the ASDA consists of 20 statements. Each item is answered on a 5-point intensity scale anchored by 1: No, and 5: Very much. Alpha reliabilities ranged from .88 to .93, and item-remainder correlations ranged between .27 and .74; the 1-week test-retest reliability was .90 (Egyptians only), denoting high internal consistency and stability. The correlations between the ASDA and Templer's DAS ranged from .60 to .74 denoting high convergent validity of the ASDA against the DAS in the 3 Arab countries. Four factors were extracted in the Egyptian sample and labeled "Fear of dead people and tombs", "Fear of postmortem events", "Fear of lethal disease", and "death preoccupation". The first two factors were almost completely identical in the three countries. The item, "I fear the torture of the grave", had a very high mean score. There were significant correlations between the ASDA and death depression, death obsession, reasons for death fear, and general anxiety, depression, obsession-compulsion, neuroticism, and being a female. All female groups attained significantly higher mean ASDA scores than their male counterparts. Kuwaitis had higher mean ASDA total scores, in comparison with their Egyptian and Syrian counterparts, whereas female Syrians attained the lowest mean ASDA total score in proportion to their female peers.

It's agony for us as well: Neonatal nurses reflect on iatrogenic pain.

PubMed

Green, Janet; Darbyshire, Philip; Adams, Anne; Jackson, Debra

2016-03-01

Improved techniques and life sustaining technology in the neonatal intensive care unit have resulted in an increased probability of survival for extremely premature babies. The by-product of the aggressive treatment is iatrogenic pain, and this infliction of pain can be a cause of suffering and distress for both baby and nurse. The research sought to explore the caregiving dilemmas of neonatal nurses when caring for extremely premature babies. This article aims to explore the issues arising for neonatal nurses when they inflict iatrogenic pain on the most vulnerable of human beings - babies ≤24 weeks gestation. Data were collected via a questionnaire to Australian neonatal nurses and semi-structured interviews with 24 neonatal nurses in New South Wales, Australia. Ethical processes and procedures set out by the ethics committee have been adhered to by the researchers. A qualitative approach was used to analyse the data. The theme 'inflicting pain' comprised three sub-themes: 'when caring and torture are the same thing', 'why are we doing this!' and 'comfort for baby and nurse'. The results show that the neonatal nurses were passionate about the need for appropriate pain relief for extremely premature babies. The neonatal nurses experienced a profound sense of distress manifested as existential suffering when they inflicted pain on extremely premature babies. Inflicting pain rather than relieving it can leave the nurses questioning their role as compassionate healthcare professionals. © The Author(s) 2014.

Risk for post-traumatic stress disorder associated with different forms of interpersonal violence in South Africa.

PubMed

Kaminer, Debra; Grimsrud, Anna; Myer, Landon; Stein, Dan J; Williams, David R

2008-11-01

The South African population is exposed to multiple forms of violence. Using nationally representative data from 4351 South African adults, this study examined the relative risk for post-traumatic stress disorder (PTSD) associated with political, domestic, criminal, sexual and other (miscellaneous) forms of assault in the South African population. Violence exposure was assessed using the 'worst event' list from the WHO's Composite International Diagnostic Interview (CIDI) and a separate questionnaire assessing experiences of human rights abuses, and lifetime PTSD was assessed according to the APA's Diagnostic and Statistical Manual of Mental Disorders criteria using the CIDI. Findings indicated that over a third of the South African population has been exposed to some form of violence. The most common forms of violence experienced by men were criminal and miscellaneous assaults, while physical abuse by an intimate partner, childhood physical abuse and criminal assaults were most common for women. Among men, political detention and torture were the forms of violence most strongly associated with a lifetime diagnosis of PTSD, while rape had the strongest association with PTSD among women. At a population level, criminal assault and childhood abuse were associated with the greatest number of PTSD cases among men, while intimate partner violence was associated with the greatest number of PTSD cases among women. Recommendations for mental health service provision in South Africa and for future research on the relative risk for PTSD are offered.

The challenges facing mental health programs for post-conflict and refugee communities.

PubMed

Silove, Derrick

2004-01-01

The majority of refugees and communities exposed to warfare and oppression live in low-income countries with few resources or special skills. Yet, epidemiological studies have identified high levels of traumatic stress reactions in such populations. These stress reactions can be intensified by harsh policies aimed at deterring survivors from seeking refuge in technologically advanced societies. The scale of the problem of mass violence and displacement creates formidable challenges for mental health professionals in their efforts to develop practical frameworks for responding to the extensive needs of displaced persons. In this article, a model is proposed for low-income, post-conflict countries, based on a two-tiered formulation. At the eco-social level, mental health professionals can play a supportive, but not a lead, role in facilitating recovery of core adaptive systems that hasten natural recovery from stress for the majority of the population. Where small-scale, community mental health services are established, the emphasis should be on assisting persons and their families who are at greatest survival and adaptive risk. Training and promotion of local workers to assume leadership in such programs are essential. In technologically advanced societies in which refugees are in a minority, torture and trauma services can focus more specifically on traumatic stress reactions, acculturation, and resettlement. In a historical epoch in which displaced persons are facing particularly harsh treatment, there is a pressing need for consensus amongst mental health professionals in advocating for their needs.

Trauma exposure and PTSD among older adolescents in foster care.

PubMed

Salazar, Amy M; Keller, Thomas E; Gowen, L Kris; Courtney, Mark E

2013-04-01

Youth in foster care represent a highly traumatized population. However, trauma research on this population has focused primarily on maltreatment rather than the full spectrum of trauma experiences identified within the DSM-IV. The current study aims to fill this gap by reporting the prevalence of exposure to specific types of traumatic events for a large sample of youth with foster care experience. The study also reports the likelihood of lifetime PTSD diagnoses associated with each specific type of trauma. Data are from a longitudinal panel study of 732 adolescents aged 17 and 18 who were in foster care. Lifetime trauma exposure and PTSD diagnosis were assessed using the Composite International Diagnostic Interview. Statistical comparisons were made using logistic regressions. The majority of respondents had experienced at least one trauma in their lifetime. While overall trauma prevalence did not differ by gender, males were more likely to experience interpersonal violence and environmental trauma, while females were more likely to experience sexual trauma. Caucasian participants reported higher rates of trauma exposure than African-American participants did. The types of trauma associated with the highest probability of a lifetime PTSD diagnosis were rape, being tortured or a victim of terrorists, and molestation. Youth in foster care are a highly traumatized population and meet diagnostic criteria for PTSD at higher rates than general youth populations. The ongoing impact of trauma may be particularly problematic for these young people given their abrupt transition to independence.

The factor structure of complex posttraumatic stress disorder in traumatized refugees.

PubMed

Nickerson, Angela; Cloitre, Marylene; Bryant, Richard A; Schnyder, Ulrich; Morina, Naser; Schick, Matthis

2016-01-01

The construct of complex posttraumatic stress disorder (CPTSD) has attracted much research attention in previous years, however it has not been systematically evaluated in individuals exposed to persecution and displacement. Given that CPTSD has been proposed as a diagnostic category in the ICD-11, it is important that it be examined in refugee groups. In the current study, we proposed to test, for the first time, the factor structure of CPTSD proposed for the ICD-11 in a sample of resettled treatment-seeking refugees. The study sample consisted of 134 traumatized refugees from a variety of countries of origin, with approximately 93% of the sample having been exposed to torture. We used confirmatory factor analysis to examine the factor structure of CPTSD in this sample and examined the sensitivity, specificity, positive predictive power and negative predictive power of individual items in relation to the CPTSD diagnosis. Findings revealed that a two-factor higher-order model of CPTSD comprising PTSD and Difficulties in Self-Organization (χ 2 (47)=57.322, p =0.144, RMSEA=0.041, CFI=0.981, TLI=0.974) evidenced superior fit compared to a one-factor higher-order model of CPTSD (χ 2 (48)=65.745, p =0.045, RMSEA=0.053, CFI=0.968, TLI=0.956). Overall, items evidenced strong sensitivity and negative predictive power, moderate positive predictive power, and poor specificity. Findings provide preliminary evidence for the validity of the CPTSD construct with highly traumatized treatment-seeking refugees.

Searching for "voices": feminism, anthropology, and the global debate over female genital operations.

PubMed

Walley, C J

1997-08-01

This article lays the groundwork for a feminist and anthropological political response to female genital "operations" that transcends the current debate over the phenomenon, which is couched in terms of cultural relativism or of politically-informed outrage. After an introduction, the study considers the politics involved in assigning a name to the procedure and explains the author's reason for choosing female genital "operation" over the more commonly used "circumcision," "mutilation," or "torture." In the next section, clitoridectomy is contextualized through a recounting of the circumstances under which the procedure was performed in the western Kenyan village of Kikhome in 1988. This discussion focuses on the ceremonies surrounding the circumcisions of young men and women, the author's attempts to discover how the young women involved really felt about the tradition, and a review of the anthropological literature on the significance and impact of these practices. The analysis then examines the international controversy surrounding female genital mutilation and provides an overview of the colonial discourse on female genital mutilation in Africa to expose 1) the origins of justifications for colonial dominance in the dominance of non-Western women by non-Western men and 2) the fact that use of cultural arguments that fuse women and tradition can support culturally-defined power relationships. The article concludes with a consideration of who is qualified to speak out against female genital mutilation given the fact that all women and all debates are the products of longstanding, tenacious power relationships.

Compulsory drug detention centers in China, Cambodia, Vietnam, and Laos: health and human rights abuses.

PubMed

Amon, Joseph; Pearshouse, Richard; Cohen, Jane; Schleifer, Rebecca

2013-12-12

According to official accounts, in 2012 more than 235,000 people were detained in over 1,000 compulsory drug detention centers in East and Southeast Asia. Between July 2007 and May 2013, in-depth interviews were conducted with 195 individuals recently released from drug detention centers in China, Cambodia, Vietnam, and Laos. Individuals reported being held for up to five years in drug detention centers without clinical determination of drug dependency or due process, and being denied evidence-based drug treatment as well as other basic health services. Many individuals reported being forced to perform arduous physical exercise or military-style drills. Forced labor was reported by all individuals having been detained in Vietnam, and some held in Cambodia and China. Physical—and less often, sexual—abuse was reported among those held in each country. Long-term, compulsory detention for treatment of drug dependency is counter to established principles of medical care and violates a wide range of human rights, including the right to health. Individuals held in drug detention centers in China, Cambodia, Vietnam, and Laos are subject to torture and cruel, inhuman, and degrading treatment. Copyright © 2013 Amon, Pearshouse, Cohen, and Schleifer. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Respiratory Health in Migrant Populations: A Crisis Overlooked

PubMed Central

Holguin, Fernando; Moughrabieh, M. Anas; Ojeda, Victoria; Patel, Sanjay R.; Peyrani, Paula; Pinedo, Miguel; Celedón, Juan C.; Douglas, Ivor S.; Upson, Dona J.

2017-01-01

The crisis in the Middle East has raised awareness about the challenges encountered by migrant populations, in particular, health-care access and delivery. Similar challenges are encountered by migrant populations around the world, including those entering the United States as refugees and/or survivors of torture as well as Mexicans and other Latin Americans crossing the border. During the 2016 International American Thoracic Society Meeting held in San Francisco, California, a group of researchers and health-care providers discussed these challenges at a minisymposium devoted to the respiratory health of migrants. The discussion focused on the increased incidence of airway diseases among individuals migrating to more developed countries, the problems created by sleep disorders and their implications for cardiovascular and mental health, the challenges inherent in the control of infections in refugee populations, and the problems resulting from deportation. The group also discussed the potential impact of novel strategies made available by Internet-based technologies and how these strategies could be deployed to support worldwide efforts in assisting migrants and refugees, even in countries that find themselves in the direst circumstances. These presentations are summarized in this document, which is not meant to be exhaustive, but to improve awareness about the challenges confronted by migrants and their host nations regarding respiratory health-care access and delivery, and about the need for adequate investment of resources to better define these challenges through research and for the development of efficient strategies for intervention. PMID:28146384

Assisting asylum seekers in a time of global forced displacement: Five clinical cases.

PubMed

McKenzie, Katherine C; Thomas, Arielle

2017-07-01

According to the United Nations High Commissioner on Refugees, over 65 million people were displaced from their homes due to conflict and persecution in 2015. Many physicians express an interest in human rights and a desire to assist this group of refugees and asylum seekers. Physicians are able to use their unique skills by performing medical forensic evaluations of individuals seeking asylum. Some asylum seekers have psychological or physical scars or functional abnormalities relating to injuries or ill-treatment they experience due to persecution. Documenting these findings can significantly improve the likelihood that they will be granted asylum. This manuscript outlines the historical and legal background of asylum. Each of the individuals presented in this paper experienced persecution in different forms. One person was tortured due to his political opinion and one was assaulted because he was gay. One woman sought asylum due to domestic violence, another woman because she had been subjected to female genital mutilation/cutting (FGM/C) and the last suffered severe psychological trauma related to a forced marriage. Five typical clinical cases of medical forensic evaluations are outlined, each with different forms of persecution and physical or psychological findings. Physicians have an interest in using their expertise to help this underserved population. They report that working with asylum seekers is rewarding, intellectually stimulating and a novel way to use their training and skills. Copyright © 2017 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Dimensions of trauma associated with posttraumatic stress disorder (PTSD) caseness, severity and functional impairment: a study of Bosnian refugees resettled in Australia.

PubMed

Momartin, S; Silove, D; Manicavasagar, V; Steel, Z

2003-09-01

Refugee survivors of inter-ethnic warfare vary greatly in the extent and range of their trauma experiences. Discerning which experiences are most salient to generating and perpetuating disorders such as posttraumatic stress disorder (PTSD) is critical to the mounting rational strategies for targeted psychosocial interventions. In a sample of Bosnian Muslim refugees (n=126) drawn from a community centre and supplemented by a snowball sampling method, PTSD status and associated disability were measured using the clinician-administered PTSD Scale (CAPS) for DSM-IV. A principal components analysis (PCA) based on a pool of trauma items yielded four coherent trauma dimensions: Human Rights Violations, Threat to Life, Traumatic Loss and Dispossession and Eviction. A cluster analysis identified three subgroupings according to extent of trauma exposure. There were no differences in PTSD risk for the group most exposed to human rights violations (internment in concentration camps, torture) compared to the general war-exposed group. Logistic regression analysis using the dimensions derived from the PCA indicated that Threat to Life alone of the four trauma factors predicted PTSD status, a finding that supports the DSM-IV definition of a trauma. Both Threat to Life and Traumatic Loss contributed to symptom severity and disability associated with PTSD. It may be that human rights violations pose a more general threat to the survivor's future psychosocial adaptation in areas of functioning that extend beyond the confines of PTSD.

Suicidal ideation among MSM in three West African countries: Associations with stigma and social capital.

PubMed

Stahlman, Shauna; Grosso, Ashley; Ketende, Sosthenes; Pitche, Vincent; Kouanda, Seni; Ceesay, Nuha; Ouedraogo, Henri G; Ky-Zerbo, Odette; Lougue, Marcel; Diouf, Daouda; Anato, Simplice; Tchalla, Jules; Baral, Stefan

2016-09-01

Suicidal ideation is understudied among men who have sex with men (MSM) across Sub-Saharan Africa. This study aimed to explore social capital and sexual behavior stigma associated with suicidal ideation among MSM in the West African nations of The Gambia, Burkina Faso and Togo. Participants were recruited using respondent-driven sampling and snowball sampling across multiple cities (n = 1555) from July 2011 to August 2013. During a single study visit, participants completed a survey. Logistic regression models were used to assess bivariate and multivariable associations with suicidal ideation. The prevalence of lifetime suicidal ideation was 13% overall and ranged 6%-17% across study sites. After adjusting for potential confounders, MSM who reported stigma as a result of having sex with men were more likely to report suicidal ideation. Physical and sexual violence was strongly associated with suicidal ideation, including being physically harmed (adjusted odds ratio (aOR) = 2.94, 95% confidence interval (CI) = 1.91, 4.52), tortured (aOR = 3.86, 95% CI = 2.17, 6.86) and raped (aOR = 3.07, 95% CI = 2.05, 4.60). In contrast, increasing social participation with the broader community was associated with decreased report of suicidal ideation (aOR = 0.91, 95% CI = 0.85, 0.99). Sexual behavior stigma should be addressed to improve mental health among MSM in Western Sub-Saharan Africa. © The Author(s) 2016.

Based on a True Story? The Portrayal of ECT in International Movies and Television Programs.

PubMed

Sienaert, Pascal

Movies and television (TV) programs are an important source of public information about ECT. To narratively review the portrayal of ECT in international movies and TV programs from 1948 until present. Several Internet movie databases and a database of phrases appearing in movies and TV programs were searched, supplemented with a Medline-search. No language restrictions were applied. ECT was portrayed in 52 movies (57 scenes), 21 TV programs (23 scenes), and 2 animated sitcoms (2 scenes). In movies, the main indication for ECT is behavioral control or torture (17/57, 29.8%), whereas in TV programs, the most frequent indication is erasing memories (7/25, 28%). In most scenes (47/82; 57.3%) ECT is given without consent, and without anesthesia (59/82; 72%). Unmodified ECT is depicted more frequently in American scenes (48/64, 75%), as opposed to scenes from other countries (11/18; 64.7%). Bilateral electrode placement is used in almost all (89%, 73/82) scenes. The vast majority of movies (46/57, 80.7%) and TV programs (18/25, 72%) show a negative and inaccurate image of the treatment. In the majority of scenes, ECT is used as a metaphor for repression, mind and behavior control, and is shown as a memory-erasing, painful and damaging treatment, adding to the stigma already associated with ECT. Only a few exceptions paint a truthful picture of this indispensable treatment in modern psychiatry. Copyright © 2016 Elsevier Inc. All rights reserved.

Foreign bodies in the urinary bladder and their management: a Pakistani experience.

PubMed

Mannan, A; Anwar, S; Qayyum, A; Tasneem, R A

2011-01-01

This was a retrospective study conducted to assess the nature, presentation, mode of insertion, diagnosis and management of foreign bodies in the urinary bladder. Between January 1998 and December 2007, 20 patients with foreign bodies in their urinary bladder were treated at our centre. The records of these patients were reviewed and analysed for their symptoms, mode of insertion, diagnosis, management and complications. A total of 20 foreign bodies were recovered from the urinary bladders during the study period. These included JJ stents with calculi, intrauterine contraceptive devices with stones, a rubber stick, ribbon gauze, encrusted pieces of Foley catheter, proline thread with calculus, a suture needle, broken cold knives, the ceramic beak of a paediatric resectoscope, a knotted suprapubic tube, a hair clip, a nail, an electrical wire and a hairpin. The common presenting features were dysuria and haematuria. The diagnosis was established radiologically in most of the cases. The circumstances of insertion were variable; iatrogenic in 16 (80.0 percent) cases, sexual stimulation in two (10.0 percent), accidental insertion by a child in one (5.0 percent) and physical torture in one (5.0 percent). 17 (85.0 percent) foreign bodies were recovered endoscopically, and cystolithotomy was required in three (15.0 percent) patients. The instances of foreign bodies in the urinary bladder are uncommon. A diagnosis is usually made radiologically. Iatrogenic foreign bodies were found to be the most frequent type of insertion encountered. Endoscopic retrieval is usually successful, with minimal morbidity.

Compulsory drug detention in East and Southeast Asia: evolving government, UN and donor responses.

PubMed

Amon, Joseph J; Pearshouse, Richard; Cohen, Jane E; Schleifer, Rebecca

2014-01-01

According to official accounts, more than 235,000 people are detained in over 1000 compulsory drug detention centers in East and South East Asia. Individuals in such centers are held for periods of months to years, and can experience a wide range of human rights abuses, including violation of the rights to freedom from torture and cruel, inhuman and degrading treatment; freedom from arbitrary arrest and detention; a fair trial; privacy; the highest attainable standard of health; and freedom from forced labor. Since 2010, an increasing number of United Nations agencies, human rights experts, and others have expressed concerns about rights abuses associated with compulsory drug detention centers, and since 2012, called for their closure. Although they do not represent a complete break from the past, these calls mark a significant shift from past engagement with drug detention, which included direct and indirect funding of detention centers and activities in detention centers by some donors. However, the lack of transparent governance, restrictions on free speech and prohibitions on monitoring by independent, international human rights organizations make assessing the evolving laws, policies and practices, as well as the attitudes of key governments officials, difficult. Looking specifically at publicly announced reforms and statements by government officials in China, Cambodia, Vietnam and Lao PDR reveals possible improvements in respect for the rights of drug users, and on-going challenges. Copyright © 2013 Elsevier B.V. All rights reserved.

Anticipatory fear and helplessness predict PTSD and depression in domestic violence survivors.

PubMed

Salcioglu, Ebru; Urhan, Sevim; Pirinccioglu, Tugba; Aydin, Sule

2017-01-01

Embracing the conceptual framework of contemporary learning theory, this study tested the hypothesis that anticipatory fear due to a sense of ongoing threat to safety and sense of helplessness in life would be the strongest determinants of PTSD and depression in domestic violence survivors. Participants were 220 domestic violence survivors recruited consecutively from 12 shelters for women in Turkey (response rate 70%). They were assessed with the Semi-Structured Interview for Survivors of Domestic Violence, Traumatic Stress Symptom Checklist, Depression Rating Scale, and Fear and Sense of Control Scale. Survivors were exposed to 21 (SD = 6.7) physical, psychological, and sexual violence stressors over 11.3 (SD = 8.8) years. They reported high levels of peritrauma perceived distress of and lack of control over stressor events. Approximately 10 months after trauma, many feared reliving the same domestic violence events, felt helpless, feared for their life, and felt in danger. PTSD and depression rates were 48.2% and 32.7%, respectively. The strongest predictors of PTSD and depression were fear due to a sense of ongoing threat to safety and sense of helplessness in life, which explained the largest amount of variances in these psychiatric conditions. The findings support the contemporary learning theory of traumatic stress and are consistent with findings of studies involving earthquake, war, and torture survivors. They imply that trauma-focused interventions designed to overcome fear, reduce helplessness, and restore sense of control over one's life would be effective in PTSD and depression in domestic violence survivors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Health and human rights in Chin State, Western Burma: a population-based assessment using multistaged household cluster sampling.

PubMed

Sollom, Richard; Richards, Adam K; Parmar, Parveen; Mullany, Luke C; Lian, Salai Bawi; Iacopino, Vincent; Beyrer, Chris

2011-02-08

The Chin State of Burma (also known as Myanmar) is an isolated ethnic minority area with poor health outcomes and reports of food insecurity and human rights violations. We report on a population-based assessment of health and human rights in Chin State. We sought to quantify reported human rights violations in Chin State and associations between these reported violations and health status at the household level. Multistaged household cluster sampling was done. Heads of household were interviewed on demographics, access to health care, health status, food insecurity, forced displacement, forced labor, and other human rights violations during the preceding 12 months. Ratios of the prevalence of household hunger comparing exposed and unexposed to each reported violation were estimated using binomial regression, and 95% confidence intervals (CIs) were constructed. Multivariate models were done to adjust for possible confounders. Overall, 91.9% of households (95% CI 89.7%-94.1%) reported forced labor in the past 12 months. Forty-three percent of households met FANTA-2 (Food and Nutrition Technical Assistance II project) definitions for moderate to severe household hunger. Common violations reported were food theft, livestock theft or killing, forced displacement, beatings and torture, detentions, disappearances, and religious and ethnic persecution. Self reporting of multiple rights abuses was independently associated with household hunger. Our findings indicate widespread self-reports of human rights violations. The nature and extent of these violations may warrant investigation by the United Nations or International Criminal Court. Please see later in the article for the Editors' Summary.

Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys.

PubMed

Rosellini, A J; Liu, H; Petukhova, M V; Sampson, N A; Aguilar-Gaxiola, S; Alonso, J; Borges, G; Bruffaerts, R; Bromet, E J; de Girolamo, G; de Jonge, P; Fayyad, J; Florescu, S; Gureje, O; Haro, J M; Hinkov, H; Karam, E G; Kawakami, N; Koenen, K C; Lee, S; Lépine, J P; Levinson, D; Navarro-Mateu, F; Oladeji, B D; O'Neill, S; Pennell, B-E; Piazza, M; Posada-Villa, J; Scott, K M; Stein, D J; Torres, Y; Viana, M C; Zaslavsky, A M; Kessler, R C

2018-02-01

Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors. The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD. 20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2-0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66-55% v. 43%) and later-recovery (75-68% v. 39%). We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.

Symptoms of distress and posttraumatic stress among South African former political detainees.

PubMed

Kagee, Ashraf

2005-05-01

Considerable debate has centred on the question of traumatisation among individuals who have survived human rights violations in societies that have undergone political conflict. In order to gain an estimate of the extent of long-term traumatisation among political activists who experienced torture and abuse in detention during the apartheid era in South Africa, a sample of 148 survivors of such experiences were recruited in a cross-sectional study and asked to complete the Hopkins Symptom Checklist (HSCL), the Impact of Event Scale (IES), and the Trauma Symptoms section of the Harvard Trauma Questionnaire (HTQ). The proportions of the sample that scored above the clinical cut-points on these measures were calculated. On the HSCL, 14.19% of the sample scored above the cut-point for clinical significance of 44; on the IES, 17.57% scored above the clinical cut-point of 44; and on the HTQ, 37.83% scored above the cut-point of 75. Moreover, the sample's mean scores were significantly higher than the cut-point for clinically significant distress on the HSCL (p < 0.001); significantly lower than the cut-point for severe traumatisation on the IES (p < 0.001); and non-significantly lower than the cut-point for clinically significant traumatisation on the HTQ (p = 0.074). These results are considered in terms of current theoretical debates on the relevance and applicability of posttraumatic stress disorder as a circumscribed nosological entity in developing countries that are in the process of coming to terms with a history of political conflict.

HUMAN RIGHTS AND NIGERIAN PRISONERS--ARE PRISONERS NOT HUMANS?

PubMed

Joshua, I A; Dangata, Y Y; Audu, O; Nmadu, A G; Omole, N V

2014-12-01

In Nigeria, just like in many other parts of the world, one of the most extensively discussed issues on the public agenda today is the increase in prison population. The aims of imprisonment are protection, retribution, deterrence, reformation and vindication. Investigations revealed that the prison services have been,neglected more than any other criminal justice agency in Nigeria. For example, most of the prisons were built during the colonial era for the purpose of accommodating a small number of inmates. Human Rights are the basic guarantees for human beings to be able to achieve happiness and self-respect; consequently, in most jurisdictions, the Human Rights Act confirms that these Rights do not stop at the prison gates. However, most States fail to meet the Human Rights obligations of their prisoners. As regards to health, for example, every prison should have proper health facilities and medical staff to provide dental and psychiatric care among others. This article discusses the Nigerian Prison System and challenges, trends and the related Human Rights and Ethical issues in Nigerian prisons. Some of the unmet needs of Nigerian prisoners which include, inter alia, living in unwholesome cells, delayed trial of inmates, lack of voting rights, access to information, lack of conjugal facilities for married prisoners, poor and inadequate nutrition, poor medical care, torture, inhumane treatment and the need to protect prisoners in a changing world. The present report has policy implications for reforming prison services in Nigeria, and countries that sing from the same song sheet with Nigeria on prison services, to conform to the Fundamental Human Rights of prisoners in the 21St century.

[Models of Mental Health Care for Vulnerable Refugees in the Community].

PubMed

Schellong, Julia; Epple, Franziska; Weidner, Kerstin; Möllering, Andrea

2017-04-01

A non-neglectable portion of people that have fled to Germany have been subjected to expulsion, violence, torture and grave human loss. In some of them, signs of secondary mental problems are obvious. In the light of the efforts at integration, these diseases must not be neglected. Outlined are the federal legal requirements and how the cost coverage, as well as the admission to health care system, is structured. Additionally, 2 exemplary regional models for psychosomatic health care are being introduced: Dresden's "Stepped Care Model for Psychologically Vulnerable Refugees" includes phased offers for prevention and treatment of acute mental crises, as well as somatoform disorders in refugees and their volunteer helpers. The PSZ in Bielefeld unites already existing expertise of social work and trauma therapy to form a shared project and favors, among other things, training courses and the instruction of language mediators. The local circumstances and differences lead to individual, sometimes totally new solutions. Already existing clinical care offers as well as concepts of trauma therapy are focal points for the development of a comprehensive health care provision. Most effective is a combination of medicinal care, psychosocial networking and psychosomatic treatment. For a working health care provision without parallel structures it is indispensible to use expertise in trauma therapy that is already in place. While being very resource-saving psychosomatic centers offer targeted applications in the network of all actors in refugee care especially when combined with well-trained volunteers and language mediators, informed on the issue of trauma. © Georg Thieme Verlag KG Stuttgart · New York.

Pain management: a fundamental human right.

PubMed

Brennan, Frank; Carr, Daniel B; Cousins, Michael

2007-07-01

This article surveys worldwide medical, ethical, and legal trends and initiatives related to the concept of pain management as a human right. This concept recently gained momentum with the 2004 European Federation of International Association for the Study of Pain (IASP) Chapters-, International Association for the Study of Pain- and World Health Organization-sponsored "Global Day Against Pain," where it was adopted as a central theme. We survey the scope of the problem of unrelieved pain in three areas, acute pain, chronic noncancer pain, and cancer pain, and outline the adverse physical and psychological effects and social and economic costs of untreated pain. Reasons for deficiencies in pain management include cultural, societal, religious, and political attitudes, including acceptance of torture. The biomedical model of disease, focused on pathophysiology rather than quality of life, reinforces entrenched attitudes that marginalize pain management as a priority. Strategies currently applied for improvement include framing pain management as an ethical issue; promoting pain management as a legal right, providing constitutional guarantees and statutory regulations that span negligence law, criminal law, and elder abuse; defining pain management as a fundamental human right, categorizing failure to provide pain management as professional misconduct, and issuing guidelines and standards of practice by professional bodies. The role of the World Health Organization is discussed, particularly with respect to opioid availability for pain management. We conclude that, because pain management is the subject of many initiatives within the disciplines of medicine, ethics and law, we are at an "inflection point" in which unreasonable failure to treat pain is viewed worldwide as poor medicine, unethical practice, and an abrogation of a fundamental human right.

Development of the nervus terminalis: origin and migration.

PubMed

Whitlock, Kathleen E

2004-09-01

The origin of the nervus terminalis is one of the least well understood developmental events involved in generating the cranial ganglia of the forebrain in vertebrate animals. This cranial nerve forms at the formidable interface of the anteriormost limits of migrating cranial neural crest cells, the terminal end of the neural tube and the differentiating olfactory and adenohypophyseal placodes. The complex cellular interactions that give rise to the various structures associated with the sensory placode (olfactory) and endocrine placode (adenohypophysis) surround and engulf this enigmatic cranial nerve. The tortured history of nervus terminalis development (see von Bartheld, this issue, pages 13-24) reflects the lack of consensus on the origin (or origins), as well as the experimental difficulties in uncovering the origin, of the nervus terminalis. Recent technical advances have allowed us to make headway in understanding the origin(s) of this nerve. The emergence of the externally fertilized zebrafish embryo as a model system for developmental biology and genetics has shed new light on this century-old problem. Coupled with new developmental models are techniques that allow us to trace lineage, visualize gene expression, and genetically ablate cells, adding to our experimental tools with which to follow up on studies provided by our scientific predecessors. Through these techniques, a picture is emerging in which the origin of at least a subset of the nervus terminalis cells lies in the cranial neural crest. In this review, the data surrounding this finding will be discussed in light of recent findings on neural crest and placode origins. Copyright 2004 Wiley-Liss, Inc.

Development of the Vicarious Resilience Scale (VRS): A measure of positive effects of working with trauma survivors.

PubMed

Killian, Kyle; Hernandez-Wolfe, Pilar; Engstrom, David; Gangsei, David

2017-01-01

Attending to the potential impacts, both positive and negative, of clinical work with trauma survivors on professionals themselves is a crucial aspect of clinical training and supervision. Vicarious resilience refers to unique, positive effects that transform therapists in response to witnessing trauma survivors' resilience and recovery process. This study describes the development and exploratory factor analysis of the first instrument to assess vicarious resilience. The Vicarious Resilience Scale (VRS) was developed and administered via electronic survey to 190 helping professionals from around the globe working with survivors of severe traumas, such as torture. Exploratory factor analysis yielded 7 factors: Changes in life goals and perspective, client-inspired hope, increased recognition of clients' spirituality as a therapeutic resource, increased capacity for resourcefulness, increased self-awareness and self-care practices, increased consciousness about power and privilege relative to clients' social location, and increased capacity for remaining present while listening to trauma narratives. The Cronbach's alpha reliability of the VRS was .92 and, as hypothesized, the VRS was moderately and positively correlated with posttraumatic growth and compassion satisfaction, indicating convergent validity. The VRS was not significantly correlated with compassion fatigue (CF) or burnout, indicating discriminant validity and that vicarious resilience is a unique construct that is not merely "the opposite" of CF or burnout. The VRS possesses sound psychometric properties and can be utilized in supervision and training contexts and for self-assessment by professionals working with trauma survivors to aid the recognition and cultivation of vicarious resilience. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

London's historic pea-soupers''

DOE Office of Scientific and Technical Information (OSTI.GOV)

Urbinato, D.

Americans may think smog was invented in Los Angeles. Not so. In fact, a Londoner coined the term smog'' in 1905 to describe the city's insidious combination of natural fog and coal smoke. By then, the phenomenon was part of London history, and dirty, acrid smoke-filled pea-soupers'' were as familiar to Londoners as Big Ben and Westminster Abby. Smog in London predates Shakespeare by four centuries. Until the 12th century, most Londoners burned wood for fuel. But as the city grew and the forests shrank, wood became scarce and increasingly expensive. Large deposits of sea-coal'' off the northeast coast providedmore » a cheap alternative. Soon, Londoners were burning the soft, bituminous coal to heat their homes and fuel their factories. Sea-coal was plentiful, but it didn't burn efficiently. A lot of its energy was spent making smoke, not heat. Coal smoke drifting through thousands of London chimneys combined with clean natural fog to make smog. If the weather conditions were right, it would last for days. Early on, no one had the scientific tools to correlate smog with adverse health effects, but complaints about the smoky air as an annoyance date back to at least 1272, when King Edward I, on the urging of important noblemen and clerics, banned the burning of sea-coal. Anyone caught burning or selling the stuff was to be tortured or executed. The first offender caught was summarily put to death. This deterred nobody. Of necessity, citizens continued to burn sea-coal in violation of the law, which required the burning of wood few could afford.« less

The mental health and help-seeking behaviour of resettled Afghan refugees in Australia.

PubMed

Slewa-Younan, Shameran; Yaser, Anisa; Guajardo, Maria Gabriela Uribe; Mannan, Haider; Smith, Caroline A; Mond, Jonathan M

2017-01-01

Psychological trauma, in particular, posttraumatic stress disorder (PTSD) and depression, are highly prevalent among resettled refugees. However, little is known regarding the mental health status and associated help-seeking behaviour of resettled Afghan refugees in Australia. A sample of 150 resettled Afghan refugees (74 males; mean age 32.8 years, SD = 12.2) living in Adelaide, South Australia were recruited. Self-reported measures of PTSD, depression, exposure to traumatic events, functional impairment, self-recognition of PTSD symptomatology and help-seeking behaviours were completed. Multivariate analysis of variables associated with help-seeking was conducted. Forty-four percent of participants met criteria for clinically significant PTSD symptoms and all but one participant reported being exposed to 1 or more traumatic and/or conflict related events, such as 'losing your property and wealth'. Moreover, 14.7% of participants had symptoms suggestive of clinically significant depression. General practitioners were the most common source of help in relation to mental health problems, with very few participants (4.6%) seeking help from specialist trauma and torture mental health services. Self-recognition of having a PTSD related mental health problem and functional impairment levels were both found to be independent predictors of help-seeking ( p  ≤ .05). The findings provide further evidence for high rates of PTSD symptomatology and low uptake of mental care among resettled refugees. Poor self-recognition of the presence and/or adverse impact of PTSD symptoms may need to be targeted in mental health promotion programs designed to improve "mental health literacy" and thereby promote early and appropriate help-seeking where this is needed.

The massacre mass grave of Schöneck-Kilianstädten reveals new insights into collective violence in Early Neolithic Central Europe

PubMed Central

Meyer, Christian; Lohr, Christian; Gronenborn, Detlef; Alt, Kurt W.

2015-01-01

Conflict and warfare are central but also disputed themes in discussions about the European Neolithic. Although a few recent population studies provide broad overviews, only a very limited number of currently known key sites provide precise insights into moments of extreme and mass violence and their impact on Neolithic societies. The massacre sites of Talheim, Germany, and Asparn/Schletz, Austria, have long been the focal points around which hypotheses concerning a final lethal crisis of the first Central European farmers of the Early Neolithic Linearbandkeramik Culture (LBK) have concentrated. With the recently examined LBK mass grave site of Schöneck-Kilianstädten, Germany, we present new conclusive and indisputable evidence for another massacre, adding new data to the discussion of LBK violence patterns. At least 26 individuals were violently killed by blunt force and arrow injuries before being deposited in a commingled mass grave. Although the absence and possible abduction of younger females has been suggested for other sites previously, a new violence-related pattern was identified here: the intentional and systematic breaking of lower limbs. The abundance of the identified perimortem fractures clearly indicates torture and/or mutilation of the victims. The new evidence presented here for unequivocal lethal violence on a large scale is put into perspective for the Early Neolithic of Central Europe and, in conjunction with previous results, indicates that massacres of entire communities were not isolated occurrences but rather were frequent features of the last phases of the LBK. PMID:26283359

Health and Human Rights in Chin State, Western Burma: A Population-Based Assessment Using Multistaged Household Cluster Sampling

PubMed Central

Sollom, Richard; Richards, Adam K.; Parmar, Parveen; Mullany, Luke C.; Lian, Salai Bawi; Iacopino, Vincent; Beyrer, Chris

2011-01-01

Background The Chin State of Burma (also known as Myanmar) is an isolated ethnic minority area with poor health outcomes and reports of food insecurity and human rights violations. We report on a population-based assessment of health and human rights in Chin State. We sought to quantify reported human rights violations in Chin State and associations between these reported violations and health status at the household level. Methods and Findings Multistaged household cluster sampling was done. Heads of household were interviewed on demographics, access to health care, health status, food insecurity, forced displacement, forced labor, and other human rights violations during the preceding 12 months. Ratios of the prevalence of household hunger comparing exposed and unexposed to each reported violation were estimated using binomial regression, and 95% confidence intervals (CIs) were constructed. Multivariate models were done to adjust for possible confounders. Overall, 91.9% of households (95% CI 89.7%–94.1%) reported forced labor in the past 12 months. Forty-three percent of households met FANTA-2 (Food and Nutrition Technical Assistance II project) definitions for moderate to severe household hunger. Common violations reported were food theft, livestock theft or killing, forced displacement, beatings and torture, detentions, disappearances, and religious and ethnic persecution. Self reporting of multiple rights abuses was independently associated with household hunger. Conclusions Our findings indicate widespread self-reports of human rights violations. The nature and extent of these violations may warrant investigation by the United Nations or International Criminal Court. Please see later in the article for the Editors' Summary PMID:21346799

Benign endometrial proliferations mimicking malignancies: a review of problematic entities in small biopsy specimens.

PubMed

Ip, Philip Pun-Ching

2018-02-14

Benign proliferations that mimic malignancies are commonly encountered during the course of assessment of small and fragmented endometrial samples. Although benign, endometrial epithelial metaplasias often coexist with premalignant or malignant lesions causing diagnostic confusion. The difficulty with mucinous metaplasia lies in its distinction from atypical mucinous glandular proliferations and mucinous carcinomas, which are associated with significant interobserver variability. Papillary proliferation of the endometrium is commonly associated with hormonal drugs and endometrial polyps and is characterised by papillae with fibrovascular cores covered by epithelial cells without cytologic atypia. They are classified into simple or complex papillary proliferations depending on the architectural complexity and extent of proliferation. Complex papillary proliferations are associated with a high risk of concurrent or subsequent hyperplasia with atypia/carcinoma. Papillary proliferations may have coexisting epithelial metaplasias and, most commonly, mucinous metaplasia and syncytial papillary change. Those with striking mucinous metaplasia overlap morphologically with papillary mucinous metaplasia. The latter has been proposed as a precursor of endometrial mucinous carcinoma. Misinterpreting the Arias-Stella reaction as a malignant or premalignant lesion is more likely to occur if the pathologist is unaware that the patient is pregnant or on hormonal drugs. Endometrial hyperplasia with secretory changes may occasionally be difficult to distinguish from the torturous and crowded glands of a late secretory endometrium. Endometrial polyps may have abnormal features that can be misinterpreted as endometrial hyperplasia or Mullerian adenosarcoma. Awareness of these benign endometrial proliferations and their common association with hormonal medication or altered endogenous hormonal levels will help prevent the over-diagnosis of premalignant and malignant lesions.

The effect of the medico-legal evaluation on asylum seekers in the Metropolitan City of Milan, Italy: a pilot study.

PubMed

Franceschetti, L; Magli, F; Merelli, V G; Muccino, E A; Gentilomo, A; Agazzi, F; Gibelli, D M; Gambarana, M; De Angelis, D; Kustermann, A; Cattaneo, C

2018-05-26

In the present-day situation, the clinical forensic documentation of an asylum seeker's narrative and his or her examination, together with the physical and psychological findings, may have very important effects on the outcome of the request for political asylum. Since 2012, the Municipality of Milan, the University Institute of Legal Medicine, and other institutions have assembled a team with the task of examining vulnerable asylum seekers and preparing a medical report for the Territorial Commission for International Protection (Prefecture, Ministry of Interiors), who will assess the application. We compared medico-legal reports and outcomes of 57 cases which were evaluated by the Commission after having undergone a medico-legal evaluation through the Istanbul Protocol criteria and examined, in particular, which medico-legal variables seem associated to the outcome. The results show that forensic assessment seems to have a significant and interesting correlation with the final assessment given by the Commission. For example, the higher the level of consistency, according to the Istanbul Protocol, the more frequently protection is granted. These data show how important clinical forensic medicine can be in such scenarios and how the presence of clinical forensic experts should be encouraged in such evaluations, as has been recently enshrined in Italy in the guidelines of a Ministerial Decree of April 3rd, 2017 for the assistance and the rehabilitation as well as the treatment of psychiatric disorders in refugees and asylum seekers who have undergone torture, rape, and other severe forms of psychological, physical, or sexual violence.

Experimental analysis of nature-nurture interactions.

PubMed

Wyman, Robert J

2005-06-01

The presumed opposition of nature and nurture has been a major concern of western civilization since its beginnings. Christian theologians interpreted Adam and Eve's eating of the forbidden fruit as the origin of an inherited 'original sin'. Saint Augustine explicitly applied the concept to human mental development, arguing that, because of original sin, children are inclined toward evil and education requires physical punishment. For centuries, it was considered parents' moral and religious obligation, not to nurture their children, in our current sense of that word, but to beat the willfulness out of them. 16thC humanists fought back, arguing that "schools have become torture chambers" while it is adults "who corrupt young minds with evil". Locke's (1690) statement that children are born as a 'white paper' was crucial in rejecting the dogma of an inborn (and sinful) nature. The original sin vs. white paper argument merged with another ancient dichotomy: inborn instinct (which controls animal behavior) vs. the reason and free will which humans have. Darwin made the concept of inherited instinct, common to both man and animals, one cornerstone of his theory of evolution. The 20(th)C saw scientists recast the debate as instinct vs. learning, bitterly argued between behaviorists and ethologists. Laboratory experimentation and field observation showed that behavior could develop without learning but also that conditioning paradigms could powerfully mold behavior. The progress of genetics and neurobiology has led to the modern synthesis that neural development, and hence behavior, results from the interdependent action of both heredity and environment. Copyright 2005 Wiley-Liss, Inc.

Ethical, legal and social issues in restoring genetic identity after forced disappearance and suppression of identity in Argentina.

PubMed

Penchaszadeh, Victor B

2015-07-01

Human genetic identification has been increasingly associated with the preservation, defence and reparation of human rights, in particular the right to genetic identity. The Argentinian military dictatorship of 1976-1983 engaged in a savage repression and egregious violations of human rights, including forced disappearance, torture, assassination and appropriation of children of the disappeared with suppression of their identity. The ethical, legal and social nuances in the use of forensic genetics to support the right to identity in Argentina included issues such as the best interest of children being raised by criminals, the right to learn the truth of one's origin and identity, rights of their biological families, the issue of voluntary versus compulsory testing of victims, as well as the duty of the state to investigate crimes against humanity, punish perpetrators and provide justice and reparation to the victims. In the 30 years following the return to democracy in 1984, the search, localization and DNA testing of disappeared children and young adults has led, so far, to the genetic identification of 116 persons who had been abducted as babies. The high value placed on DNA testing to identify victims of identity suppression did not conflict with the social consensus that personal identity is a complex and dynamic concept, attained by the interaction of genetics with historical, social, emotional, educational, cultural and other important environmental factors. The use of genetic identification as a tool to redress and repair human rights violations is a novel application of human genetics within a developing set of ethical and political circumstances.

Factors associated with posttraumatic stress disorder and depression in war-survivors displaced in Croatia

PubMed Central

Letica-Crepulja, Marina; Salcioglu, Ebru; Frančišković, Tanja; Basoglu, Metin

2011-01-01

Aim To examine the role of perceived stressfulness of trauma exposure and economic, social, occupational, educational, and familial adaptation after trauma in posttraumatic stress disorder (PTSD) and depression in displaced war survivors. Methods A cross-sectional survey was conducted between March 2000 and July 2002 with a sample of 173 internally displaced persons or refugees and 167 matched controls in Croatia. Clinical measures included Structured Clinical Interview for DSM-IV and Clinician-Administered PTSD Scale. Results Displaced war survivors reported the exposure to a mean ± standard deviation of 13.1 ± 8.3 war stressors, including combat, torture, serious injury, death of close persons, and loss of property. Compared to controls, they reported higher rates of marked to severe impact of war on family (16.2% vs 51.6%), social (7.2% vs 43.5%), economic (12.6% vs 55.4%), occupational (1.8% vs 15.9%), and educational (2.4% vs 8.8%) adaptation. In two logistic regression analyses, the strongest predictor of PTSD and depression was high level of perceived distress during trauma exposure. PTSD but not depression was associated with economic, social, occupational, educational, and familial adaptation after trauma. Conclusion Displaced survivors who experienced multiple war events perceived greater negative impact of war on their life domains compared to individuals who lived in a war setting but had no trauma exposure. The most important determinant of psychological outcomes was perceived stressfulness of war stressors. Although post-trauma adaptation in different life spheres had an impact, its effect was not robust and consistent across disorders. These findings suggest that it would be effective to use a trauma-focused approach in rehabilitation of war survivors. PMID:22180270

Secondary psychotic features in refugees diagnosed with post-traumatic stress disorder: a retrospective cohort study.

PubMed

Nygaard, Mette; Sonne, Charlotte; Carlsson, Jessica

2017-01-05

A substantial amount of refugees (10-30%) suffer from Post-Traumatic Stress Disorder (PTSD). In Denmark there are different facilities specialised in psychiatric treatment of trauma-affected refugees. A previously published case report from such a facility in Denmark shows that some patients suffer from secondary psychotic symptoms alongside their PTSD. The aim of this study was to illustrate the characteristics and estimate the prevalence of psychotic features in a clinical population of trauma-affected refugees with PTSD. Psychiatric records from 220 consecutive patients at Competence Centre for Transcultural Psychiatry (CTP) were examined, and all the PTSD patients were divided into two groups; one group with secondary psychotic features (PTSD-SP group) and one without (PTSD group). A categorisation and description of the secondary psychotic features was undertaken. One hundred eighty-one patients were diagnosed with PTSD among which psychotic symptoms were identified in 74 (40.9, 95% CI 33.7-48.1%). The majority of symptoms identified were auditory hallucinations (66.2%) and persecutory delusions (50.0%). There were significantly more patients diagnosed with enduring personality change after catastrophic experience in the PTSD-SP group than in the PTSD group (P = 0.009). Furthermore the PTSD-SP group included significantly more patients exposed to torture (P = 0.001) and imprisonment (P = 0.005). This study provides an estimation of PTSD-SP prevalence in a clinical refugee population with PTSD. The study points to the difficulties distinguishing psychotic features from flashbacks and the authors call for attention to psychotic features in PTSD patients in order to improve documentation and understanding of the disorder.

Vitalism and the resistance to experimentation on life in the eighteenth century.

PubMed

Wolfe, Charles T

2013-01-01

There is a familiar opposition between a 'Scientific Revolution' ethos and practice of experimentation, including experimentation on life, and a 'vitalist' reaction to this outlook. The former is often allied with different forms of mechanism - if all of Nature obeys mechanical laws, including living bodies, 'iatromechanism' should encounter no obstructions in investigating the particularities of animal-machines - or with more chimiatric theories of life and matter, as in the 'Oxford Physiologists'. The latter reaction also comes in different, perhaps irreducibly heterogeneous forms, ranging from metaphysical and ethical objections to the destruction of life, as in Margaret Cavendish, to more epistemological objections against the usage of instruments, the 'anatomical' outlook and experimentation, e.g. in Locke and Sydenham. But I will mainly focus on a third anti-interventionist argument, which I call 'vitalist' since it is often articulated in the writings of the so-called Montpellier Vitalists, including their medical articles for the Encyclopédie. The vitalist argument against experimentation on life is subtly different from the metaphysical, ethical and epistemological arguments, although at times it may borrow from any of them. It expresses a Hippocratic sensibility - understood as an artifact of early modernity, not as some atemporal trait of medical thought - in which Life resists the experimenter, or conversely, for the experimenter to grasp something about Life, it will have to be without torturing or radically intervening in it. I suggest that this view does not have to imply that Nature is something mysterious or sacred; nor does the vitalist have to attack experimentation on life in the name of some 'vital force' - which makes it less surprising to find a vivisectionist like Claude Bernard sounding so close to the vitalists.

The nurse, the Geneva Conventions and human rights.

PubMed

1992-01-01

Alleged reports from the warfronts over the past few years have been shocking: bombing of hospitals and ambulances, health workers refusing to care for wounded members of the opposition, medical involvement in the torture of prisoners, etc. Such conduct is in violation of professional codes of conduct and the Geneva Conventions. Yet the combatants and health care personnel in too many instances remain impervious. In many economically and politically unstable countries, where uprisings and war can explode any day, anyone can become involved, but particularly health care professionals because of the nature of their work. When confronted with a dilemma in a conflict situation, nurses must remember that they are accountable for their own professional actions and as such must be aware of patient/client rights and of their rights and obligations under the terms of the Geneva Conventions of 1949 and the Additional Protocols of 1977. To assist nurses in making the right decisions, ICN developed a Code for Nurses and in 1984, with the League of Red Cross and Red Crescent Societies, prepared an educational package for nurses on the Geneva conventions and the principles of humanitarian law. Subsequently ICN, with its member nurses' associations, developed position papers on the role of nurses in caring for prisoners and detainees and in safeguarding human rights. And today in face of daily reports of humanitarian violations, ICN urges NNAs to reconfirm their commitment and to take concrete moves to assure that their members fully understand what is expected of nurses in conflict situations. Extracts of the Geneva Conventions' essential provisions and ICN's position statements are provided below as one step in bringing about this awareness.

The black box in somatization: unexplained physical symptoms, culture, and narratives of trauma.

PubMed

Waitzkin, H; Magaña, H

1997-09-01

Stimulated by our clinical work with patients who manifest unexplained "somatoform" symptoms in the primary care setting, this article addresses a theoretical black box in our understanding of somatization: how does culture mediate severe stress to produce symptoms that cannot be explained by the presence of physical illness? Despite various problems in his explanation of hysteria, Freud broke new ground by emphasizing narratives of traumatic experiences in the development and treatment of unexplained physical symptoms. Except in anthropologically oriented cultural psychiatry, contemporary psychiatry has traveled away from a focus on narrative in the study of somatization. On the other hand, recent interest in narrative has spread across many intellectual disciplines, including the humanities and literary criticism, psychology, history, anthropology, and sociology. We operationally define narratives as attempts at storytelling that portray the interrelationships among physical symptoms and the psychologic, social, or cultural context of these symptoms. Regarding somatization and trauma, we focus on the ways that narrative integrates the cultural context with traumatic life events. In explaining the black box, we postulate that extreme stress (torture, rape, witnessing deaths of relatives, forced migration, etc.) is processed psychologically as a terrible, largely incoherent narrative of events too awful to hold in consciousness. Culture patterns the psychologic and somatic expression of the terrible narrative. Methodologically, we have developed some techniques for eliciting narratives of severe stress and somatic symptoms, which we illustrate with observations from an ongoing research project. In designing interventions to improve the care of somatizing patients, we are focusing on the creation of social situations where patients may feel empowered to express more coherent narratives of their prior traumatic experiences.

Internal strain estimation for quantification of human heel pad elastic modulus: A phantom study.

PubMed

Holst, Karen; Liebgott, Hervé; Wilhjelm, Jens E; Nikolov, Svetoslav; Torp-Pedersen, Søren T; Delachartre, Philippe; Jensen, Jørgen A

2013-02-01

Shock absorption is the most important function of the human heel pad. However, changes in heel pad elasticity, as seen in e.g. long-distance runners, diabetes patients, and victims of Falanga torture are affecting this function, often in a painful manner. Assessment of heel pad elasticity is usually based on one or a few strain measurements obtained by an external load-deformation system. The aim of this study was to develop a technique for quantitative measurements of heel pad elastic modulus based on several internal strain measures from within the heel pad by use of ultrasound images. Nine heel phantoms were manufactured featuring a combination of three heel pad stiffnesses and three heel pad thicknesses to model the normal human variation. Each phantom was tested in an indentation system comprising a 7MHz linear array ultrasound transducer, working as the indentor, and a connected load cell. Load-compression data and ultrasound B-mode images were simultaneously acquired in 19 compression steps of 0.1mm each. The internal tissue displacement was for each step calculated by a phase-based cross-correlation technique and internal strain maps were derived from these displacement maps. Elastic moduli were found from the resulting stress-strain curves. The elastic moduli made it possible to distinguish eight of nine phantoms from each other according to the manufactured stiffness and showed very little dependence of the thickness. Mean elastic moduli for the three soft, the three medium, and the three hard phantoms were 89kPa, 153kPa, and 168kPa, respectively. The combination of ultrasound images and force measurements provided an effective way of assessing the elastic properties of the heel pad due to the internal strain estimation. Copyright © 2012 Elsevier B.V. All rights reserved.

Publication bias, with a focus on psychiatry: causes and solutions.

PubMed

Turner, Erick H

2013-06-01

Publication bias undermines the integrity of the evidence base by inflating apparent drug efficacy and minimizing drug harms, thus skewing the risk-benefit ratio. This paper reviews the topic of publication bias with a focus on drugs prescribed for psychiatric conditions, especially depression, schizophrenia, bipolar disorder, and autism. Publication bias is pervasive; although psychiatry/psychology may be the most seriously afflicted field, it occurs throughout medicine and science. Responsibility lies with various parties (authors as well as journals, academia as well as industry), so the motives appear to extend beyond the financial interests of drug companies. The desire for success, in combination with cognitive biases, can also influence academic authors and journals. Amid the flood of new medical information coming out each day, the attention of the news media and academic community is more likely to be captured by studies whose results are positive or newsworthy. In the peer review system, a fundamental flaw arises from the fact that authors usually write manuscripts after they know the results. This allows hindsight and other biases to come into play, so data can be "tortured until they confess" (a detailed example is given). If a "publishable" result cannot be achieved, non-publication remains an option. To address publication bias, various measures have been undertaken, including registries of clinical trials. Drug regulatory agencies can provide valuable unpublished data. It is suggested that journals borrow from the FDA review model. Because the significance of study results biases reviewers, results should be excluded from review until after a preliminary judgment of study scientific quality has been rendered, based on the original study protocol. Protocol publication can further enhance the credibility of the published literature.

Human rights and mental health among Latin American women in situations of state-sponsored violence. Bibliographic resources.

PubMed

Lykes, M B; Brabeck, M M; Ferns, T; Radan, A

1993-12-01

The Task Force of the American Psychological Association Division 35, Psychology of Women, conducted a literature review of resources from Latin America to examine the social dimensions of state-sponsored violence in Latin America, their effects on socialization and community, and some responses of women surviving these experiences. It limited its review to works of women's groups, progressive organizations, and individual women exploring the effects of war and state-sponsored violence on women's mental health. Recurring emergent themes included the false dichotomy of violence committed against women in public versus that committed in private, silencing of women accompanies state imposed terror, collective resistance to such terror. The resources addressed 3 types of women's experiences of violence: exile within and beyond one's national borders; torture--an extreme form of state-sponsored violence; and nontraditional, culturally appropriate interventions--alternatives to Western models. This review motivated the Task Force to call on their colleagues to contribute to the on-going documentation of state-sponsored violence. Task Force members identified several areas for collaborative research and/or theory development. Psychologists should question the validity of clinical neutrality and examine the particular meanings of non-neutrality within different cultures. For example, some Latin American psychologists reject diagnoses of intrapsychic syndromes (e.g., post-traumatic stress syndrome) and propose concepts that center on the nexus of individuals and social life. The Task Force sees great opportunities for US psychologists to network and to form solidarity-based relationships with Latin American women. It has identified many women's groups working in Latin America. Human rights organizations (e.g., Americas Watch) have formed women's projects. Further work should be done to improve resource exchanges.

The enduring mental health impact of mass violence: a community comparison study of Cambodian civilians living in Cambodia and Thailand.

PubMed

Mollica, Richard F; Brooks, Robert; Tor, Svang; Lopes-Cardozo, Barbara; Silove, Derrick

2014-02-01

No population-based studies have directly compared the long-term health and mental health outcomes of conflict- versus non-conflict-affected communities from the same ethnic background. To identify and compare levels of psychiatric morbidity between a traumatized and non-traumatized civilian community; to investigate the long-term impact of mass violence. Double-stratified community surveys in Siem Reap and Surin provinces were conducted by highly qualified Cambodian interviewers using culturally validated survey instruments with known psychometric properties. These included Cambodian versions of the Hopkins Symptom Checklist-25, the Harvard Trauma Questionnaire and the Medical Outcome Study Short Form. Siem Reap and Surin respondents experienced 12,266 and 621 major trauma events, respectively; 745 (76.2%) Siem Reap respondents and six (0.6%) Surin respondents reported torture events; 499 (49.5%) Siem Reap respondents and 203 (19.7%) Surin respondents met the clinical threshold for depression (OR 4.01, 95% CI 3.29-4.88); 204 (20.6%) Siem Reap respondents and 23 (2.2%) Surin respondents met the clinical threshold for post-traumatic stress disorder (PTSD) (OR 11.39, 95% CI 7.3-17.7). The MOS physical disability was higher in Siem Reap versus Surin respondents (74 (7.5%) vs 13 (1.3%), χ(2) = 47.4 df = 1, p < .001). Health status was poorest among Siem Reap respondents when compared with Surin respondents (mean score 1.59 vs 0.59, respectively; t = 19.85 df = 2018, p < .001). Path analysis reveals that recent and past extreme violence are associated with the health and mental health status of the Siem Reap community. After 25 years, the Khmer civilian population that experienced the Pol Pot genocide continues to suffer psychiatric morbidity and poor health.

World War I psychoneuroses: hysteria goes to war.

PubMed

Tatu, Laurent; Bogousslavsky, Julien

2014-01-01

During the First World War, military physicians from the belligerent countries were faced with soldiers suffering from psychotrauma with often unheard of clinical signs, such as camptocormia. These varied clinical presentations took the form of abnormal movements, deaf-mutism, mental confusion, and delusional disorders. In Anglo-Saxon countries, the term 'shell shock' was used to define these disorders. The debate on whether the war was responsible for these disorders divided mobilized neuropsychiatrists. In psychological theories, war is seen as the principal causal factor. In hystero-pithiatism, developed by Joseph Babinski (1857-1932), trauma was not directly caused by the war. It was rather due to the unwillingness of the soldier to take part in the war. Permanent suspicion of malingering resulted in the establishment of a wide range of medical experiments. Many doctors used aggressive treatment methods to force the soldiers exhibiting war neuroses to return to the front as quickly as possible. Medicomilitary collusion ensued. Electrotherapy became the basis of repressive psychotherapy, such as 'torpillage', which was developed by Clovis Vincent (1879-1947), or psychofaradism, which was established by Gustave Roussy (1874-1948). Some soldiers refused such treatments, considering them a form of torture, and were brought before courts-martial. Famous cases, such as that of Baptiste Deschamps (1881-1953), raised the question of the rights of the wounded. Soldiers suffering from psychotrauma, ignored and regarded as malingerers or deserters, were sentenced to death by the courts-martial. Trials of soldiers or doctors were also held in Germany and Austria. After the war, psychoneurotics long haunted asylums and rehabilitation centers. Abuses related to the treatment of the Great War psychoneuroses nevertheless significantly changed medical concepts, leading to the modern definition of 'posttraumatic stress disorder'.

Joseph Conrad's tormented Rescue (fantasy).

PubMed

Freedman, William

2014-02-01

Joseph Conrad was a notoriously tormented writer for whom the creative act was often a punishment severe enough to drive him into paralyzing depressions that delayed the completion of his novels, sometimes for years. By far the most agonizing of these projects was The Rescue, a novel he began in 1898, abandoned a year later, tried unsuccessfully to continue several times over the next two decades, but was only able to resume in 1918 and to complete, after another tortured two-year struggle, in 1920. An explanation for this incapacity, that is powerfully suggested by the novel's evocative title and perhaps unintentionally ironic subtitle (A Romance of the Shallows) has not yet been explored. Using Freud's 1910 essay on the rescue fantasy, "Contributions to the Psychology of Love: A Special Type of Choice of Object Made by Men," and Emanuel Berman's instructive revision and expansion of the concept in his 2003 American Imago essay, "Ferenczi, Rescue, and Utopia," I argue that a substantial explanation for Conrad's tormented history with The Rescue is ascribable to its quite remarkably faithful treatment of a rescue fantasy with deep and disabling resonance for its author. More specifically, the difficulty was compounded by the novel's dramatization of the soul-crushing conflict between two such fantasies: one in the service of the masculine ideal of unflinching dedication to a heroic purpose, the other promising satisfaction to the equally potent demands of emotional and sexual desire. Features of Conrad's narrative fit so tightly and consistently with the theory as Freud (and Abraham) proposed and as Berman elaborated it that The Rescue offers itself as one of those rare and reinforcing instances wherein the literary text seems to validate the psychoanalytic theory at least as persuasively as the theory "understands" the text.

Towards a psychoanalytic understanding of Fascism and anti-Semitism: perceptions from the 1940s.

PubMed

Fisher, David James

2004-01-01

After selecting five representative European psychoanalytic thinkers, all of whom emigrated to the United States, this essay surveys their earliest perceptions and interpretations of the historical and psychological roots of Fascism, with particular emphasis on anti-Semitism. My samples almost all derive from the period before, during, and immediately after World War II. In examining the writings of Otto Fenichel, Ernst Simmel, Erik Homburger Erikson, Rudolf Loewenstein and Bruno Bettelheim, it discusses the various environmental and psychological dimensions of their understandings of racial prejudice. The paper argues that each thinker attempted to integrate historical, sociological, cultural and clinical factors into their psychodynamic formulations about the individual and group mind of the Fascist anti-Semite. This generation of psychoanalysts explained Fascist anti-Semitism by exploring the mechanisms of projection, the process of massive splitting mechanisms of the group mind, fantasies of delinquent adolescent aggrandizement in Hitler, sado-masochistic and perverse oedipal dynamics, and a macabre identification with the torturers on the part of Jewish inmates in the concentration camps, that obliterated the individual's sense of autonomy and capacity to respond morally. The paper points out the pronounced ambivalence of this generation of Jewish analysts and intellectuals toward their own Jewish backgrounds and sense of themselves as Jews. It also argues that this generation muted its left-wing and socialist political tendencies once they arrived in America, taking a turn against politics. It suggests that some of the features of this Jewish ambivalence can be seen in the exploration of a so-called "Jewish psychology," itself a disguised form of racism, a derivative of projection, which may have had rather negative and authoritarian consequences for the psychoanalytic movement in America.

The persistence of ligature marks: towards a new protocol for victims of abuse and torture.

PubMed

Spagnoli, L; Mazzarelli, D; Porta, D; Gibelli, D; Grandi, M; Kustermann, A; Cattaneo, C

2014-01-01

One of the most frequently observed lesions in clinical forensic practice concerns the patterned abrasion on skin due to constriction by various types of ligature. Detection of ligature marks and their patterns may be fundamental for reconstructing events and supporting testimony of an aggression, sexual abuse, or maltreatment. But very little actually exists in literature concerning their detectability and how long they last. This study aims at evaluating the time of persistence and detectability of skin signs left by different types of ligatures in living persons: on the arms of three volunteers, eight different ligatures were applied; 123 tests were performed, with time of contact ranging between 1 min and 2 h and 45 min. In addition, the persistence of the shape and pattern of the ligature was evaluated 15, 30, and 60 min after a 5- and 15-min compression. Polyvinyl siloxane, applied by a gun dispenser, was used to perform a cast of the skin mark. The results show that the pattern was less distinguishable with the decrease of time of contact, going from 75 % after 10 and 15 min of contact, to 45.8 % after 1 min. Above 15 min, the specific pattern was always recognizable. In addition, a progressive decrease of the detectability of the pattern with time, respectively, up to 12.5 and 37.5 % in 5- and 15-min tests was observed. This study provides useful results for the assessment of patterned injuries in forensic pathology and clinical forensic medicine, both on dead and living persons: in addition, the use of silicone casts seems to be a reliable and cheap method for easily recording and preserving the morphological profile of skin lesions.

Explicitly correlated benchmark calculations on C8H8 isomer energy separations: how accurate are DFT, double-hybrid, and composite ab initio procedures?

NASA Astrophysics Data System (ADS)

Karton, Amir; Martin, Jan M. L.

2012-10-01

Accurate isomerization energies are obtained for a set of 45 C8H8 isomers by means of the high-level, ab initio W1-F12 thermochemical protocol. The 45 isomers involve a range of hydrocarbon functional groups, including (linear and cyclic) polyacetylene, polyyne, and cumulene moieties, as well as aromatic, anti-aromatic, and highly-strained rings. Performance of a variety of DFT functionals for the isomerization energies is evaluated. This proves to be a challenging test: only six of the 56 tested functionals attain root mean square deviations (RMSDs) below 3 kcal mol-1 (the performance of MP2), namely: 2.9 (B972-D), 2.8 (PW6B95), 2.7 (B3PW91-D), 2.2 (PWPB95-D3), 2.1 (ωB97X-D), and 1.2 (DSD-PBEP86) kcal mol-1. Isomers involving highly-strained fused rings or long cumulenic chains provide a 'torture test' for most functionals. Finally, we evaluate the performance of composite procedures (e.g. G4, G4(MP2), CBS-QB3, and CBS-APNO), as well as that of standard ab initio procedures (e.g. MP2, SCS-MP2, MP4, CCSD, and SCS-CCSD). Both connected triples and post-MP4 singles and doubles are important for accurate results. SCS-MP2 actually outperforms MP4(SDQ) for this problem, while SCS-MP3 yields similar performance as CCSD and slightly bests MP4. All the tested empirical composite procedures show excellent performance with RMSDs below 1 kcal mol-1.

The Würzburg Anatomical Institute and its supply of corpses (1933-1945).

PubMed

Blessing, Tim; Wegener, Anna; Koepsell, Hermann; Stolberg, Michael

2012-06-01

The Würzburg Anatomical Institute was one of the largest institutions of its kind in early 20th-century Germany. Little is known so far, however, about its history in the Third Reich. This paper presents the first results of current research on the Institute's directors Hans Petersen (1925-1940) and Curt Elze (1940-1945) and the sources from which it received its corpses during that period. For both directors there is little evidence for a marked affinity to National-Socialist ideology but a substantial degree of opportunism emerges from the surviving sources, at least in the case of Elze. Elze not only joined the NSDAP, by his own admission, without strict necessity. He also did not protest when Werner Heyde, principal medical actor in the Nazi "euthanasia" program, supplied him with 80 corpses of men and women who clearly had been murdered with carbon monoxide. The Institute's supply of corpses is analyzed based on the registers of received corpses and other, supplementary sources. Before 1933, the Würzburg Institute received most of its corpses from hospitals, old age homes. Between 1933 and 1945 some marked changes occurred. In particular, the number of corpses not only from psychiatric hospitals but also from other places of institutional care declined, presumably due, at least to a substantial degree, to "euthanasia". On the other hand, the number of corpses delivered from execution sites, prisons and Gestapo rose dramatically, reflecting the massive increase of the number of death sentences as well as, by all appearances, that of deaths from physical violence and torture in the prisons. Copyright © 2012 Elsevier GmbH. All rights reserved.

The Brain Functional Networks Associated to Human and Animal Suffering Differ among Omnivores, Vegetarians and Vegans

PubMed Central

Filippi, Massimo; Riccitelli, Gianna; Falini, Andrea; Di Salle, Francesco; Vuilleumier, Patrik; Comi, Giancarlo; Rocca, Maria A.

2010-01-01

Empathy and affective appraisals for conspecifics are among the hallmarks of social interaction. Using functional MRI, we hypothesized that vegetarians and vegans, who made their feeding choice for ethical reasons, might show brain responses to conditions of suffering involving humans or animals different from omnivores. We recruited 20 omnivore subjects, 19 vegetarians, and 21 vegans. The groups were matched for sex and age. Brain activation was investigated using fMRI and an event-related design during observation of negative affective pictures of human beings and animals (showing mutilations, murdered people, human/animal threat, tortures, wounds, etc.). Participants saw negative-valence scenes related to humans and animals, alternating with natural landscapes. During human negative valence scenes, compared with omnivores, vegetarians and vegans had an increased recruitment of the anterior cingulate cortex (ACC) and inferior frontal gyrus (IFG). More critically, during animal negative valence scenes, they had decreased amygdala activation and increased activation of the lingual gyri, the left cuneus, the posterior cingulate cortex and several areas mainly located in the frontal lobes, including the ACC, the IFG and the middle frontal gyrus. Nonetheless, also substantial differences between vegetarians and vegans have been found responding to negative scenes. Vegetarians showed a selective recruitment of the right inferior parietal lobule during human negative scenes, and a prevailing activation of the ACC during animal negative scenes. Conversely, during animal negative scenes an increased activation of the inferior prefrontal cortex was observed in vegans. These results suggest that empathy toward non conspecifics has different neural representation among individuals with different feeding habits, perhaps reflecting different motivational factors and beliefs. PMID:20520767

Inflammatory, autoimmune, chronic diseases: bad diet and physical inactivity are causes or effects?

PubMed

Gracia, M C

2006-01-01

It is now well established that most chronic diseases, especially those identified as inflammatory, are statistically correlated with some typical dietary excesses and physical inactivity. But do really these habits cause the diseases, or they result from them? Current opinion favours the first option, but fails to explain why the satisfaction of eating, naturally evolved in our brains to produce health, apparently induces countless millions of people to eat unrestrictedly until becoming mortally sick, whereas trying to keep a theoretically healthy diet is most often a real torture. The inverse explanation makes much more sense: since inflammation produces much heat, calorie-rich diets are required. An inflamed digestive tract lacks digestive power and is easily irritated or damaged by solid objects, therefore requiring a refined, concentrated, low-fibre diet. And inflamed or merely sick organisms are easily exhausted by physical effort, hence physical inactivity. This study confirms that, most probably, the primary causes of inflammatory diseases are always external inflammatory agents, like infectious micro-organisms or toxic substances, of which a particularly ubiquitous example is nicotine. High-calorie/low-fibre diets and physical inactivity are direct consequences of generalised inflammation. Inversely, in most cases, physical exercise and moderation in eating, by themselves, cannot substantially suppress inflammations, but they can prevent them from being further reinforced by the neural reward system. Moreover, diets and exercise causing important suffering will usually do more harm than good, especially to children and young people, not to mention pregnant or nursing women. Only the identification and elimination of the inflammatory agents can efficiently prevent and cure inflammatory diseases, and currently nicotine, absorbed intentionally or passively, from tobacco or other sources, must be considered the chief suspect because of its inflammatory power, ubiquity and addictive properties.

A programme of mental health for political refugees: dealing with the invisible pain of political exile.

PubMed

Barudy, J

1989-01-01

Political persecution, state terrorism, torture, political assassinations, kidnapping and forced exile have become common occurrences in many parts of the world. Several researchers have tried to determine the impact of these situations on the mental health of those affected. At the same time, different types of aid programmes have been developed to prevent and treat the effects of violence on mental health. In this article we present clinical materials collected for 10 years by the Latin American Collective of Psychosocial Work [Colectivo Latinamericano de Trabajo Psicosocial (Colat)], a medical-psychosocial assistance programme for political refugees. The programme was under the academic supervision of the Catholic Universities of Leuven (KUL, ULC), Belgium. The concept of identity is the central theme of a model which tries to understand and explain the suffering of exiles. We try to identify and expose the mechanisms of political violence that have traumatized an individual's self-esteem and disordered his familial and social bonds. In the second part of this article, the central ideas which support the medical-psychosocial practice of the programme are presented. This programme seeks to heal the damage caused by repression and exile through the active participation of those affected. Only in a context of communal action is it possible to develop a therapy to promote an individual recovery. It is in this sense that the strategic goal of the programme is to permit elaboration of the suffering at an individual, familial and group level, and to facilitate group dynamics which can trigger the potential of the exiles to transform the conditions of violence that originated and maintain their pain.

Adjusting the light in the limit conditions of consciousness by the means of ascending reticular activating system (ARAS) and of subordinated systems

PubMed Central

Aliu, Octavian Florin

2014-01-01

Background: In our activity in the Ambulance Service of Bucharest Municipality during March 2002 – March 2003 we studied a casuistry of patients who had fallen in a coma of varying degrees. To aid better understanding of coma, the concept of “pre-coma stage” or “diencephalic 0 stage” was introduced. This concept complements the Arseni classification already used in medical practice, because some doctors alternatively use the term of “inaugural coma” for the same condition that we call diencephalic “0 stage”. In the median hypothalamus and on the retino-hypothalamic path (SCN - AN) optical waves are transmitted, probably in the near infrared spectral range (800–1000 nm) in what we term the ascending reticular activating system (ARAS). These waves would constitute a means of transmitting information via the ARAS about the infradian biorhythm of coordination (frequencies below 1 cycle/28 hours), essential for the modulation and pre-processing of the consciousness and wakefulness, a fact which has already been demonstrated in animals. Methods: The current work is based on observations made on a group of 51 patients with the precoma and coma conditions, and on a thorough study of the specialized (especially Romanian) literature. Also, we used validated scientific proof of torture in conditions of lack of light. Results: We found a perfect interpenetration between the ARAS and the following two complementary subsystems: 1. The hypothalamic suprachiasmatic nucleus, that has the role of coordinating the periodicity of some biological functions depending on the circadian rhythm; and 2. The main photoperiodic organ, the pineal gland (epiphysis), which together with the ARAS has a role in the photoperiodicity modulation of some biological functions during the state of vigilance. PMID:25071308

The right to health of prisoners in international human rights law.

PubMed

Lines, Rick

2008-01-01

This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non-binding or so-called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.

The progressive nature of concentration camp syndrome in former prisoners of Nazi concentration camps--Not just history, but the important issue of contemporary medicine.

PubMed

Jabłoński, Robert; Rosińczuk, Joanna; Leszek, Jerzy; Uchmanowicz, Izabella; Panaszek, Bernard

2016-04-01

Constant stress, slave labor, tortures, and starvation all affected the health of concentration camp prisoners, contributing to multimorbidities, increased mortality and accelerated development of chronic illnesses, what we have shown in an earlier publication. The interrelated somatic and psychological symptoms gave rise to concentration camp syndrome (KZ-syndrome), which has many features of PTSD, occurring frequently nowadays. The paper attempts at assessing the influence of concentration camp conditions on functional disorders in each system of the human body, occurring in KZ-syndrome, and at demonstrating the progressive nature of the syndrome. A retrospective assessment of the former prisoners' health after 5 and 30 years following their leaving camps was performed based on medical records and surveys. The materials included 250 former prisoners who underwent medical examination in 1950, i.e. 5 years after leaving the camp, of whom 120 former prisoners survived and were examined and surveyed in 1975, i.e. 30 years after leaving the camp. KZ-syndrome was shown to occur in 58.8% of former prisoners 5 years after leaving the camp, and in 77.5% after 30 years (p < 0.001), which confirms the syndrome's chronic and progressive nature. Pathological sequels of internment in concentration camps, in the form of KZ-syndrome, were observed in most former prisoners. Over time, the number of morbidities and the intensity of symptoms increased, which indicates that the syndrome has a chronic and progressive nature. KZ-syndrome is a multi-organ disorder, with numerous chronic comorbidities exacerbating the progression. Copyright © 2015 Elsevier Ltd. All rights reserved.

Persistent Complex Bereavement Disorder and Culture: Early and Prolonged Grief in Nepali Widows.

PubMed

Kim, Jane; Tol, Wietse A; Shrestha, Abina; Kafle, Hari Maya; Rayamajhi, Rajin; Luitel, Nagendra P; Thapa, Lily; Surkan, Pamela J

2017-01-01

Persistent complex bereavement disorder (PCBD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has not been well studied in socioculturally diverse populations. Thus, this qualitative study examined (a) how widows in Nepal understand grief, (b) whether a local construct of PCBD exists, and (c) its comparability with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), terminology. Using an adapted Explanatory Model Interview Catalogue (EMIC) framework, semistructured interviews with 25 widows and 12 key informants, as well as three focus-group discussions (n = 20), were conducted between October 2014 and April 2015. Through an inductive grounded theory-based approach, we used the constant comparative method, iteratively coding transcripts to identify themes and patterns in the data. Also, we created two lists of grief responses, one of early reactions and another all reactions to grief, based on the frequency of mention. No single term for grief was reported. Widows reported a local construct of PCBD, which was broadly compatible with DSM-5 terminology but with important variation reflecting societal influence. Surviving torture during conflict, economic and family stressors, and discrimination were mentioned as important determinants that prolong and complicate grief. Suicidal ideation was common, with about 31% and 62% of widows reporting past-year and lifetime suicidality, respectively. Findings may not be generalizable to all Nepali widows; participants were recruited from a non-governmental organization, from Kathmandu and its neighboring districts, and were primarily of reproductive age. While PCBD symptoms proposed in DSM-5 were mentioned as relevant by study participants, some components may need adaptation for use in non-Western settings, such as Nepal.

Aspects of abuse: recognizing and responding to child maltreatment.

PubMed

Jackson, Allison M; Kissoon, Natalie; Greene, Christian

2015-03-01

Child maltreatment is a public health problem and toxic stress impacting at least 1 in 8 children by the age of 18 years. Maltreatment can take the form of physical and sexual abuse, neglect, and emotional maltreatment. While some children may experience only one form of maltreatment, others may survive multiple forms, and in some cases particularly complex forms of maltreatment such as torture and medical child abuse. When considering maltreatment, providers should be adept at obtaining a thorough history not only from the parent but when appropriate also from the patient. The most common form of child maltreatment is neglect, which encompasses nutritional and medical neglect, as well as other forms such as physical and emotional neglect. Talking with caregivers about stressors and barriers to care may give insight into the etiology for neglect and is an opportunity for the provider to offer or refer for needed assistance. Familiarity with injury patterns and distribution in the context of developmental milestones and injury mechanisms is critical to the recognition of physical abuse. While most anogenital exam results of child victims of sexual abuse are normal, knowing the normal variations for the female genitalia, and thereby recognizing abnormal findings, is important not only forensically but also more importantly for patient care. Pattern recognition does not only apply to specific injuries or constellation of injuries but also applies to patterns of behavior. Harmful patterns of behavior include psychological maltreatment and medical child abuse, both of which cause significant harm to patients. As health professionals serving children and families, pediatric providers are in a unique position to identify suspected maltreatment and intervene through the health care system in order to manage the physical and psychological consequences of maltreatment and to promote the safety and well-being of children and youth by making referrals to child protective services. Copyright © 2015 Mosby, Inc. All rights reserved.

Imprisoned and imperiled: access to HIV and TB prevention and treatment, and denial of human rights, in Zambian prisons

PubMed Central

2011-01-01

Background Although HIV and tuberculosis (TB) prevalence are high in prisons throughout sub-Saharan Africa, little research has been conducted on factors related to prevention, testing and treatment services. Methods To better understand the relationship between prison conditions, the criminal justice system, and HIV and TB in Zambian prisons, we conducted a mixed-method study, including: facility assessments and in-depth interviews with 246 prisoners and 30 prison officers at six Zambian prisons; a review of Zambian legislation and policy governing prisons and the criminal justice system; and 46 key informant interviews with government and non-governmental organization officials and representatives of international agencies and donors. Results The facility assessments, in-depth interviews and key informant interviews found serious barriers to HIV and TB prevention and treatment, and extended pre-trial detention that contributed to overcrowded conditions. Disparities both between prisons and among different categories of prisoners within prisons were noted, with juveniles, women, pre-trial detainees and immigration detainees significantly less likely to access health services. Conclusions Current conditions and the lack of available medical care in Zambia's prisons violate human rights protections and threaten prisoners' health. In order to protect the health of prisoners, prison-based health services, linkages to community-based health care, general prison conditions and failures of the criminal justice system that exacerbate overcrowding must be immediately improved. International donors should work with the Zambian government to support prison and justice system reform and ensure that their provision of funding in such areas as health services respect human rights standards, including non-discrimination. Human rights protections against torture and cruel, inhuman or degrading treatment, and criminal justice system rights, are essential to curbing the spread of HIV and TB in Zambian prisons, and to achieving broader goals to reduce HIV and TB in Zambia. PMID:21314929

Health workers and the weaponisation of health care in Syria: a preliminary inquiry for The Lancet-American University of Beirut Commission on Syria.

PubMed

Fouad, Fouad M; Sparrow, Annie; Tarakji, Ahmad; Alameddine, Mohamad; El-Jardali, Fadi; Coutts, Adam P; El Arnaout, Nour; Karroum, Lama Bou; Jawad, Mohammed; Roborgh, Sophie; Abbara, Aula; Alhalabi, Fadi; AlMasri, Ibrahim; Jabbour, Samer

2017-12-02

The conflict in Syria presents new and unprecedented challenges that undermine the principles and practice of medical neutrality in armed conflict. With direct and repeated targeting of health workers, health facilities, and ambulances, Syria has become the most dangerous place on earth for health-care providers. The weaponisation of health care-a strategy of using people's need for health care as a weapon against them by violently depriving them of it-has translated into hundreds of health workers killed, hundreds more incarcerated or tortured, and hundreds of health facilities deliberately and systematically attacked. Evidence shows use of this strategy on an unprecedented scale by the Syrian Government and allied forces, in what human rights organisations described as a war-crime strategy, although all parties seem to have committed violations. Attacks on health care have sparked a large-scale exodus of experienced health workers. Formidable challenges face health workers who have stayed behind, and with no health care a major factor in the flight of refugees, the effect extends well beyond Syria. The international community has left these violations of international humanitarian and human rights law largely unanswered, despite their enormous consequences. There have been repudiated denunciations, but little action on bringing the perpetrators to justice. This inadequate response challenges the foundation of medical neutrality needed to sustain the operations of global health and humanitarian agencies in situations of armed conflict. In this Health Policy, we analyse the situation of health workers facing such systematic and serious violations of international humanitarian law. We describe the tremendous pressures that health workers have been under and continue to endure, and the remarkable resilience and resourcefulness they have displayed in response to this crisis. We propose policy imperatives to protect and support health workers working in armed conflict zones. Copyright © 2017 Elsevier Ltd. All rights reserved.