scholarly journals Legacies of humanitarian neglect: long term experiences of children who returned from the Lord’s Resistance Army in Uganda

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Melissa Parker ◽  
Cristin A. Fergus ◽  
Charlotte Brown ◽  
Dorothy Atim ◽  
James Ocitti ◽  
...  
Keyword(s):  
Social Protection ◽  
Skills Training ◽  
Structured Interviews ◽  
Lord's Resistance Army ◽  
Post Conflict ◽  
Close Relatives ◽  
Lord’S Resistance Army ◽  
Reception Centre

Abstract Background Much has been written about the short-term challenges facing children returning ‘home’ from rebel fighting groups, but little is known about the longer term day to day realities of return. This article presents findings from the first long-term assessment of the social and economic challenges facing an officially registered group of children who passed through an internationally-financed reception centre after a period of time with the Lord’s Resistance Army (LRA). Methods Records from a reception centre were used to trace a random sample of individuals to their current location. Two hundred and thirty in-depth semi-structured interviews were carried out and 40 follow-up interviews between 2013 and 2016. Interviews were informed by long-term ethnographic research in the region. These interviews were subsequently coded and analysed to describe the long-term day to day realities of return. Results At the time of interview, 90% of formerly abducted people returned ‘home’ six or more years ago, and 75% returned nine or more years ago. The majority have managed to access family land for farming, but concerns about what they may have done to survive whilst living with the LRA adversely affects their day-to-day lives. However, some important differences were noted: those men and women who spent less time with the LRA are more likely to live on ancestral land with close relatives; and they are more likely to report experiencing stigma and a spiritual affliction called ‘cen’. In contrast, those who spent the longest time with the LRA are less likely to report these problems, they are mainly living in urban locations and tend to manage slightly better. Children born of war are vulnerable to abuse, irrespective of current residence. Conclusions Research findings question the merits of post-conflict reintegration programmes emphasising immediate family reunifications, without follow-up monitoring, social protection, education and skills training. By overlooking the diverse experiences of those who lived and fought with the LRA, and failing to anticipate or respond to the long term socio-political and economic challenges facing children on their return, reception centre processes not only failed to foster social reintegration, but they also inadvertently exacerbated the vulnerability of returning children.

From lack of awareness to meticulous action. Strategies toward old-age pension insurance among Polish migrant domestic workers in Germany

2021 ◽  
Vol 148 (1) ◽  
pp. 1-22
Author(s):  
Kamil Matuszczyk
Keyword(s):  
Migrant Workers ◽  
Social Protection ◽  
Significant Proportion ◽  
Pension Plans ◽  
Structured Interviews ◽  
Pension Insurance ◽  
Migration Strategy ◽  
Care Workers ◽  
Action Strategies

A significant proportion of migrant workers around the world have difficult access to social protection, especially long-term benefits such as pensions. Domestic care workers are a particularly vulnerable group in this regard. Analysing the example of Polish migration to Germany, the aim of this paper is to present the strategies that migrants aged 45 and over undertake in the context of pension plans and ensuring an adequate level of social protection while working abroad. Using empirical material collected during semi-structured interviews with migrant care workers, representatives of employment agencies and experts, the article sheds light on the diverse conditions that influence the strategies of individual workers. Depending on the general knowledge of their social rights, their migration strategy or their personal situation, migrants adopt three main strategies called (1) escape from problems instead of social security, (2) secure and legal work above all and (3) an informed and inquisitive insured worker.

Classical but Not Rap Music Significantly Improves Transferability and Long-Term Acquisition of Laparoscopic Suturing Skills: A Randomized Controlled Trial

2020 ◽  
Vol 30 (06) ◽  
pp. 541-547 ◽  
Author(s):  
Stefan Mietzsch ◽  
Robert Bergholz ◽  
Johannes Boettcher ◽  
Lea Klippgen ◽  
Julia Wenskus ◽  
...  
Keyword(s):  
Motor Skills ◽  
Classical Music ◽  
Skills Training ◽  
Laparoscopic Suturing ◽  
Complex Motor ◽  
And Performance ◽  
Complex Motor Skills ◽  
Suturing Skills

Abstract Introduction Acoustic distractions have been shown to increase the level of stress and workload in the operating room (OR). Noise significantly reduces surgical performance, but experienced surgeons are able to reduce the acoustic perception of their surroundings to maintain a high level of performance in complex surgical tasks. However, music has been shown to improve learning and performance of complex motor skills. The aim of this study was to evaluate the influence of music on transferability and long-term acquisition of laparoscopic suturing skills. Materials and Methods To evaluate the effects of music on training, subjects were asked to perform four surgeon's square knots on a bowel model within 30 minutes—prior and post 3 hours of hands-on training. To examine long-term skills, the same students were asked to perform a comparable, but more complex, task (four slip knots in a model of esophageal atresia) 6 months post initial training, as a follow-up measurement. Total time, knot stability (evaluated via tensiometer), suture accuracy, knot quality (Muresan scale), and laparoscopic performance (Munz checklist) were assessed. Results Twenty-four students were included in the study; after simple randomization, 16 were trained while exposed to music (eight to Bach and eight to Bushido) and eight with traditional methods. Seven were lost due to follow-up. Both groups had comparable baseline characteristics and significantly improved after training, in all parameters assessed in this study. Subjects that trained with classical music were superior in terms of speed (p = 0.006), knot quality (p = 0.014), and procedural performance (p = 0.034) compared with controls. Conclusion Music during acquisition of complex motor skills, like laparoscopic suturing and knot tying, is superior to traditional training. Especially music considered nondisturbing significantly improved speed, knot quality, and performance. Thus, incorporation of pleasant music into surgical skills training and the OR should be considered.

scholarly journals What Happened to Children Who Returned from the Lord’s Resistance Army in Uganda?

2020 ◽  
Author(s):  
Tim Allen ◽  
Jackline Atingo ◽  
Dorothy Atim ◽  
James Ocitti ◽  
Charlotte Brown ◽  
...  
Keyword(s):  
Best Practice ◽  
Northern Uganda ◽  
Negative Consequences ◽  
Vulnerable Children ◽  
Long Period ◽  
Lord's Resistance Army ◽  
Best Practice Guidelines ◽  
Displaced Children ◽  
Lord’S Resistance Army ◽  
Reception Centre

Abstract In northern Uganda, more than 50,000 people were recruited by the Lord’s Resistance Army (LRA) between the late 1980s and 2004, mostly by force. Around half of those taken were children (under 18 years old). A large number were never seen by their families again, but more than 20,000 returned through aid-financed reception centres. Endeavours were made to reunite them with their relatives, who were mostly living in insecure displacement camps. Relatively few were subsequently visited, even after the fighting ended in 2006. Thousands of vulnerable children were largely left to their own devices. This article draws on research carried out in 2004–06 and from 2012 to 2018, and compares findings with other publications on reintegration in the region. It argues that implementing best-practice guidelines for relocating displaced children with their immediate relatives had negative consequences. The majority of children who passed through a reception centre are now settled as young adults on ancestral land, where they are commonly abused because of their LRA past. With few exceptions, it is only those who spent a long period with the LRA and who are not living on ancestral land who have managed to avoid such experiences.

Unwilling and Unprepared: Collective Responsibility for Traumatic Wartime Motherhood

2020 ◽  
pp. 174387212096471
Author(s):  
Andreea M. Prundeanu-Thrower
Keyword(s):  
Collective Responsibility ◽  
Child Trauma ◽  
Lord's Resistance Army ◽  
Post Conflict ◽  
Maternal Roles ◽  
Systemic Violence ◽  
Lord’S Resistance Army

What does it mean to mother children born of illicit wartime relations? This article examines the detrimental effects of motherhood as a patriarchal institution shaped by nationalism/ethnocentrism and its impact on “sentimental collaborators” in WWII France, survivors of genocidal rape in Rwanda, and returning Lord’s Resistance Army (LRA) “wives” in Uganda. Using a corpus of written and oral testimonies by/about mothers of children born of war (CBOW), it argues that all mothers experienced trauma in their maternal roles and that communities were often complicit in perpetuating mother–child trauma post-conflict. Understanding such collective responsibility is crucial to our capacity to help future survivors of systemic violence.

Long-term follow-up after bilateral percutaneous epiphysiodesis around the knee to reduce excessive predicted final height

2017 ◽  
Vol 103 (3) ◽  
pp. 219-223 ◽  
Author(s):  
Wesley J Goedegebuure ◽  
Frank Jonkers ◽  
Annemieke M Boot ◽  
Willie M Bakker-van Waarde ◽  
Vera van Tellingen ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Final Height ◽  
Treated Group ◽  
Knee Function ◽  
Tall Stature ◽  
Complication Rates ◽  
Significant Difference ◽  
Close Relatives

ContextPercutaneous epiphysiodesis (PE) around the knee to reduce predicted excessive final height. Studies until now included small numbers of patients and short follow-up periods.Objective and designThis Dutch multicentre, long-term, retrospective, follow-up study aimed to assess adult height (AH), complications, knee function and patient satisfaction after PE. The primary hypothesis was that PE around the knee in constitutionally tall boys and girls is an effective treatment for reducing final height with low complication rates and a high level of patient satisfaction.Participants77 treated adolescents and 60 comparisons.InterventionPercutaneous epiphysiodesis.OutcomeAH, complications, knee function, satisfaction.ResultsIn the PE-treated group, final height was 7.0 cm (±6.3 cm) lower than predicted in boys and 5.9 cm (±3.7 cm) lower than predicted in girls. Short-term complications in file search were seen in 5.1% (three infections, one temporary nerve injury), one requiring reoperation. Long-term complications in file search were seen in 2.6% (axis deformity 1.3%, prominent head of fibula 1.3%). No significant difference in knee function was found between treated cases and comparisons. Satisfaction was high in both the comparison and PE groups; most patients in the PE group recommended PE as the treatment for close relatives with tall stature.ConclusionPE is safe and effective in children with predicted excessive AH. There was no difference in patient satisfaction between the PE and comparison group. Careful and detailed counselling is needed before embarking on treatment.

OS10.6.A Supportive care needs of TYA childhood brain tumour survivors and their caregivers: a mixed methods study

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii14-ii14
Author(s):  
E Nicklin ◽  
G Velikova ◽  
A Glaser ◽  
N Sarwar ◽  
M Kwok-Williams ◽  
...  
Keyword(s):  
Supportive Care ◽  
Brain Tumour ◽  
Qualitative Data ◽  
Unmet Needs ◽  
Supportive Care Needs ◽  
Structured Interviews ◽  
Care Needs ◽  
Long Term Follow Up

Abstract BACKGROUND Childhood brain tumour survivors and their family caregivers can experience many late effects of treatment including social, cognitive and physical issues. Yet, the supportive care needs of survivors, now teenagers and young adults (TYAs), and their caregivers population are largely unknown. We aimed to gain an in-depth understanding of this populations’ supportive care needs. MATERIAL AND METHODS This study used a convergent mixed methods design including quantitative (survey) and qualitative data (in-depth semi-structured interviews). Participants were recruited from long-term follow-up clinics (in three NHS Trusts in England) and online. Participants included childhood brain tumour survivors, at least five years from diagnosis, currently aged 13–30 and their primary caregivers. The results from quantitative and qualitative data were integrated using a Joint Display Table. RESULTS 136 eligible survivors and caregivers (78 survivors/58 caregivers) were approached to take part in the survey. In total, 112 participants (69 survivors/43 caregivers) completed the survey. A further 22 participants took part in face-to-face semi-structured interviews (11 survivors/11 caregivers). The integrated findings indicate that both survivors and caregivers have unmet needs many years after diagnosis. TYA survivors specifically had high unmet needs in relation to their psychological health, social lives (including romantic relationships), employment, and independence. Caregivers experienced even more unmet needs - including regarding their own psychological well-being and survivors’ financial issues. Survivors further from diagnosis, unemployed survivors and single caregivers were more likely to report unmet needs. Barriers preventing survivors and caregivers accessing supportive services were highlighted, including (but not exclusive to) families not being aware of support available, location of services, and accessibility to information/support. CONCLUSION This research provides leads to improving supportive care and long-term follow-up services. Understanding unmet needs and recognising what services are required is critical to improving survivor and caregiver quality of long-term survival.

‘Alert not alarm’: The UK experience of public counter-terrorism awareness and training, with explicit reference to Project ARGUS

2019 ◽  
Vol 93 (3) ◽  
pp. 167-182
Author(s):  
Dylan Aplin ◽  
Marian Brooke Rogers
Keyword(s):  
Significant Contribution ◽  
Structured Interviews ◽  
Training Tool ◽  
Counter Terrorism ◽  
Shopping Centre ◽  
The Uk ◽  
The Impact ◽  
And Training

This study evaluates the contribution of a UK counter-terrorism training tool, the Project ARGUS simulation exercise format, designed to increase preparedness by ‘alerting not alarming’ the populace to the prevailing ‘severe’ international terrorist threat. The paper draws upon the theoretical basis for preparedness in order to contend that, despite exceeding expectations in terms of quantity of events delivered and evidence of immediate post-event learning, Project ARGUS does not wholly live up to its promise to change the behaviour of individuals and organisations by embedding long-term learning. The researchers designed and analysed pre- and post-event questionnaires (N = 120) in order to explore the impact of attendance at an ARGUS Retail event within a shopping centre. This information was then augmented with a follow-up survey (N = 44) and semi-structured interviews (N = 9) of key facilitators and participants. The authors recommend the immediate adoption of an appropriate evaluation and certification scheme to mandate participation and embed organisational learning. They argue that adoption of these approaches would better enable ARGUS to fulfil its potential and make a significant contribution to improving the resilience of busy crowded places to terrorism in the UK.

scholarly journals Postoperative improvement in acoustic rhinometry measurements after septoplasty correlates with long-term satisfaction

2013 ◽  
Vol 51 (2) ◽  
pp. 171-175
Author(s):  
N.M. Toyserkani ◽  
T. Frisch ◽  
C. Von Buchwald
Keyword(s):  
Acoustic Rhinometry ◽  
Sectional Area ◽  
Cavity Volume ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Data Set ◽  
Postoperative Improvement ◽  
Preoperative Patient

Background: Not much is known about long-term satisfaction of septoplasty. Our goal was to compare pre- and postoperative acoustic rhinometry measurements with satisfaction 11 years after surgery. Methodology: Acoustic rhinometry measurements were performed preoperatively and 3 months postoperatively. Satisfaction was evaluated with semi-structured interviews by telephone 11 years after surgery. Symptoms were evaluated using the NOSE score. Results: In total, 222 patients were interviewed and eligible to enter the study. Of these, 213 had preoperative acoustic rhinometry and 159 had postoperative acoustic rhinometry. In total, 157 patients had a complete data set. Mean follow-up time was 11.3 years. Patients satisfied with surgery had a bigger improvement in total minimum cross-sectional area before decongestion and total nasal cavity volume after decongestion. NOSE scores were not correlated with acoustic rhinometry measurements. Conclusion: Acoustic rhinometry could be a valuable tool for evaluating the results of septoplasty. Satisfaction at 11 years follow-up was associated with 3 months postoperative acoustic rhinometry improvements. Acoustic rhinometry did not show preoperative patient selection potential.

Comparison of the effectiveness of hands-on versus online education in child passenger safety

2017 ◽  
Vol 24 (5) ◽  
pp. 365-371
Author(s):  
Anita Mantha ◽  
Kristen L Beckworth ◽  
John A Ansiaux ◽  
Carol C Chen ◽  
Benjamin Hoffman ◽  
...  
Keyword(s):  
Online Education ◽  
Assessment Tool ◽  
Skills Training ◽  
Child Passenger Safety ◽  
Passenger Safety ◽  
Skill Scores ◽  
Hands On ◽  
Online Group

BackgroundCommunity paediatricians’ knowledge of appropriate child safety seat (CSS) use in vehicles may be inadequate. We compared the effectiveness of hands-on and online education in improving and retaining child passenger safety (CPS) knowledge and skills among paediatric trainees.MethodsPaediatric trainees were randomised to receive hands-on skills training versus a 1-hour online module in CPS. CSS knowledge and installation skills were assessed using a validated 10-item/point questionnaire and an assessment tool respectively at baseline and after 6 months. Preintervention and postintervention knowledge improvement and CSS installation skills between groups were assessed using paired t-tests and effect size (d).ResultsForty-eight students agreed to participate and were randomised. Thirty-nine completed training (hands-on: 23 and online: 15). At entry, no significant differences in learners’ demographics and prior CPS education existed. Baseline CPS knowledge scores did not differ significantly between groups (p=0.26). Postintervention, both groups demonstrated a significant increase in knowledge scores (hands-on=3.1 (95% CI 2.4 to 3.7), p<0.0001; online=2.6 (95% CI 1.9 to 3.3), p<0.0001), though the pre–post gain in knowledge scores were not significantly different between groups (p=0.35). At follow-up, both groups demonstrated a significant increase in knowledge scores (hands-on=1.8 (95% CI 1.2 to 2.4), p<0.0001; online=1.1 (95% CI 0.7 to 1.6), p<0.0001) with the hands-on group scores significantly better than the online group (p<0.02). The long-term gain in knowledge scores was not significantly different between groups (p=0.12).Baseline CSS installation skill scores did not significantly differ between groups for forward-facing seats (p=0.16) and rear-facing seats (p=0.51). At follow-up, mean CSS installation skill scores significantly increased for the hands-on group (forward-facing seat: 0.8 (95% CI 0.16 to 1.44), p<0.02; rear-facing seat: 1.2 (95% CI 0.6 to 1.7), p<0.001) but not for the online group (forward-facing seat: 0.9 (95% CI −0.08 to 1.9), p=0.07); rear-facing seat: −0.2 (95% CI −1.1 to 0.7), p=0.6).ConclusionsAmong paediatric trainees, hands-on and online CPS education are both effective in improving long-term CPS knowledge. Long-term installation skills for forward-facing and rear-facing CSS persist for hands-on education but are inconclusive for online education.

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