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PubMed2004

The Kosovo family support project: offering psychosocial support for families with missing persons.

This article presents a case that illustrates the vital role that social workers and other mental health and public health workers provided to support families following the 1999 conflict between Serb forces and Kosovar Albanians in Kosovo. A public health and social work team from Boston-based Physicians for Human Rights responded to an emergency postconflict situation by planning and implementing a community-based intervention that mobilized local mental health providers and established collaboration among national and international agencies, including the International War Crimes Tribunal for the Former Yugoslavia, to provide a support network for families with missing family members. The intervention included assessment of local resources, training, fieldwork, professional development of local staff, and the establishment of long-term local responsibility and autonomy.

Community-Institutional Relations↗
PubMed1996

Blood lead and blood pressure in young children.

We examined associations between blood lead concentration (BPb) and blood pressure in 282 children age 5.5 years, residing in an exposed or unexposed town in Kosovo, Yugoslavia. Mean BPb in the exposed town was 37.3 micrograms per dl (standard deviation = 12.0 micrograms per dl) and in the unexposed town was 8.7 micrograms per dl (standard deviation = 2.8 micrograms per dl). After adjustment, a 10 micrograms per dl increase in BPb was associated with a 0.5 (95% CL = -0.2, 1.3) mmHg increase in systolic and a 0.4 (95%, CL = -0.1, 0.9) mmHg increase in diastolic blood pressure. These associations, although compatible with no relation, are similar to those observed in adults; and the data are most consistent with a small association between BPb and blood pressure.

Blood Pressure↗
PubMed2004

Evaluation of maxillofacial weapon injuries: 15-year experience in Belgrade.

The aim of this research was to evaluate maxillofacial weapon-related injuries from the epidemiological, clinical, and forensic points of view. Analysis of medical records of 183 patients treated for weapon-related injuries in Belgrade maxillofacial surgery clinics in the period 1988 through 2002 has been carried out. Most treated patients were male, 21 to 50 years of age, and injured during the war in the territory of the former Yugoslavia. Injuries involving the mandible were the most frequent (40%); firearm (85%) and perforating (70%) wounds occurred more frequently than explosive (25%) and penetrating (30%) wounds; in certain cases, medical records were incomplete and thus useless for forensic court expertise and evidence. A rapid increase in maxillofacial weapon-related injuries was recorded in the period from 1991 to 1995 as a result of war injuries; high-velocity projectiles caused most of the injuries. It is necessary to keep adequate medical records for successful forensic and court expertise and evidence.

Adolescent↗
PubMed2002

Depleted uranium in Kosovo: results of a survey by gamma spectrometry on soil samples.

The presence of depleted uranium in the soil of former Yugoslavia after the 1999 conflict raised great public concern all over the world. The so-called Balkan-syndrome is often linked with depleted uranium contamination. An excellent compilation of data about DU and its possible impact on health and environment can be found in the 1999 UNEP report and publications from the Swedish Radiation Protection Institute. Unfortunately, very few systematic and reliable data on the possible depleted uranium concentrations were until now available. Some of these rare data are only available on the web, without adequate information about the experimental procedure used. To clarify the situation, a systematic survey was started in the summer of 2000 as a collaborative effort between Ghent University (Physics Laboratory) and the Belgian Ministry of Defense (Medical Service). From 50 sites selected all over Kosovo, 150 soil samples were measured in the laboratory with a high-resolution gamma-spectrometer. Some sites (14) were explicitly selected based on military information on the use of depleted uranium munitions in the vicinity. After careful analysis we can conclude that there is no indication of any depleted uranium contamination on these 50 sites with a minimal detectable activity of 15 Bq; this corresponds approximately to 1 mg depleted uranium in a typical sample (100-150 g).

Cesium Radioisotopes↗
PubMed2002

Predictors of posttraumatic stress in civilians 1 year after air attacks: a study of Yugoslavian students.

The level of posttraumatic stress, other psychological symptoms, and potential predictors were assessed in 139 medical students 1 year after experiencing air attacks in Belgrade, Yugoslavia. Eleven percent of the students showed high levels of posttraumatic stress (scores > 34) on the Impact of Event Scale; lower degrees of intrusion symptoms were reported by 32% of the students and avoidance symptoms were reported by 45%. Although gender, distress during previous stressful events, and exposure to trauma during the attacks were all of some predictive value, distress during the attacks was the best predictor for symptoms. This association remained significant when the influence of other psychological symptoms was controlled. The type of previous stressful events interacted with the degree of exposure to trauma during the attacks in predicting avoidance symptoms, but not intrusion symptoms. The findings suggest that predictors for high and low thresholds of symptoms may be similar. The quality of previous stressful events can modify the response to subsequent trauma.

Adult↗
PubMed2000

Field hospital treatment of blast wounds of the musculoskeletal system during the Yugoslav civil war.

The spectrum of wounding and treatment of forty-one patients with musculoskeletal blast injuries at a U.S. military field hospital in the former Yugoslavia was reviewed. Patients underwent wound exploration, irrigation, debridement, broad-spectrum antibiotic therapy, early fracture stabilization, and appropriate reconstructive surgery. Four patients developed wound infections. Two patients died as a result of their injuries (overall mortality 5 percent). There were three below-knee amputations and five other amputations (above-knee, ankle, midtarsal, partial forefoot, and finger). Three patients sustained lumbar burst fractures from mines that exploded under their vehicles, resulting in paraplegia in one case. Our patients underwent 112 surgical procedures, an average of 2.1 per patient. Twenty-two patients (54 percent) had other injuries or conditions in addition to their orthopaedic wounds. There were wide variations in the bone and soft tissue injuries caused by detonating ordnance, and the tissue damage was qualitatively different from that caused by gunshot wounds. Early debridement, leaving wounds open, and treatment with broad-spectrum antibiotics were important factors in wound healing to allow subsequent successful reconstructive surgery in an austere field setting.

Adult↗
PubMed1996

Treatment of wounded in the combat zone.

Authors presented their own experiences in treating 735 wounded in high-intensity combat zones in the territories of former Yugoslavia during 1991 to 1992. The mobile field hospital with surgical crews was situated 5 to 10 km from the front line, and its basic task had been continuous triage, immediate resuscitation with vital surgical aid, as well as organization of adequate primary and secondary air evacuation. At the field hospital level, fresh wounds were explored according to principles of war surgery, and major surgical interventions were performed in 3.3% of the wounded. Patients with massive hematothorax were treated with autotransfusion. Mortality at this primary level, field hospital was 0.75% with primary immediate resuscitation and 1.9% with immediate evacuation. We concluded that immediate resuscitation with delayed transport had advantages, compared with fast evacuation of only the wounded.

Blast Injuries↗
PubMed2003

International pediatric emergency care: establishment of a new specialty in a developing country.

BACKGROUND: Emergency medicine is being established as a unique and independent specialty throughout the world. Pediatric emergency medicine, however, is a relatively new subspecialty in the United States and a newer subspecialty in the rest of the world. In most of Europe and Asia, this specialty has yet to be developed. OBJECTIVE: To analyze the establishment of a new pediatric emergency care system in a developing country and identify areas of need and potential collaboration. SETTING: Pristina University Hospital, the main academic medical center in Kosovo, Federal Republic of Yugoslavia. METHODS: Data were collected using convenience sample surveys of all emergency visits in 2001, hospital admissions, health department statistics, and interviews with government officials and healthcare providers. RESULTS: Emergency care of children in Kosovo is provided by three parallel 24-hour clinic systems. During 2001, approximately 31,000 children sought emergency care (10,000 in the pediatric clinic, 5000 in an emergency facility, and 16,000 in the infectious disease clinic). There was no coordination or cooperation between these different facilities. No attempt was made to diagnose acute otitis media or urinary tract infection in young children. No records were kept. No physician in this study had pediatric emergency medicine and/or emergency medicine training. Prehospital providers had limited equipment and training. CONCLUSIONS: Hospital clinic systems in this environment provide high-volume and often a high level of acute care. Barriers to improved care include limited specialized training, lack of coordination between departments, and failure to establish a medical records system.

Ambulances↗
PubMed2001

Humanitarian war: a new consensus?

The NATO bombing operation Allied Force against Yugoslavia in March-June 1999 represents the final disappearance of the narrowing divide between humanitarianism and politics: a war initiated and justified on humanitarian grounds. Although unlikely to be repeated any time soon, the Kosovo case appears to have cemented an ideological shift on the international right and even necessity of sing military force to protect civilians within sovereign states. Rather than humanitarians acknowledging the political context and consequences of their work, however, the case suggests the embrace of humanitarian principles of universality and neutrality by military organisations. This article discusses some consequences of the new consensus: neglect of the political context (both local and foreign) of such operations, interaction between the operational dynamics of relief operations and the logic of war and the political consequences of using the humanitarian legitimation and mission in such cases.

Altruism↗
PubMed1997

Research in the war zones of Eritrea and northern Ethiopia.

The paper engages in the discussion of conducting research in war zones, initiated in Disasters by Barakat and Ellis. It looks specifically at possibilities for research in the war zones of Eritrea and Northern Ethiopia during the 1980s, and notes the ways in which this context differs from wars in the former Yugoslavia to which Barakat and Ellis mainly refer. The authors suggest that the unique context of every internal war, and the institutional actors that converge around this context, create both the potential and the demand for particular kinds of information, especially when humanitarian programmes involving international donors are under way. De-contexualising research in war zones from the specific context in which it occurs, in order to derive general guidelines, can thus be problematic.

Disaster Planning↗
PubMed2001

How do mothers signal shared feeling-states to their infants? An investigation of affect attunement and imitation during the first year of life.

The present study examined how mothers signal shared feeling-states to their infants. Affect attunement and imitation were investigated cross-culturally in 39 mother-infant dyads from Sweden (N = 22) and the former Yugoslavia (N = 17) during the first year of life. Video-recordings of playful interaction between mothers and their infants were analysed using the Affect Attunement Protocol. A significant negative association between imitation and age was found, while there was a significant positive association between affect attunement and age. Single occurrences of affect attunement appeared already at two or three months of age, and by 6 months of age episodes of affect attunement were more common than imitation. Frequencies of imitation and affect attunement were similar cross-culturally and in terms of gender, although there was a significant interaction between age and gender. The results suggest that the signalling of shared feeling-states is not a static process. Mothers do not signal shared feeling-states in the same manner at different ages. Imitation is the most important process during the earliest months, but is superseded by affect attunement earlier than previously thought. The functional implications of this developmental variation are discussed.

Affect↗
PubMed1975

Lead in human scalp hair: some factors affecting its variability.

The accumulation of lead in human scalp hair was compared in male and female children and adults from various locations in the United Sates, Japan, Yugoslavia, Iran, and South Africa. The most significant variables which influenced the concentration of lead in hair were ingestion of lead-containing substances, exposure to lead of environmental origin, place of residence, site from which the hair specimen was sampled relative to its distance from the scalp, and age. The least significant variables were sex and nutritional deficiencies.

Adolescent↗
PubMed2005

Beliefs about health and diabetes in men of different ethnic origin.

AIM: This paper reports the findings of a study exploring the health and illness beliefs of men with diabetes, who were from different cultural backgrounds and living in Sweden. BACKGROUND: No studies have been reported that have focused on the beliefs about health and illness in men with diabetes mellitus of different ethnic origin. Beliefs may affect self-care and care-seeking behaviour. METHOD: An explorative study design and purposive sampling procedure was used. Focus-group interviews were held with 35 men with diabetes and aged between 39 and 78 years. Fourteen participants were born in Arabic countries, 10 in former Yugoslavia and 11 in Sweden. FINDINGS: Important factors for health were the ability to be occupied/employed and economically independent and, especially among Arabs and former Yugoslavians, sexual functioning. Swedes focused on heredity, lifestyle and management of diabetes, while non-Swedes claimed the influence of supernatural factors and emotional stress related to the role of being an immigrant and migratory experiences as factors related to development of diabetes and having a negative influence on health. Swedes and Arabs described health as "freedom from disease" in contrast to many former Yugoslavians who described health as "wealth and the most important thing in life". Knowledge about diabetes was limited among the men studied, but Arabs showed an active information-seeking behaviour compared with Swedes and former Yugoslavians. Non-Swedish respondents, particularly Arabs, had sought help from health care professionals to a greater extent than Swedes, who were more likely to use self-care measures. CONCLUSION: Being occupied/employed and having knowledge about the body and management of diabetes are important for positive health development. There are dissimilarities in beliefs about health and diabetes that influence self-care behaviour and health care seeking. Men's cultural backgrounds and spiritual beliefs need to be considered in diabetes care.

Adult↗
PubMed2006

The Belgrade childhood diabetes study - comparison of children with type 1 diabetes with their siblings.

A case-control study was conducted in Belgrade (about 320,000 inhabitants 0-16 years old) during the period 1994-97, comprising 68 diabetic children (cases) and 68 controls chosen from the siblings of the cases. Analysis using multivariable logistic regression analysis indicated the following independent risk factors for Type 1 diabetes: higher birth order, infections during the 6 months preceding the onset of the disease and stressful events. Out of individual stressful and psychological factors, 'other' stressful events (severe accident or hospitalisation or death of a close friend, conflict with a teacher, death of a pet, failure in competition, quarrel between parents, punishment, physical attack, war in republics of former Yugoslavia and near drowning in the pool) and learning problems were independent risk factor for Type 1 diabetes. The results obtained in this study of siblings supports the hypothesis that environmental factors play a role in the development of Type 1 diabetes.

Adolescent↗
PubMed1986

Allergy induced by Parietaria officinalis pollen in southern Croatia.

Pollen of Parietaria officinalis causes season-associated respiratory symptoms. In Southern Croatia (Yugoslavia) we found 65% patients with rhinitis and/or asthma to be allergic to this pollen. They showed positive cutaneous reactions and had specific IgE antibodies to the respective isolated allergen. The finding represents the first report on Parietaria officinalis-induced allergy on the east Adriatic coast.

Allergens↗
PubMed1978

HLA system and Balkan endemic nephropathy (a collective study with the collaboration of all participants in the HLA workshop--Sofia 1976).

Balkan endemic nephropathy, a fatal family disease with unknown aetiology and pathogenesis is typical for three neighbouring regions in Bulgaria, Yugoslavia and Rumania. HLA typing of 180 patients from the endemic area in Bulgaria was done and the antigen frequencies were compared with 1264 healthy controls. An increased frequency (P less than 0.001) of the antigen HLA-B18 in the patients was demonstrated.

Bulgaria↗
PubMed1982

Recent European immigration to the Chicago metropolitan area.

Patterns of European migration to the Chicago metropolitan area are examined to determine the urban spatial distribution of various ethnic groups. Data are from petitions of 1,185 male immigrants 18 years old and over from Greece, Italy, Poland, and Yugoslavia who applied for U.S. citizenship between June 2, 1975, and June 1, 1976. It is found that the majority of those studied chose to live within the city of Chicago. It is suggested that "residential locations of relatives, availability of low-cost housing, religious affiliations, proximity and access to employment opportunities, and avoidance of Black and Hispanic neighborhoods...were involved in the decision of where to reside." (summary in FRE, SPA)

Americas↗
PubMed1988

Changing patterns of migration in the Adriatic region.

International migration in the Adriatic countries of Albania, Greece, Italy, San Marino, and Yugoslavia is briefly examined using data from official and other published sources. The main types of migratory movements identified by the author within the region are "1) economically motivated migration (legal and clandestine); 2) immigration of refugees for resettlement; 3) immigration with the scope of final resettlement in a third country (transit movements); [and] 4) return migration by former emigrants."

Albania↗