Last data update: Jun 24, 2024. (Total: 47078 publications since 2009)
Records 1-5 (of 5 Records) |
Query Trace: Greene-Cramer B [original query] |
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Patterns of posttraumatic stress symptoms among international humanitarian aid workers
Greene-Cramer BJ , Hulland EN , Russell SP , Eriksson CB , Lopes-Cardozo B . Traumatology 2020 27 (2) 177-184 Most studies of mental health in humanitarian aid workers have found low levels of posttraumatic stress disorder, making it hard to disaggregate and look at differences between subgroups. This study sought to identify the risk and protective factors associated with resistant, resilient, and nonresilient trajectories of stress response over time that could be used to inform more targeted training and organizational support programs for aid workers. Aid workers from 19 qualifying humanitarian organizations who aged >=18 years and were to deploy for 3 to 12 months completed questionnaires at 3 time points (pre, post, and follow-up). We identified 3 unique groups (nonresilient, resistant, and resilient) using latent class growth analysis and identified predictors of subgroup classification using multivariate logistic regression. Single individuals were less likely to be in the resilient group than in the resistant group compared to coupled individuals. Individuals with one prior deployment were three times more likely to be nonresilient than resistant compared to individuals with no previous deployments. There was no significant difference in resistant, resilient, and nonresilient classification for individuals with >2 deployments. Findings suggest a need for supplemental training and psychosocial support post the first deployment as well as resources focused on potential this should be cumulative rather than accumulative effects of stress and trauma exposure for more seasoned deployers. (PsycInfo Database Record (c) 2020 APA, all rights reserved) |
Noncommunicable disease burden among conflict-affected adults in Ukraine: A cross-sectional study of prevalence, risk factors, and effect of conflict on severity of disease and access to care
Greene-Cramer B , Summers A , Lopes-Cardozo B , Husain F , Couture A , Bilukha O . PLoS One 2020 15 (4) e0231899 BACKGROUND: There is limited research on noncommunicable diseases (NCDs) in humanitarian settings despite the overall global burden and disproportionate growth in many conflicts and disaster-prone settings. This study aimed to determine the prevalence of NCDs and assess the perceived effect of conflict on NCD severity and access to treatment among conflict-affected adults (>/= 30 years) in Ukraine. METHODS AND FINDINGS: We conducted two population-representative, stratified, cross-sectional household surveys: one among adult internally displaced people (IDPs) throughout Ukraine and one among adults living in Donbas in eastern Ukraine. One randomly selected adult per household answered questions about their demographics, height and weight, diagnosed NCDs, access to medications and healthcare since the conflict began, as well as questions assessing psychological distress, trauma exposure, and posttraumatic stress disorder. More than half of participants reported having at least one NCD (55.7% Donbas; 59.8% IDPs) A higher proportion of IDPs compared to adults in Donbas experienced serious psychological distress (29.9% vs. 18.7%), interruptions in care (9.7-14.3% vs. 23.1-51.3%), and interruptions in medication than adults in Donbas (14.9-45.6% vs. 30.2-77.5%). Factors associated with perceived worsening of disease included psychological distress (p: 0.002-0.043), displacement status (IDP vs. Donbas) (p: <0.001-0.011), interruptions in medication (p: 0.002-0.004), and inability to see a doctor at some point since the start of the conflict (p: <0.001-0.008). CONCLUSIONS: Our study found a high burden of NCDs among two conflict-affected populations in Ukraine and identified obstacles to accessing care and medication. Psychological distress, interruptions to care, and interruptions in medication were all reported by a higher proportion of IDPs than adults in Donbas. There is a need for targeted policies and programs to support the unique needs of displaced conflict-affected individuals in Ukraine that address the economic and perceived barriers to NCD treatment and care. |
Systematic identification of facility-based stillbirths and neonatal deaths through the piloted use of an adapted RAPID tool in Liberia and Nepal
Greene-Cramer B , Boyd AT , Russell S , Hulland E , Tromble E , Widiati Y , Sharma S , Pun A , Roth Allen D , Dokubo EK , Handzel E . PLoS One 2019 14 (9) e0222583 Maternal, fetal, and neonatal health outcomes are interdependent. Designing public health strategies that link fetal and neonatal outcomes with maternal outcomes is necessary in order to successfully reduce perinatal and neonatal mortality, particularly in low- and middle- income countries. However, to date, there has been no standardized method for documenting, reporting, and reviewing facility-based stillbirths and neonatal deaths that links to maternal health outcomes would enable a more comprehensive understanding of the burden and determinants of poor fetal and neonatal outcomes. We developed and pilot-tested an adapted RAPID tool, Perinatal-Neonatal Rapid Ascertainment Process for Institutional Deaths (PN RAPID), to systematically identify and quantify facility-based stillbirths and neonatal deaths and link them to maternal health factors in two countries: Liberia and Nepal. This study found an absence of stillbirth timing documented in records, a high proportion of neonatal deaths occurring within the first 24 hours, and an absence of documentation of pregnancy-related and maternal factors that might be associated with fetal and neonatal outcomes. The use of an adapted RAPID methodology and tools was limited by these data gaps, highlighting the need for concurrent strengthening of death documentation through training and standardized record templates. |
Acute malnutrition and anemia among Rohingya children in Kutupalong Camp, Bangladesh
Leidman E , Humphreys A , Greene Cramer B , Toroitich-Van Mil L , Wilkinson C , Narayan A , Bilukha O . JAMA 2018 319 (14) 1505-1506 This survey study assesses the health and nutritional status of Rohingya children aged 6 to 59 months in the Kutupalong refugee camp in Bangladesh. |
The influence of "westernization" on nutrition and physical activity behaviors of adolescents in New Delhi, India: are we exporting an epidemic of obesity?
Harrell M , Ussery E , Greene-Cramer B , Ranjit N , Sharma SV , Arora M . J Appl Res Child 2015 6 (2) Purpose. To examine the relationships between “westernization” and nutrition and physical activity behaviors among older adolescents in Delhi, India. These relations have not been explored, despite increasingly strong and pervasive socio-cultural influences from the West. | Methods. Students (n=1818) in 8th and 10th grades in 4 Private (higher SES) and 4 Government (lower SES) schools in Delhi, India participated in a cross-sectional study. Height and weight were measured to determine weight status. Information on “westernization” and nutrition, physical activity, sedentary, and dieting behaviors was collected in a survey. The measure of “westernization” assessed 4 domains of culture on a bi-dimensional scale that focused on these young people’s identification with Indian (α=0.86) and Western (α=0.81) ways of living. Mixed-effects regression models were used to investigate the association between “westernization,” weight status, and health behaviors. Gender, school type (SES), and grade were evaluated as effect modifiers. Results. “Westernization” was not directly associated with weight status or BMI (p>0.500). However, adolescents’ identification with Western ways of living was consistently related to both unhealthy (e.g., fast food consumption, pppConclusions. The influence of “westernization” on nutrition and physical activity behaviors of older adolescents in Delhi, India is complex and not wholly negative, as might be hypothesized. |
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