Astier M. Almedom | Lund University (original) (raw)

Papers by Astier M. Almedom

Research paper thumbnail of "Hope is the Engine of Life" and "Hope dies with the Person"..

Research paper thumbnail of Resilience is not the absence of PTSD anymore that Health is the absence of disease.

Research paper thumbnail of "Hope" makes sense in Eritrean Sense of Coherence, but "Loser" does not...

Research paper thumbnail of Resilience, hardiness, sense of coherence, and posttraumatic growth: all paths leading to “light at the end of the tunnel”

Journal of Loss and Trauma, Jan 1, 2005

Two questions prompted this targeted review: (a) What are the behavioral and social determinants ... more Two questions prompted this targeted review: (a) What are the behavioral and social determinants of individual and=or collective resilience-the capacity to rebound from crisis? and (b) Is the evidence base for related concepts, including hardiness, sense of coherence, and posttraumatic growth consistent? The findings suggest that the theory of salutogenesis, operationalized by the sense of coherence construct, is inclusive of the related concepts of resilience and hardiness. Moreover, it is grounded in robust primary research of cross-cultural relevance. More recent concepts of recovery and posttraumatic growth also contribute to our understanding of resilience. Implications for international humanitarian psychosocial programming are discussed.

Research paper thumbnail of Social capital and mental health: An interdisciplinary review of primary evidence

Social Science & Medicine, Jan 1, 2005

An interdisciplinary interrogation of primary evidence linking social capital and mental health s... more An interdisciplinary interrogation of primary evidence linking social capital and mental health sought to establish: (1) 'quality of evidence' (assessed in terms of study design, methods used to address stated questions, rigor of data analysis, and logic and clarity of interpretation of results), and (2) applicability of the evidence to public health policy and practice with respect to mental health. It is found that social capital, a complex and compound construct, can be both an asset and a liability with respect to mental health of those in receipt of and those providing services and other interventions. The most meaningful assessment of social capital or components thereof may examine individual access to rather than possession of social capital, a property of groups, and therefore an ecological variable. Theoretical advances in research on social capital serve to identify mainly two types of social capital: bonding (between individuals in a group) and bridging (between groups). Each type of social capital has cognitive and/or structural component(s) and may operate at micro and/or macro level(s). Effective mental health policy and service provision may build or strengthen bridging social capital and benefit from both bonding and bridging social capital where either or both exist. Established indicators of social capital are amenable to quantitative and qualitative assessment, preferably in tandem. However studies that employ combined research design are rare or non-existent. Interdisciplinary multi-method investigations and analyses are called for in order to unravel mechanisms whereby social capital and mental health might be meaningfully associated. r

Research paper thumbnail of Hygiene Evaluation Procedures: Approaches and methods for assessing water-and sanitation-related hygiene practices

Research paper thumbnail of Factors that mitigate war-induced anxiety and mental distress

Journal of Biosocial Science, Jan 1, 2004

The effects of war-induced anxiety and mental distress on individuals and groups can either be mi... more The effects of war-induced anxiety and mental distress on individuals and groups can either be mitigated or exacerbated by 'humanitarian action'. This paper focuses on two key factors that protect the mental well-being of war-affected populations: organized displacement or assisted relocation; and coordinated humanitarian aid operations that are responsive to local needs. Qualitative data from two internally displaced person (IDP) camps in Eritrea are presented. Analysis of these data serves to substantiate and refine a working hypothesis: that social support of the right type, provided at the right time and level, can mitigate the worst effects of war and displacement on victims/survivors. An integrated model of psychosocial transition is suggested. The implications of this approach for humanitarian policy and practice are discussed in the wider context of current debates and lamentations of the 'humanitarian idea'.

Research paper thumbnail of Infant feeding in urban low-income households in Ethiopia. I: The weaning process

Ecology of food and nutrition, Jan 1, 1991

Research paper thumbnail of MENTAL WELL-BEING IN SETTINGS OF'COMPLEX EMERGENCY': AN OVERVIEW

Journal of biosocial science, Jan 1, 2004

The mental state of people affected by war and other disasters has been a subject of special inte... more The mental state of people affected by war and other disasters has been a subject of special interest to academic researchers and practitioners in humanitarian assistance and public health for over two decades. The last decade in particular has seen a rise in the number of papers published in scholarly journals around the Post-Traumatic Stress Disorder (PTSD) debate. Anthropologists have rarely engaged in this debate. Nevertheless, some of the most illuminating contributions have come from socio-medical anthropology .

Research paper thumbnail of Maternal psychosocial well-being in Eritrea: application of participatory methods and tools of investigation and analysis in complex emergency settings

BULLETIN-WORLD …, Jan 1, 2003

Objective To establish the context in which maternal psychosocial well-being is understood in war... more Objective To establish the context in which maternal psychosocial well-being is understood in war-affected settings in Eritrea. Method Pretested and validated participatory methods and tools of investigation and analysis were employed to allow participants to engage in processes of qualitative data collection, on-site analysis, and interpretation. Findings Maternal psychosocial well-being in Eritrea is maintained primarily by traditional systems of social support that are mostly outside the domain of statutory primary care. Traditional birth attendants provide a vital link between the two. Formal training and regular supplies of sterile delivery kits appear to be worthwhile options for health policy and practice in the face of the post-conflict challenges of ruined infrastructure and an overstretched and/or ill-mannered workforce in the maternity health service. Conclusion Methodological advances in health research and the dearth of data on maternal psychosocial well-being in complex emergency settings call for scholars and practitioners to collaborate in creative searches for sound evidence on which to base maternity, mental health and social care policy and practice. Participatory methods facilitate the meaningful engagement of key stakeholders and enhance data quality, reliability and usability.

Research paper thumbnail of Use of “Sense of Coherence (SOC)” scale to measure resilience in Eritrea: Interrogating both the data and the scale

Journal of …, Jan 1, 2007

An adapted 'sense of coherence&am... more An adapted 'sense of coherence' scale short form (SOC-13) was administered in nine languages of Eritrea with a total of 265 participants (162 women and 103 men) in order to assess 'resilience' in quantitative terms. Statistical analysis yielded significant differences in SOC scores between the displaced and non-displaced: mean=54.84 (SD=6.48) in internally displaced person (IDP) camps, compared with mean=48.94 (SD=11.99) in urban and rural settlements (t=3.831, p<0.001). Post-hoc tests revealed that the main difference is between IDP camp dwellers and urban (non-displaced) residents. Those in rural but traditionally mobile (pastoralist or transhumant) communities scored more or less the same as the urban non-displaced - i.e. significantly higher than those in IDP camps (p<0.05). Analysis of variance showed that displacement has a significantly negative effect on women compared with men (RR=0.262, p<0.001). Repeating the analysis for the three groups confirmed that urban and pastoralist/transhumant groups are similar, while women in IDP camps are lower scoring (RR=0.268, p<0.001), Hamboka women being worst affected due to their experience of serial displacement. These findings are interpreted and discussed in the light of qualitative information gleaned from the study participants' interrogation of the content of the SOC scale; and in the wider context of historical, socio-political and cultural characteristics of Eritrea. The study's implications for humanitarian and public health policy are considered.

Research paper thumbnail of Promotion of handwashing as a measure of quality of care and prevention of hospital-acquired infections in Eritrea: the Keren study

African Health …, Jan 1, 2005

A complex interplay of cognitive, socio-economic and technical factors may determine hand-washing... more A complex interplay of cognitive, socio-economic and technical factors may determine hand-washing practice among hospital-based health workers, particularly doctors, regardless of the location of the country or hospital they work in.ObjectiveTo assess quality of care with respect to handwashing practice as a routine measure of infection prevention in Keren hospital, a provincial referral hospital, second largest in Eritrea; with a view to putting in place quality standards and effective means of monitoring and evaluation.DesignQualitative study with a participatory and iterative/dynamic design.MethodsSemi-structured interviews and focus group discussions were held with 34 members of the hospital staff; and a total of 30 patients in the medical, surgical and obstetric wards were interviewed. Direct observation of handwashing practice and facilities were also employed.ResultsAlthough only 30% of health workers routinely washed their hands between patient contact, the study revealed genuine interest in training and the need to reward good practice in order to motivate health workers. Educational intervention and technical training resulted in significant improvements in health workers' compliance with hospital infection prevention standards. Patient satisfaction with health workers' hygiene practices also improved significantly.ConclusionHospital-based health workers' handwashing practice needs to improve globally. There is no room for complacency, however, in Eritrea (as indeed in other African countries) where public health services need to keep patients' welfare at heart; particularly with respect to women in childbirth, as mothers continue to bear the lion's share of post-war rebuilding of lives, livelihoods, and the country as a whole.

Research paper thumbnail of Social capital and mental health. An updated interdisciplinary review of primary evidence

Social capital and health, eds. Kawachi I, Subramanian …, Jan 1, 2008

Research paper thumbnail of Exploring the Dynamics of social-ecological resilience in East and West Africa: Preliminary evidence from Tanzania and Niger

African health sciences, Jan 1, 2008

Social-ecological resilience refers to the dynamic process of adaptive learning, reorganization a... more Social-ecological resilience refers to the dynamic process of adaptive learning, reorganization and meaning-making demonstrated in linked human, animal, and plant ecosystems often organized in formal and/or informal social institutions, as they anticipate, withstand and/or judiciously engage with adversity while maintaining function without fundamentally losing their identity. To present two sets of examples that illustrate the complex ways in which transformation and persistence, two key aspects of the adaptive cycle may work together to preserve established patterns of human and/or animal uses of water resources and food plant species, in rural East and West Africa, respectively around the Serengeti National Park (Tanzania), and "Park W" (Niger), with the aim of identifying possible indicators of social-ecological resilience. Selective combinations of ecological and anthropological, quantitative and qualitative methods, including participatory tools of investigation and analysis. Our preliminary results are presented with minimal commentary and discussion in order to avoid hasty and/or unwarranted interpretation of the ongoing purposely iterative processes of investigation and analysis in the two study sites. Nevertheless we have identified a number of possible indicators of social-ecological resilience that may be tested in other localities in Africa and elsewhere.

Research paper thumbnail of Postnatal salivary cortisol and sense of coherence (SOC) in Eritrean mothers

American Journal of …, Jan 1, 2005

This pilot study explores possible physiological correlates of maternal sense of coherence (SOC) ... more This pilot study explores possible physiological correlates of maternal sense of coherence (SOC) by looking at salivary cortisol levels in Eritrean mothers during the immediate pre-and postnatal period. Samples of pre-and postnatal resting whole saliva were obtained from 19 mothers and from 31 controls in Ghinda. Radioimmunoassay results revealed no differences between prenatal and control concentrations of salivary cortisol, but postnatal levels were significantly lower (P < 0.014). Mothers who delivered in hospital had significantly higher SOC scores compared to those who opted for home birth (P < 0.045). This difference was particularly pronounced in the comprehensibility subscale of the SOC scores (P < 0.037). Moreover, mothers with higher comprehensibility scores showed significantly lower postnatal cortisol levels (P < 0.017). No associations were found between cortisol and age or parity. The implications of these findings for maternity health service policy and practice in Eritrea are considered. Am. J.

Research paper thumbnail of Resilience research and policy/practice discourse in health, social, behavioral, and environmental sciences over the last ten years

African health sciences, Jan 1, 2008

Resilience research has gained increased scientific interest and political currency over the last... more Resilience research has gained increased scientific interest and political currency over the last ten years. To set this volume in the wider context of scholarly debate conducted in previous special theme issue and/or special section publications of refereed journals on resilience and related concepts (1998-2008). Peer reviewed journals of health, social, behavioral, and environmental sciences were searched systematically for articles on resilience and/or related themes published as a set. Non-English language publications were included, while those involving non-human subjects were excluded. A total of fifteen journal special issues and/or special sections (including a debate and a roundtable discussion) on resilience and/or related themes were retrieved and examined with the aim of teasing out salient points of direct relevance to African social policy and health care systems. Viewed chronologically, this series of public discussions and debates charts a progressive paradigm shift from the pathogenic perspectives on risk and vulnerability to a clear turn of attention to health-centered approaches to building resilience to disasters and preventing vulnerability to disease, social dysfunction, human and environmental resource depletion. Resilience is a dynamic and multi-dimensional process of adaptation to adverse and/or turbulent changes in human, institutional, and ecological systems across scales, and thus requires a composite, multi-faceted Resilience Index (RI), in order to be meaningfully gauged. Collaborative links between interdisciplinary research institutions, policy makers and practitioners involved in promoting sustainable social and health care systems are called for, particularly in Africa.

Research paper thumbnail of Social Capital and Mental Health

Social capital and health, Jan 1, 2008

Research paper thumbnail of Evidence from samples of one

BMJ, Jan 1, 2004

... Left undocumented, the triumphs over cancer of Susan Sontag (Illness as Metaphor) and Michael... more ... Left undocumented, the triumphs over cancer of Susan Sontag (Illness as Metaphor) and Michael Gearin-Tosh (Living Proof), the late Alice Trillin&amp;#x27;s battles with the aftermath of treatment for lung cancer (N Engl J Med 1981;304: 699), and Lenore Manderson&amp;#x27;s account of a ...

Research paper thumbnail of Resilience in Post-Katrina New Orleans, Louisiana: A Preliminary Study

African health sciences, Jan 1, 2008

Background: Much scholarly and practitioner attention to the impact of Hurricane Katrina on the c... more Background: Much scholarly and practitioner attention to the impact of Hurricane Katrina on the city of New Orleans, Louisiana has focused on the failures of government disaster prevention and management at all levels, often overlooking the human strength and resourcefulness observed in individuals and groups among the worst-affected communities. Objectives: This preliminary study sought to investigate human resilience in the city of New Orleans, State of Louisiana, eighteen months after Hurricane Katrina struck the Mississippi delta region. Methods: The Sense of Coherence scale, short form (SOC-13) was administered to a sample of 41 residents of Lower Ninth Ward and adjacent Wards who had been displaced by Hurricane Katrina but were either living in or visiting their home area during March 2007. Study participants were recruited through the local branch of the Association of Community Organizations for Reform Now (ACORN), a nation-wide grassroots organization whose mission is to promote the housing rights of low and moderate-income individuals and families across the USA and in several other countries. Results: Those who had returned to their homes had significantly higher SOC scores compared to those who were still displaced (p<0.001). Among the latter, those who were members of ACORN scored significantly higher than non-members (p<0.005), and their SOC-13 scores were not significantly different from the scores of study participants who had returned home (including both members and non-members of ACORN).

Research paper thumbnail of Re-reading the Short and Long-Rigged History of Eritrea 1941–1952: Back to the Future?

Nordic Journal of African Studies, Jan 1, 2006

This paper examines the impact of the publication of a venomous anonymous newspaper editorial pub... more This paper examines the impact of the publication of a venomous anonymous newspaper editorial published in Tigrinya under the British Military Administration of 1941-52.

Research paper thumbnail of "Hope is the Engine of Life" and "Hope dies with the Person"..

Research paper thumbnail of Resilience is not the absence of PTSD anymore that Health is the absence of disease.

Research paper thumbnail of "Hope" makes sense in Eritrean Sense of Coherence, but "Loser" does not...

Research paper thumbnail of Resilience, hardiness, sense of coherence, and posttraumatic growth: all paths leading to “light at the end of the tunnel”

Journal of Loss and Trauma, Jan 1, 2005

Two questions prompted this targeted review: (a) What are the behavioral and social determinants ... more Two questions prompted this targeted review: (a) What are the behavioral and social determinants of individual and=or collective resilience-the capacity to rebound from crisis? and (b) Is the evidence base for related concepts, including hardiness, sense of coherence, and posttraumatic growth consistent? The findings suggest that the theory of salutogenesis, operationalized by the sense of coherence construct, is inclusive of the related concepts of resilience and hardiness. Moreover, it is grounded in robust primary research of cross-cultural relevance. More recent concepts of recovery and posttraumatic growth also contribute to our understanding of resilience. Implications for international humanitarian psychosocial programming are discussed.

Research paper thumbnail of Social capital and mental health: An interdisciplinary review of primary evidence

Social Science & Medicine, Jan 1, 2005

An interdisciplinary interrogation of primary evidence linking social capital and mental health s... more An interdisciplinary interrogation of primary evidence linking social capital and mental health sought to establish: (1) 'quality of evidence' (assessed in terms of study design, methods used to address stated questions, rigor of data analysis, and logic and clarity of interpretation of results), and (2) applicability of the evidence to public health policy and practice with respect to mental health. It is found that social capital, a complex and compound construct, can be both an asset and a liability with respect to mental health of those in receipt of and those providing services and other interventions. The most meaningful assessment of social capital or components thereof may examine individual access to rather than possession of social capital, a property of groups, and therefore an ecological variable. Theoretical advances in research on social capital serve to identify mainly two types of social capital: bonding (between individuals in a group) and bridging (between groups). Each type of social capital has cognitive and/or structural component(s) and may operate at micro and/or macro level(s). Effective mental health policy and service provision may build or strengthen bridging social capital and benefit from both bonding and bridging social capital where either or both exist. Established indicators of social capital are amenable to quantitative and qualitative assessment, preferably in tandem. However studies that employ combined research design are rare or non-existent. Interdisciplinary multi-method investigations and analyses are called for in order to unravel mechanisms whereby social capital and mental health might be meaningfully associated. r

Research paper thumbnail of Hygiene Evaluation Procedures: Approaches and methods for assessing water-and sanitation-related hygiene practices

Research paper thumbnail of Factors that mitigate war-induced anxiety and mental distress

Journal of Biosocial Science, Jan 1, 2004

The effects of war-induced anxiety and mental distress on individuals and groups can either be mi... more The effects of war-induced anxiety and mental distress on individuals and groups can either be mitigated or exacerbated by &amp;amp;#39;humanitarian action&amp;amp;#39;. This paper focuses on two key factors that protect the mental well-being of war-affected populations: organized displacement or assisted relocation; and coordinated humanitarian aid operations that are responsive to local needs. Qualitative data from two internally displaced person (IDP) camps in Eritrea are presented. Analysis of these data serves to substantiate and refine a working hypothesis: that social support of the right type, provided at the right time and level, can mitigate the worst effects of war and displacement on victims/survivors. An integrated model of psychosocial transition is suggested. The implications of this approach for humanitarian policy and practice are discussed in the wider context of current debates and lamentations of the &amp;amp;#39;humanitarian idea&amp;amp;#39;.

Research paper thumbnail of Infant feeding in urban low-income households in Ethiopia. I: The weaning process

Ecology of food and nutrition, Jan 1, 1991

Research paper thumbnail of MENTAL WELL-BEING IN SETTINGS OF'COMPLEX EMERGENCY': AN OVERVIEW

Journal of biosocial science, Jan 1, 2004

The mental state of people affected by war and other disasters has been a subject of special inte... more The mental state of people affected by war and other disasters has been a subject of special interest to academic researchers and practitioners in humanitarian assistance and public health for over two decades. The last decade in particular has seen a rise in the number of papers published in scholarly journals around the Post-Traumatic Stress Disorder (PTSD) debate. Anthropologists have rarely engaged in this debate. Nevertheless, some of the most illuminating contributions have come from socio-medical anthropology .

Research paper thumbnail of Maternal psychosocial well-being in Eritrea: application of participatory methods and tools of investigation and analysis in complex emergency settings

BULLETIN-WORLD …, Jan 1, 2003

Objective To establish the context in which maternal psychosocial well-being is understood in war... more Objective To establish the context in which maternal psychosocial well-being is understood in war-affected settings in Eritrea. Method Pretested and validated participatory methods and tools of investigation and analysis were employed to allow participants to engage in processes of qualitative data collection, on-site analysis, and interpretation. Findings Maternal psychosocial well-being in Eritrea is maintained primarily by traditional systems of social support that are mostly outside the domain of statutory primary care. Traditional birth attendants provide a vital link between the two. Formal training and regular supplies of sterile delivery kits appear to be worthwhile options for health policy and practice in the face of the post-conflict challenges of ruined infrastructure and an overstretched and/or ill-mannered workforce in the maternity health service. Conclusion Methodological advances in health research and the dearth of data on maternal psychosocial well-being in complex emergency settings call for scholars and practitioners to collaborate in creative searches for sound evidence on which to base maternity, mental health and social care policy and practice. Participatory methods facilitate the meaningful engagement of key stakeholders and enhance data quality, reliability and usability.

Research paper thumbnail of Use of “Sense of Coherence (SOC)” scale to measure resilience in Eritrea: Interrogating both the data and the scale

Journal of …, Jan 1, 2007

An adapted &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;sense of coherence&amp;amp;amp;am... more An adapted &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;sense of coherence&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; scale short form (SOC-13) was administered in nine languages of Eritrea with a total of 265 participants (162 women and 103 men) in order to assess &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;resilience&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; in quantitative terms. Statistical analysis yielded significant differences in SOC scores between the displaced and non-displaced: mean=54.84 (SD=6.48) in internally displaced person (IDP) camps, compared with mean=48.94 (SD=11.99) in urban and rural settlements (t=3.831, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Post-hoc tests revealed that the main difference is between IDP camp dwellers and urban (non-displaced) residents. Those in rural but traditionally mobile (pastoralist or transhumant) communities scored more or less the same as the urban non-displaced - i.e. significantly higher than those in IDP camps (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Analysis of variance showed that displacement has a significantly negative effect on women compared with men (RR=0.262, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Repeating the analysis for the three groups confirmed that urban and pastoralist/transhumant groups are similar, while women in IDP camps are lower scoring (RR=0.268, p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001), Hamboka women being worst affected due to their experience of serial displacement. These findings are interpreted and discussed in the light of qualitative information gleaned from the study participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; interrogation of the content of the SOC scale; and in the wider context of historical, socio-political and cultural characteristics of Eritrea. The study&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s implications for humanitarian and public health policy are considered.

Research paper thumbnail of Promotion of handwashing as a measure of quality of care and prevention of hospital-acquired infections in Eritrea: the Keren study

African Health …, Jan 1, 2005

A complex interplay of cognitive, socio-economic and technical factors may determine hand-washing... more A complex interplay of cognitive, socio-economic and technical factors may determine hand-washing practice among hospital-based health workers, particularly doctors, regardless of the location of the country or hospital they work in.ObjectiveTo assess quality of care with respect to handwashing practice as a routine measure of infection prevention in Keren hospital, a provincial referral hospital, second largest in Eritrea; with a view to putting in place quality standards and effective means of monitoring and evaluation.DesignQualitative study with a participatory and iterative/dynamic design.MethodsSemi-structured interviews and focus group discussions were held with 34 members of the hospital staff; and a total of 30 patients in the medical, surgical and obstetric wards were interviewed. Direct observation of handwashing practice and facilities were also employed.ResultsAlthough only 30% of health workers routinely washed their hands between patient contact, the study revealed genuine interest in training and the need to reward good practice in order to motivate health workers. Educational intervention and technical training resulted in significant improvements in health workers' compliance with hospital infection prevention standards. Patient satisfaction with health workers' hygiene practices also improved significantly.ConclusionHospital-based health workers' handwashing practice needs to improve globally. There is no room for complacency, however, in Eritrea (as indeed in other African countries) where public health services need to keep patients' welfare at heart; particularly with respect to women in childbirth, as mothers continue to bear the lion's share of post-war rebuilding of lives, livelihoods, and the country as a whole.

Research paper thumbnail of Social capital and mental health. An updated interdisciplinary review of primary evidence

Social capital and health, eds. Kawachi I, Subramanian …, Jan 1, 2008

Research paper thumbnail of Exploring the Dynamics of social-ecological resilience in East and West Africa: Preliminary evidence from Tanzania and Niger

African health sciences, Jan 1, 2008

Social-ecological resilience refers to the dynamic process of adaptive learning, reorganization a... more Social-ecological resilience refers to the dynamic process of adaptive learning, reorganization and meaning-making demonstrated in linked human, animal, and plant ecosystems often organized in formal and/or informal social institutions, as they anticipate, withstand and/or judiciously engage with adversity while maintaining function without fundamentally losing their identity. To present two sets of examples that illustrate the complex ways in which transformation and persistence, two key aspects of the adaptive cycle may work together to preserve established patterns of human and/or animal uses of water resources and food plant species, in rural East and West Africa, respectively around the Serengeti National Park (Tanzania), and &quot;Park W&quot; (Niger), with the aim of identifying possible indicators of social-ecological resilience. Selective combinations of ecological and anthropological, quantitative and qualitative methods, including participatory tools of investigation and analysis. Our preliminary results are presented with minimal commentary and discussion in order to avoid hasty and/or unwarranted interpretation of the ongoing purposely iterative processes of investigation and analysis in the two study sites. Nevertheless we have identified a number of possible indicators of social-ecological resilience that may be tested in other localities in Africa and elsewhere.

Research paper thumbnail of Postnatal salivary cortisol and sense of coherence (SOC) in Eritrean mothers

American Journal of …, Jan 1, 2005

This pilot study explores possible physiological correlates of maternal sense of coherence (SOC) ... more This pilot study explores possible physiological correlates of maternal sense of coherence (SOC) by looking at salivary cortisol levels in Eritrean mothers during the immediate pre-and postnatal period. Samples of pre-and postnatal resting whole saliva were obtained from 19 mothers and from 31 controls in Ghinda. Radioimmunoassay results revealed no differences between prenatal and control concentrations of salivary cortisol, but postnatal levels were significantly lower (P < 0.014). Mothers who delivered in hospital had significantly higher SOC scores compared to those who opted for home birth (P < 0.045). This difference was particularly pronounced in the comprehensibility subscale of the SOC scores (P < 0.037). Moreover, mothers with higher comprehensibility scores showed significantly lower postnatal cortisol levels (P < 0.017). No associations were found between cortisol and age or parity. The implications of these findings for maternity health service policy and practice in Eritrea are considered. Am. J.

Research paper thumbnail of Resilience research and policy/practice discourse in health, social, behavioral, and environmental sciences over the last ten years

African health sciences, Jan 1, 2008

Resilience research has gained increased scientific interest and political currency over the last... more Resilience research has gained increased scientific interest and political currency over the last ten years. To set this volume in the wider context of scholarly debate conducted in previous special theme issue and/or special section publications of refereed journals on resilience and related concepts (1998-2008). Peer reviewed journals of health, social, behavioral, and environmental sciences were searched systematically for articles on resilience and/or related themes published as a set. Non-English language publications were included, while those involving non-human subjects were excluded. A total of fifteen journal special issues and/or special sections (including a debate and a roundtable discussion) on resilience and/or related themes were retrieved and examined with the aim of teasing out salient points of direct relevance to African social policy and health care systems. Viewed chronologically, this series of public discussions and debates charts a progressive paradigm shift from the pathogenic perspectives on risk and vulnerability to a clear turn of attention to health-centered approaches to building resilience to disasters and preventing vulnerability to disease, social dysfunction, human and environmental resource depletion. Resilience is a dynamic and multi-dimensional process of adaptation to adverse and/or turbulent changes in human, institutional, and ecological systems across scales, and thus requires a composite, multi-faceted Resilience Index (RI), in order to be meaningfully gauged. Collaborative links between interdisciplinary research institutions, policy makers and practitioners involved in promoting sustainable social and health care systems are called for, particularly in Africa.

Research paper thumbnail of Social Capital and Mental Health

Social capital and health, Jan 1, 2008

Research paper thumbnail of Evidence from samples of one

BMJ, Jan 1, 2004

... Left undocumented, the triumphs over cancer of Susan Sontag (Illness as Metaphor) and Michael... more ... Left undocumented, the triumphs over cancer of Susan Sontag (Illness as Metaphor) and Michael Gearin-Tosh (Living Proof), the late Alice Trillin&amp;#x27;s battles with the aftermath of treatment for lung cancer (N Engl J Med 1981;304: 699), and Lenore Manderson&amp;#x27;s account of a ...

Research paper thumbnail of Resilience in Post-Katrina New Orleans, Louisiana: A Preliminary Study

African health sciences, Jan 1, 2008

Background: Much scholarly and practitioner attention to the impact of Hurricane Katrina on the c... more Background: Much scholarly and practitioner attention to the impact of Hurricane Katrina on the city of New Orleans, Louisiana has focused on the failures of government disaster prevention and management at all levels, often overlooking the human strength and resourcefulness observed in individuals and groups among the worst-affected communities. Objectives: This preliminary study sought to investigate human resilience in the city of New Orleans, State of Louisiana, eighteen months after Hurricane Katrina struck the Mississippi delta region. Methods: The Sense of Coherence scale, short form (SOC-13) was administered to a sample of 41 residents of Lower Ninth Ward and adjacent Wards who had been displaced by Hurricane Katrina but were either living in or visiting their home area during March 2007. Study participants were recruited through the local branch of the Association of Community Organizations for Reform Now (ACORN), a nation-wide grassroots organization whose mission is to promote the housing rights of low and moderate-income individuals and families across the USA and in several other countries. Results: Those who had returned to their homes had significantly higher SOC scores compared to those who were still displaced (p<0.001). Among the latter, those who were members of ACORN scored significantly higher than non-members (p<0.005), and their SOC-13 scores were not significantly different from the scores of study participants who had returned home (including both members and non-members of ACORN).

Research paper thumbnail of Re-reading the Short and Long-Rigged History of Eritrea 1941–1952: Back to the Future?

Nordic Journal of African Studies, Jan 1, 2006

This paper examines the impact of the publication of a venomous anonymous newspaper editorial pub... more This paper examines the impact of the publication of a venomous anonymous newspaper editorial published in Tigrinya under the British Military Administration of 1941-52.