Following the October 7th 2023 HAMAS' attack, approximately 220,000 Israeli reservists were mobilized. This study examined anxiety among women whose partners were mobilized and assessed the protective roles of resilience, self-efficacy, and sense of coherence (SOC) as independent variables, in anxiety as a dependent variable. In a cross-sectional correlational design, 265 female partners completed validated instruments. Psychological variables were analyzed alongside demographic and contextual factors using correlation and moderation analyses. Seventy-five percent of participants scored above the severe-anxiety threshold. SOC and resilience showed significant inverse associations with anxiety, whereas self-efficacy was not significantly correlated. Within SOC, comprehensibility and manageability were each negatively related to anxiety, and meaningfulness was positively associated with selfefficacy. More frequent home visits by the deployed partners were linked to lower anxiety and higher self-efficacy. Women with children reported greater resilience and lower anxiety than those without children. These findings suggest that cognitive and instrumental components of SOC, together with resilience, help buffer distress in spouses of reservists under acute conflict conditions. Tailored psychosocial interventions that strengthen comprehensibility and manageability, bolster resilience, and facilitate contact with deployed partners may mitigate anxiety in this high-risk group. The null association for self-efficacy suggests confidence may be insufficient under sustained threat. Programs should prioritize screening, psychoeducation, and communication protocols between units and families, alongside parent-focused supports, to protect mental health during prolonged mobilizations and the transition to post-deployment. Longitudinal research is warranted to clarify causal pathways and inform targeted support.

This study examined the effectiveness of puppet-based teaching in enhancing behavioral engagement among children with Autism Spectrum Disorder (ASD) requiring substantial to very substantial support (Levels 2-3). Seven male students aged 10-11 participated in a within-subjects design comparing conventional and puppet-based lessons, each comprising five 30-minute sessions on the topic of seasons. Behavioral engagement was evaluated across four parameters: active participation, enjoyment, attention span, and eye contact. Statistical analyses revealed significant improvements during puppet-based lessons in active participation, enjoyment, and eye contact, alongside reductions in disruptive behaviors compared to conventional teaching. The largest effect sizes were observed for active participation (d = 1.64), eye contact (d = 1.20), and communication response (d = 1.79). These findings indicate that puppets serve as effective mediating tools, creating a less threatening and more motivating learning environment for students with ASD. The results align with existing research suggesting that creative and interactive teaching approaches can reduce social-communication barriers and enhance engagement among learners with developmental disabilities. Puppet-based teaching provides educators with a practical, lowcost, and adaptable strategy to improve classroom participation, foster emotional connection, and support communication for students requiring higher levels of support. Integrating puppets into daily instruction may help teachers establish positive routines, increase student responsiveness, and create a more inclusive and emotionally safe learning environment in special education classrooms.

This study examined how Big Five personality traits influence PTSD symptom development in civilian populations exposed to prolonged, multi-front conflict. Regression analyses of 100 participants revealed substantial increases, yielding three findings challenging conventional trauma models. First, personality traits demonstrated validity: neuroticism amplified PTSD severity while extraversion conferred protection, explaining 21% of variance. Second, contrary to proximity-based frameworks, geographic distance, gender, and military experience showed no effects, suggesting vulnerability transcends conventional demographics. Third, pre-conflict symptoms emerged as the strongest predictor, accounting for 62.5% of variance (R2 = 68%). Findings necessitate personality-informed intervention and early identification of vulnerable individuals in conflict-affected populations.

This study examines how Israel’s legal and institutional arrangements, including migration policies, health-insurance eligibility rules, and safety enforcement mechanisms, shape health risks for Thai migrant agricultural workers, and identifies policy levers to mitigate preventable harm. Using a legal policy analysis informed by syndemics and labor frameworks, we mapped laws, regulatory oversight, and enforcement chains, and synthesized evidence from worker surveys, affidavits, and civil society reports to link institutional structures with barriers experienced in workplaces and healthcare settings. The findings reveal that health inequalities stem from structural design rather than isolated failures, including exclusion from public insurance, dependence on employer-based plans, employer-tied visas, opaque injury-claim procedures, fragmented oversight, absence of occupational-health surveillance, limited language access, poor housing conditions, and weak inspections. These interlocking features reinforce one another, resulting in under-reporting, delayed medical attention, and cumulative physical and psychological harm. The study concludes that structural legal and administrative reforms—rather than individual adaptation—are required to address these inequities. Policy priorities include integrating migrant workers into public insurance or ensuring equivalent coverage, decoupling residency from single employers, guaranteeing multilingual access, establishing independent health monitoring, and enforcing safety, housing standards and other social determinants of health through transparent inspections, positive incentives and meaningful sanctions.

BACKGROUND Earthquakes and other catastrophic events can lead to conditions of being trapped under the rubble, which can cause minor-major health consequences. One of the most challenging issues in entrapment is the need to rescue people as fast as possible. A related issue for rescue forces is how long to continue searching survivors. Indeed, sometimes victims survive longer than expected. The cases described below led us to postulate that certain adverse psychological effects of being trapped under the rubble may be beneficial for survival in such extreme situations. CASE REPORT In this article, we report two cases of children who were rescued from under the rubble following the earthquake in Turkey in February 2023. The children were rescued approximately one week after the earthquake, exhibiting symptoms that could be understood as dissociation. We bring converging neuropsychological and neurophysiological scientific evidence which enables us to propose that dissociation-related imagination together with excessive sleep may have increased vagal nerve activity. Vagal activity in turn may have helped to reduce risk of infections and inflammation, and possibly increased the chance of survival. CONCLUSIONS Though impossible to measure and prove in such extreme contexts, we propose a plausible psychobiological mechanism for those children’s symptoms and relatively long survival under entrapment. While only a speculation, dissociation might have been protective in such conditions. We discuss the limitations of these reports and the speculative mechanisms, and provide  further implications for policy.

Background: The ongoing conflict in Ukraine has forced numerous migrants into neighboring countries, many suffering from pre-existing or newly acquired physical and mental health conditions. Addressing these complex challenges in humanitarian settings requires innovative, evidence-based interventions that are cost-effective and easy to administer. Drawing upon research highlighting the vagus nerve’s role in regulating well-being, we hypothesized that vagal nerve activation could offer a promising therapeutic approach. Method: We conducted a proof-of-concept study in which 21 Ukrainian forced migrants were trained in a biofeedback-guided paced breathing intervention designed to stimulate the vagus nerve and promote self-regulation of stress response systems. Changes in pain perception, perceived stress, blood pressure, and heart rate were assessed before and after the vagal breathing intervention using a t-test. Correlations were examined at baseline. Results: Statistically significant improvements were observed in all measures except systolic blood pressure, providing preliminary evidence for the efficacy of vagal nerve activation in alleviating stress-related health symptoms. Conclusions: This study demonstrates the feasibility and therapeutic potential of a vagal nerve-activating intervention in a humanitarian setting. These findings warrant replication in larger, controlled trials. If substantiated, this low-cost, scalable intervention could help mitigate health burdens among forced migrant populations worldwide.

Background: Humanitarian aid workers (HAWs) are indirectly exposed to atrocities relating to people of concern (POC). This may result in a risk of secondary traumatization demonstrated by post-traumatic stress symptoms (PTSSs). Previous studies have demonstrated that hemispheric lateralization (HL) moderates the relationship between threat exposure and post-traumatic stress symptoms (PTSSs). Aims: We hypothesized that indirect exposure to atrocities (IETA) would be positively correlated with PTSSs among HAWs with right and not left HL. Method: Fifty-four HAWs from several countries that provided humanitarian support in Greece and Colombia participated in this correlational and cross-sectional observation study. They completed scales relating to IETA, PTSSs were assessed using a brief, valid scale, and HL was measured. Results: IETA was positively and significantly related to PTSSs (r = 0.39, p < 0.005). Considering HL, IETA was unrelated to PTSSs among people with right HL (r = 0.29, p = 0.14), while IETA was related to PTSSs among people with left HL (r = 0.52, p = 0.008). Right HL emerged as a protective factor in the relationship between IETA and PTSS. Conclusions: An assessment of dominant HL can serve as one consideration among others when deploying HAWs in specific locations and roles, vis à vis IETA. Moreover, those found to have a higher risk for PTSSs based on their HL could be monitored more closely to prevent adverse reactions to IETA.

Humanitarian crises often require urgent medical care to people of concern. Such medical aid includes assessing and treating acute medical needs and ongoing chronic health conditions. Among the people of concern there are children, who are often the most vulnerable population in humanitarian contexts because they often lack the experience, independence, and cognitive and verbal skills to deal with the ordeals they are facing. These limitations might prevent identification and diagnosis of pain. The under-diagnosis and under-treated pain by health care providers might be also due to the perceived urgency of more acute or life-threatening medical needs with limited medical equipment and personnel, lack of awareness, or assessment tools in such contexts. Additionally, due to issues of anonymity and lack of formal guidelines, there is a severe lack of standardized registration of children's pain conditions in humanitarian crises. Finally, acute pain is also a predictor of post-traumatic stress disorder, a common outcome in such disasters. We call on health care providers to use standardized scales to assess children's pain intensity, frequency, and duration, and to treat it appropriately. These will not only reduce children's physical suffering but may also prevent subsequent risk of PTSD.

OBJECTIVE:The association between explicit and implicit psychological measures might be affected by the similarity of the assessment method and by the overlap of the components of the constructs being assessed. This study examined the association between condom use barriers and explicit and implicit measurements of condom use and the moderating role of sexual intercourse in these associations. DESIGN:This was a cross sectional correlational study. An analysis of baseline data from a randomized controlled trial including 149 university students was included. MAIN MEASURES:These included a questionnaire assessing condom use barriers, an implicit condom use test (a structured semi-projective test), and an explicit condom use question. Hierarchical regressions and correlations were examined in the full sample and by groups of participants with and without sexual intercourse. RESULTS:In those without sexual intercourse, all barriers sub-scales were significantly and negatively correlated with implicit condom use and unrelated to explicit condom use. In contrast, among those engaged in sexual intercourse, barriers were significantly and negatively correlated with the explicit condom use measure, and only barriers concerning partner and motivation correlated with implicit condom use tendencies. CONCLUSION:Having a sexual partner plays a major role in the relations between barriers and implicit and explicit condom use measures. The pattern of the results is discussed in relation to cognitive and social factors.

Abstract Objectives The covid-19 pandemic calls for adherence to multiple health behaviours. While authorities mostly use health information to deal with these issues, such an approach may be insufficient. This study examined the effects of a cognitive method, namely psychological inoculation (PI) + health information (experimental) versus health information alone (control) on anxiety, resilience and adherence. Design A randomized controlled trial was used. Participants were assigned to the experimental or control conditions, all provided on an automatized computerized system. Main outcome measures These included anxiety, adherence to the Covid-19 Israeli health ministry’s recommendations, and mental resilience. Participants were assessed before, immediately after and a week after the interventions. Results Controls increased only in adherence at 1 week compared to baseline. In contrast, those in the PI increased in resilience and adherence and reported lower anxiety immediately after treatment compared to baseline levels. In the PI condition, degree of refuting challenging sentences correlated with less anxiety. Conclusions Results showed better immediate improvements in anxiety, resilience and intention to adhere in the experimental condition compare to the controls. Authorities may wish to add PI to help the public deal with the effects of such a pandemic and to increase adherence to health recommendations.

Background: Following the earthquake of August 2021 in Haiti, humanitarian agencies provided support to the local population. NATAN, a voluntary based non-governmental organization, had arrived in the field five days after the earthquake and provided medical support based on a mobile clinic in seven villages close to the epicenter of the earthquake. Methods: We conducted a cross-sectional study on data collected from 331 persons of concern, as part of ‘good clinical practice’. They received basic treatment such as antibiotics and minor surgical interventions following a diagnosis. The main variables that were collected in this intervention included demographic data, main diagnoses, and main treatments. We also examined the distance from the earthquake epicenter (DfE) and its effects on the diagnoses and treatments. Results: Several interesting findings were observed. A significant association between the DfE and the diagnoses was found, where within the group closest to the epicenter, the most prevalent diagnosis was internal medicine problems (40.3%). Conclusions: It is possible that since five days had passed since the earthquake, the expected diagnoses of traumatic injuries were reduced, leaving sub-acute problems to be diagnosed and treated. Finally, mental health symptoms and stress levels should be assessed systematically and with validated measures.

OBJECTIVE:Condom use prevents the contraction of the HIV. Research shows limited effects of education on increasing condom use. Psychological inoculation (PI) has been found to be more effective in this domain, however, its mechanism is unknown. This study examined effects of PI versus education on condom use barriers and tendencies, and its relations with cognitive dissonance, using a fully automatized online system.DESIGN:The study was a randomized controlled trial (RCT) and included 149 students from a German University randomly assigned to PI or a control condition.MAIN OUTCOME MEASURES:An indirect condom use test (I-CUTE), a condom use barriers questionnaire, self-reported condom use, and cognitive dissonance estimations were all assessed at baseline and one-month post-intervention.RESULTS:PI significantly increased I-CUTE scores when participants had sexual relations. Control participants increased in self-reported condom use and on I-CUTE scores in people without sexual relations. No changes in barriers were seen in either group. The cognitive dissonance tended to be higher in PI participants as compared to control participants.CONCLUSIONS:PI increases I-CUTE scores compared to controls (based on effect sizes), and significantly in those with sexual relations. The role of relationship status and the mechanisms of PI should be further examined.

Conditions prevailing in humanitarian crises often create a coercive environment for women. Material and security needs and pre-exisiting inequalities render women particularly vulnerable to social and contextual coercion in such situations, which can often result in unwanted pregnancies. Some women may resort to unsafe abortions, sometimes resulting in death. Currently, abortion services provided by humanitarian agencies are either unavailable or fail to meet the real need in humanitarian settings. Accessible family planning, contraceptives, and early remedies should all be available, along with counselling. In addition, a pro-choice approach and accompanying abortion services should be a fundamental pillar of health services available to women in emergencies.

Thousands of migrants passed through the Balkans whilst migrating from the Middle East to Europe between 2015 and 2016. Humanitarian actions were conducted throughout this route as agencies and governments provided support. The Camp of Presevo, on the Southern border of Serbia, was established by the local authorities as a registration camp to monitor the migration and deliver aid. Part of this aid was psychosocial. Past studies show a relatively high prevalence of stress symptoms among forced migrants, presumably due to exposure to war-related atrocities and experience of forced migration. NATAN, an Israeli non-governmental organisation, is a volunteer-based organisation that delivered psychosocial support to the migrants using the 'SIX Cs model'. This model focuses on cognitive and behavioural components and is based on the neuropsychology of resilience. It has advantages that were relevant to the context of the camp, namely culturally adaptive, easy to administer, short and adjustable to varied contexts. Moreover, the model gives tools, which could be used later by the migrants in the absence of a therapist. This report describes the SIX Cs model and the implementation of its intervention in the Presevo camp.

Objective: An effective method for preventing the Human Immunodeficiency Virus (HIV) is condom use. Yet, research shows limited effects of education on increasing condom use. This research examined the effects of psychological inoculation (PI) versus education on condom use -barriers and –tendencies, using a fully automatized online system. Design: Two randomized controlled trials. In Study 1, 59 Sub-Saharan students were included while Study 2 20 European students were included. In both studies, participants were randomly assigned to PI or control conditions. In Study 2, we additionally matched pairs on gender and condom barriers. In the PI, participants received challenging sentences they had to refute. Main outcome measures: An indirect condom use test (I-CUTE) and a condom use barriers questionnaire, assessed at baseline and a month later. Results: In Study 1, a significant increase in I-CUTE scores and no change in barriers was found in the PI condition. Controls did not change on either outcome. In Study 2, two sub-scales of condom barriers (concerning partner and satisfaction) were significantly decreased in the PI group, while in controls, barriers significantly increased over time. In both groups, I-CUTE scores tended to increase. Conclusions: These results replicate previous studies and extend them to a fully automatized system without counselors.

Background Health education alone has a limited impact on HIV prevention programs, possibly because it does not systematically target social and cognitive factors that affect condom use. Objectives To systematically evaluate the effectiveness and methodological quality of HIV prevention interventions, which targeted factors related to social cognitive models (SCM) in the Sub-Saharan context. Method Ten online databases were searched using prespecified terms. Data extraction and quality assessment (on a 0–8 scale) were carried out and study results were critically described. Results Eight studies meeting the inclusion criteria were identified and reviewed. Three interventions showed significant effects on condom use. The most targeted SCM factors were communication skills and self-efficacy. The average methodological quality score was 5.75. Conclusion There is a need to use other intervention methods targeting SCM determinants of condom use and to improve the quality of the assessment tools, to increase condom use towards HIV prevention.

s of Scientific Papers-WADEM Congress on Disaster and Emergency Medicine 2017 Medical Conditions and Treatments in a Transit Camp in Serbia for Syrian, Afghani and Iraqi Migrants Einav Levy, Michael Alkan, Sharon Shaul, Yori Gidron 1. Faculty Of Medicine And Pharmacy, Vrije Universiteit Brussels (VUB), Belgium, and The Israeli School of Humanitarian Aid (ISHA), Israel, Brussels/Belgium 2. School for International Health, Ben Gurion University, Israel,