The role of warfare is central to our understanding of the ancient Greek world. In this book and the companion work, War and Society in the Roman World, the wider social context of war is explored. ...This volume examines its impact on Greek society from Homeric times to the age of Alexander and his successors and discusses the significance of the causes and profits of war, the links between war, piracy and slavery, and trade, and the ideology of warfare in literature and sculpture.
COVID-19 infection has disproportionately affected socially disadvantaged neighborhoods. Despite this disproportionate burden of infection, these neighborhoods have also lagged in COVID-19 ...vaccinations. To date, we have little understanding of the ways that various types of social conditions intersect to explain the complex causes of lower COVID-19 vaccination rates in neighborhoods.
We used configurational comparative methods (CCMs) to study COVID-19 vaccination rates in Philadelphia by neighborhood (proxied by zip code tabulation areas). Specifically, we identified neighborhoods where COVID-19 vaccination rates (per 10,000) were persistently low from March 2021 - May 2021. We then assessed how different combinations of social conditions (pathways) uniquely distinguished neighborhoods with persistently low vaccination rates from the other neighborhoods in the city. Social conditions included measures of economic inequities, racial segregation, education, overcrowding, service employment, public transit use, health insurance and limited English proficiency.
Two factors consistently distinguished neighborhoods with persistently low COVID-19 vaccination rates from the others: college education and concentrated racial privilege. Two factor values together - low college education AND low/medium concentrated racial privilege - identified persistently low COVID-19 vaccination rates in neighborhoods, with high consistency (0.92) and high coverage (0.86). Different values for education and concentrated racial privilege - medium/high college education OR high concentrated racial privilege - were each sufficient by themselves to explain neighborhoods where COVID-19 vaccination rates were not persistently low, likewise with high consistency (0.93) and high coverage (0.97).
Pairing CCMs with geospatial mapping can help identify complex relationships between social conditions linked to low COVID-19 vaccination rates. Understanding how neighborhood conditions combine to create inequities in communities could inform the design of interventions tailored to address COVID-19 vaccination disparities.
Many Black men suffer symptoms of traumatic stress in the aftermath of traumatic injury, and they also often carry social concerns, including experiences of discrimination and stigma, and a lack of ...financial resources. The objective of the present study was to understand how traumatic symptoms and social factors combine in complex ways toward the outcome of psychological help‐seeking. We analyzed qualitative and quantitative data from 32 injured Black men admitted to a Level 1 trauma center. Qualitative interviews explored their attitudes toward seeking professional psychological help. We analyzed quantitative data, collected using validated instruments, on posttraumatic stress and depression symptoms, financial worry, and discrimination/stigma. Fuzzy set qualitative comparative analysis (fsQCA) was conducted by calibrating each condition to fuzzy set membership scores based on our knowledge of the causal conditions and the cases. We then constructed truth tables for QCA analysis using fsQCA software. Three causal pathways for psychological help‐seeking were identified: Two pathways showed that severe trauma symptoms in the absence of financial worry were sufficient for seeking help, whereas the third showed that financial worry and discrimination in the absence of trauma symptoms were sufficient for help‐seeking. We identified two causal pathways for negated help‐seeking, in which low posttraumatic symptom severity and low levels of discrimination or financial worry were sufficient for not seeking psychological help. The QCA analysis revealed multiple pathways for psychological help‐seeking among Black men who suffer trauma. These findings highlight the need for further research to understand complex pathways toward psychological help‐seeking in this population.
Background Violent injury is a major cause of disability, premature mortality, and health disparities worldwide. Hospital-based violence intervention programs (HVIPs) show promise in preventing ...violent injury. Little is known, however, about how the impact of HVIPs may translate into monetary figures. Purpose To conduct a cost−benefit analysis simulation to estimate the savings an HVIP might produce in healthcare, criminal justice, and lost productivity costs over 5 years in a hypothetical population of 180 violently injured patients, 90 of whom received HVIP intervention and 90 of whom did not. Methods Primary data from 2012, analyzed in 2013, on annual HVIP costs/number of clients served and secondary data sources were used to estimate the cost, number, and type of violent reinjury incidents (fatal/nonfatal, resulting in hospitalization/not resulting in hospitalization) and violent perpetration incidents (aggravated assault/homicide) that this population might experience over 5 years. Four different models were constructed and three different estimates of HVIP effect size (20%, 25%, and 30%) were used to calculate a range of estimates for HVIP net savings and cost−benefit ratios from different payer perspectives. All benefits were discounted at 5% to adjust for their net present value. Results Estimates of HVIP cost savings at the base effect estimate of 25% ranged from $82,765 (narrowest model) to $4,055,873 (broadest model). Conclusions HVIPs are likely to produce cost savings. This study provides a systematic framework for the economic evaluation of HVIPs and estimates of HVIP cost savings and cost−benefit ratios that may be useful in informing public policy decisions.
Recurrent interpersonal violence is a major cause of death and disability among young Black men. Quantitative studies have uncovered factors associated with reinjury, but little is known about how ...these factors work together. We interviewed young Black male victims to understand their experience of violence. Qualitative analysis of their narratives revealed how their struggle to reestablish safety shaped their response to injury. Aspects of the "code of the street" (including the need for respect) and lack of faith in the police combined with traumatic stress and substance use to accentuate their sense of vulnerability. Victims then reacted to protect themselves in ways that could increase their risk of reinjury. We describe a model with implications for reducing rates of recurrent violent injuries.
Our study examines the association between Adverse Childhood Experience (ACE) exposure and posttraumatic stress disorder (PTSD) symptoms among survivors of violence. In this cross-sectional study, an ...ACE questionnaire and PTSD Checklist for DSM-5 (PCL-5) were completed by 147 participants ≤ 3 months after presenting to a Philadelphia, PA emergency department between 2014 and 2019 with a violent injury. This study treated ACEs, both separate and cumulative, as exposures and PTSD symptom severity as the outcome. Most participants (63.3%) met criteria for provisional PTSD, 90% reported experiencing ≥ 1 ACE, and 39% reported experiencing ≥ 6 ACEs. Specific ACEs were associated with increasing PCL-5 scores and increased risk for provisional PTSD. Additionally, as participants’ cumulative ACE scores increased, their PCL-5 scores worsened (
b
= 0.16;
p
< 0.05), and incremental ACE score increases predicted increased odds for a positive provisional PTSD screen. Results provide further evidence that ACEs exacerbate the development of PTSD in young survivors of violence. Future research should explore targeted interventions to treat PTSD among survivors of interpersonal violence.
Deep Lake in Antarctica is a globally isolated, hypersaline system that remains liquid at temperatures down to −20 °C. By analyzing metagenome data and genomes of four isolates we assessed genome ...variation and patterns of gene exchange to learn how the lake community evolved. The lake is completely and uniformly dominated by haloarchaea, comprising a hierarchically structured, low-complexity community that differs greatly to temperate and tropical hypersaline environments. The four Deep Lake isolates represent distinct genera (∼85% 16S rRNA gene similarity and ∼73% genome average nucleotide identity) with genomic characteristics indicative of niche adaptation, and collectively account for ∼72% of the cellular community. Network analysis revealed a remarkable level of intergenera gene exchange, including the sharing of long contiguous regions (up to 35 kb) of high identity (∼100%). Although the genomes of closely related Halobacterium, Haloquadratum, and Haloarcula (>90% average nucleotide identity) shared regions of high identity between species or strains, the four Deep Lake isolates were the only distantly related haloarchaea to share long high-identity regions. Moreover, the Deep Lake high-identity regions did not match to any other hypersaline environment metagenome data. The most abundant species, tADL, appears to play a central role in the exchange of insertion sequences, but not the exchange of high-identity regions. The genomic characteristics of the four haloarchaea are consistent with a lake ecosystem that sustains a high level of intergenera gene exchange while selecting for ecotypes that maintain sympatric speciation. The peculiarities of this polar system restrict which species can grow and provide a tempo and mode for accentuating gene exchange.
Objectives: Psychological distress is common in survivors of traumatic injury, yet across United States' trauma systems, it is rare that standard injury care integrates psychological evaluation and ...professional mental healthcare. The purpose of this study was to explore help-seeking for psychological symptoms in injured Black men living in Philadelphia.
Design: A subset of a cohort of 551 injured Black men admitted to a Trauma Center in Philadelphia participated in qualitative interviews that explored their perceptions of psychological symptoms after injury and the factors that guided their decision to seek professional mental health help. Data from 32 participants were analyzed for narrative and thematic content.
Results: Three overarching themes emerged: (1) facilitators of help-seeking, (2) barriers to help-seeking, and (3) factors underlying the decision not to consider professional help. Five participants felt that their injury-related psychological distress was severe enough to merit professional help despite any perceived barriers. Seventeen participants identified systemic and interpersonal obstacles to professional help that prevented them from seeking this kind of care. These included: financial constraints, limited access to mental healthcare services, and fear of the judgments of mental healthcare professionals. Ten participants would not consider professional help; these men perceived a lack of need and sufficiency in their existing social support networks.
Conclusions: Research is needed to inform or identify interventions that diminish the impact of barriers to care, and identify from whom, where, and how professional mental health help might be more effectively offered to injured Black men in recovery environments like Philadelphia.
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