An application of QVAR dynamic connectedness between geopolitical risk and renewable energy volatility during the COVID-19 pandemic and Russia-Ukraine conflicts.

The article is the first to employ a quantile vector autoregression (QVAR) to identify the connectedness between geopolitical risks and energy volatility from January 1, 2015, to April 03, 2023. This paper is also the first to examine the mediating roles of uncertain events like the COVID-19 pandemic and the Russia-Ukraine conflict on this interlinkage. Dynamic connectedness is 29% in the short term and approximately 6% in the long term. Dynamic net total directional connectedness over a quantile also indicates that connectedness is very intense for both highly positive changes (above the 80% quantile) and negative changes (below the 20% quantile). In the short term, the geopolitical risks remained net receivers of shock, but they turned into net shock transmitters during 2020 in the long term. Clean energy, in the short term, transmits shocks to other markets, and it plays the same role in the long term. Crude oil was a net receiver of shocks during COVID-19 and turned into a net transmitter of shocks in early 2022. Dynamic net pairwise directional connectedness over a quantile suggests that uncertain events like the COVID-19 epidemic or the Russia-Ukraine conflict influence the dynamic interlinkages between geopolitical risks and renewable energy volatility and change their roles in the designed system. These findings are critical since they help authorities develop effective policies to lessen the vulnerabilities of these indicators and minimize how widely the renewable and non-renewable energy market is exposed to risk or uncertainty.

WHO Country Office in Ukraine, 2022 report

This report provides an overview of the operations and activities of the WHO Country Office in Ukraine during 2022. Despite the acute health impacts of the war in Ukraine, WHO’s Country Office continued its work according to its core mandate. WHO supported the Government of Ukraine to manage the health emergency according to the WHO Strategic Response Plan and pursued existing priorities set out in WHO’s Thirteenth General Programme of Work 2019–2023, the European Programme of Work 2020–2025 and the Biennial Collaborative Agreement 2022–2023 signed with the Government of Ukraine. This included containing the COVID-19 pandemic and continuing to support the health reform process that had been ongoing since 2015. The report presents the achievements of the WHO Country Office in Ukraine during 2022, in the context of the impacts of the war on the lives, health and well-being of Ukrainians.

Threats to sustainability in face of post-pandemic scenarios and the war in Ukraine.

As the World slowly emerged from the then-ongoing pandemic, War broke out in Europe with the invasion of Ukraine by Russia. The enduring military conflict in Ukraine has had sweeping consequences at the human, social, economic, and environmental levels, not only for the nations involved but across Europe and globally. Damaged infrastructures, severe disruption of economic activity, and forced migration have led to negative impacts on sustainability. The COVID-19 pandemic has added another layer of complexity to this already challenging situation, as the virus has further disrupted economic activity and strained healthcare systems. Herein, we examine how the intersection of war and COVID-19 affect the United Nations' 2030 Agenda for Sustainable Development. How these intersecting challenges have impacted efforts to build a more sustainable future, and how these impacts have a global reach are also assessed. The broader implications of this case for understanding the linkages between conflict, pandemics, and sustainability more generally are also considered, relating these with the United Nations' Sustainable Development Goals (SDG) Agenda for 2030.

Challenges of COVID-19 prevention during protracted conflicts: differential adherence to preventive measures in "contact line" regions in eastern Ukraine.

Objectives: Despite the epidemiological importance of social vulnerabilities in compliance with preventive measures, little is known about the disproportional nature of preventive behaviors in crisis-affected populations. We examined adherence to COVID-19 preventive behaviors, focusing on social distancing measures in the conflict-affected regions in eastern Ukraine. Methods: From a multisectoral needs assessment conducted in 2020 using a household interview of a stratified simple random sample, we included 1,617 rural and urban households located in the government-controlled area. We performed multivariable binary logistic regression analysis with latent class analysis (LCA) to identify unmeasured patterns of classification of preventive measures using data from a cross-sectional survey. Results: The conflict-affected populations showed difficulty in complying with COVID-19 preventive measures due to losses of housing, partners, and access to food resources due to conflicts. Among the various preventive measures, wearing a face mask (88.1%) and washing hands more regularly (71.4%) were the most frequently reported. Compliance with social distancing was significantly lower in those who experienced the direct impacts of conflicts indicated by damaged accommodation or being widowed. Three different groups who showed distinctive patterns of employing COVID-19 preventive measures were identified via the LCA model, which were "highly complying group", "moderately complying group", and "face masks only group". The group membership was associated with a respondent's poverty status. Conclusion: The findings show the difficulty in compliance with COVID-19 preventive measures among conflict-affected populations indicating secondary impacts of the conflicts on preventive health behaviors. To mitigate the health impacts of conflicts, immediate attention is needed to address barriers to COVID-19 preventive measures among conflict-affected populations in Ukraine. This study suggests the need for public health strategies to improve preventive health behaviors in conflict-affected populations under pandemics or large-scale outbreaks.

Evaluation of Chemical, Biological, Radiological, Nuclear, Explosives (CBRNE) Knowledge Change and Skills Confidence Among Frontline-Line Providers During the Russia-Ukraine War.

OBJECTIVE: The aim of this study was to evaluate the change in knowledge and skill confidence after implementation of a chemical, biological, radiological, nuclear, and explosive (CBRNE) training course during the Russia-Ukraine War. METHODS: Pre/post-test study in the Ukrainian cities of Kyiv, Dnipro, Zaporizhzhia, and Odesa. Fifteen CBRNE courses were conducted over a 3-mo period, August to October 2022. Change in knowledge and skills confidence were evaluated with pre/post-course written exams and practical skill assessments that were observed during the training exercises. Changes were analyzed based on nonparametric Wilcoxon matched-pairs signed-rank testing. Pre/post self-efficacy surveys were analyzed with McNemar's test for paired data. Course evaluations were conducted with standardized questions which assessed instruction quality, teaching relevance, knowledge gained, and post-course skills confidence. RESULTS: A total of 523 participants registered and completed 1 of the 15 courses. Overall mean pre-course test score: 57.8% (SD 20.7%); mean post-course test score: 81.4% (SD 11.3%); participants with increasing test scores: 90.7%; mean difference in score (95% confidence interval) 23.6% (21.2%-25.9%), P < 0.0001. Pre/post self-efficacy surveys (4-point Likert scale) noted participants recognized signs and symptoms of a CBRNE incident, and necessary skills to manage CBRNE exposures, P < 0.0001. CONCLUSIONS: The implementation of this CBRNE course for front-line providers in Ukraine was successful. To our knowledge, it was the first implementation of a field course during the current Russian-Ukraine war. Future research should evaluate knowledge retention and impact of our innovative Train-the-Trainer model. Further iterations should emphasize expanding the quantity of training equipment and practical skill sessions.

Environmental reverberations of geopolitical risk and economic policy uncertainty resulting from the Russia-Ukraine conflict: A wavelet based approach for sectoral CO2 emissions.

After the COVID-19 pandemic, Russia invaded Ukraine in February 2022, and a natural gas crisis between the European Union (EU) and Russia has begun. These events have negatively affected humanity and resulted in economic and environmental consequences. Against this background, this study examines the impact of geopolitical risk (GPR) and economic policy uncertainty (EPU) caused by the Russia-Ukraine conflict, on sectoral carbon dioxide (CO2) emissions. To this end, the study analyzes data from January 1997 to October 2022 by using wavelet transform coherence (WTC) and time-varying wavelet causality test (TVWCT) approaches. The WTC results show that GPR and EPU reduce CO2 emissions in the residential, commercial, industrial, and electricity sectors, while GPR increases CO2 emissions in the transportation sector during the period from January 2019 to October 2022, which includes Russia-Ukraine conflict. The WTC analysis also indicates that the reduction in CO2 emissions provided by the EPU is higher than that of the GPR for several periods. According to the TVWCT, there are causal impacts of the GPR and the EPU on sectoral CO2 emissions, but the timing of the causal impacts differs between the raw and decomposed data. The results suggest that the EPU has a larger impact on reducing sectoral CO2 emissions during the Ukraine-Russia crisis and that production disruptions due to uncertainty have the greatest impact on reducing CO2 emissions in the electric power and transportation sectors.

Multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection and severe abdominal syndrome: the Lviv "OHMATDYT" (Western Ukraine) experience.

Multisystem inflammatory syndrome in children (MIS-C) associated with Severe Acute Respiratory Coronavirus 2 (SARS-CoV-2) usually develops 1-1.5 months after mild or asymptomatic COVID-19 in countries with high incidence. MIS-C has a polymorphism of clinical manifestations, which include prolonged fever, polymorphic rash, non-purulent conjunctivitis, pneumonia complicated by distress syndrome, myocarditis, coronary artery disease, toxic shock syndrome, limb edema, polyserositis, severe abdominal syndrome with diarrhea and others. Establishing this diagnosis requires significant efforts to rule out diseases of other etiology. The aim of our study was to analyze the clinical and laboratory features of children with MIS-C associated with SARS-CoV-2 and severe abdominal syndrome. Six children with MIS-C associated with SARS-CoV-2 and severe abdominal syndrome were hospitalized in Lviv Regional Children's Clinical Hospital "OHMATDYT", Ukraine, from April 2020 to September 2021. For differential diagnosis IgM, IgG to SARS-CoV-2 by ELISA, RNA to SARS-CoV-2 by PCR, bacteriological tests of blood, urine and feces were performed. Furthermore, the diagnostic work up included chest radiography, echocardiography, ultrasound of the lungs and abdominal organs. Laboratory findings revealed an increase in the normal value of inflammatory markers and high levels of IgG to SARS-CoV-2. Administration of intravenous immunoglobulin at a dose of 1 to 2 g/kg body weight per day prevented further coronary artery disease in patients and provided regression in already affected coronary arteries. At the same time, regression of abdominal syndrome was observed. Early diagnosis of MIS-C in patients with SARS-CoV-2 and severe abdominal syndrome allows to define the appropriate treatment strategy.

Nurses and global health responsibility: In light of the COVID-19 pandemic and the war in Ukraine.

AIM: The aim of this paper was to reflect on global ethical challenges for nurses in light of the COVID-19 pandemic and the war in Ukraine and to discuss 'Nurses and Global Health', a new element in the revised ICN Code of Ethics for Nurses, 2021, and its implications for nurses. BACKGROUND: The authors participated in the latest revision of the Code. When we were revising the ICN Code of Ethics, there was neither an ongoing pandemic nor a war in Europe. SOURCES OF EVIDENCE: Relevant scientific articles and other academic literature, documents from international organisations, and authors' views. DISCUSSION: The discussion emanated from our reflections on how to actually apply the ICN Code of Ethics, i.e., moving the words from the document itself into everyday practice, in light of the COVID-19 pandemic and the war in Ukraine. In the Code, the nurse's responsibility is highlighted, but there is little or no instruction on how to undertake it. CONCLUSION AND IMPLICATIONS FOR NURSES: The ICN Code of Ethics needs to be operationalised through ethical reflection and discussion in all contexts where nurses work, from policy level to the care environment.

Excess mortality in Ukraine during the course of COVID-19 pandemic in 2020-2021.

In this work, the COVID-19 pandemic burden in Ukraine is investigated retrospectively using the excess mortality measures during 2020-2021. In particular, the epidemic impact on the Ukrainian population is studied via the standardized both all-cause and cause-specific mortality scores before and during the epidemic. The excess mortality counts during the pandemic were predicted based on historic data using parametric and nonparametric modeling and then compared with the actual reported counts to quantify the excess. The corresponding standardized mortality P-score metrics were also compared with the neighboring countries. In summary, there were three "waves" of excess all-cause mortality in Ukraine in December 2020, April 2021 and November 2021 with excess of 32%, 43% and 83% above the expected mortality. Each new "wave" of the all-cause mortality was higher than the previous one and the mortality "peaks" corresponded in time to three "waves" of lab-confirmed COVID-19 mortality. The lab-confirmed COVID-19 mortality constituted 9% to 24% of the all-cause mortality during those three peak months. Overall, the mortality trends in Ukraine over time were similar to neighboring countries where vaccination coverage was similar to that in Ukraine. For cause-specific mortality, the excess observed was due to pneumonia as well as circulatory system disease categories that peaked at the same times as the all-cause and lab-confirmed COVID-19 mortality, which was expected. The pneumonias as well as circulatory system disease categories constituted the majority of all cases during those peak times. The seasonality in mortality due to the infectious and parasitic disease category became less pronounced during the pandemic. While the reported numbers were always relatively low, alcohol-related mortality also declined during the pandemic.

Not only COVID-19. Not only Ukraine. Under-reported hunger crises in the Horn of Africa and the politics around them.

Funding requirements for humanitarian needs have reached a record high, driven by Ukraine's war, other conflicts worldwide, the COVID-19 pandemic, climate change-related disasters, economic slowdown, and their combined global consequences. More people are in need of humanitarian assistance, and more are forcibly displaced than ever before, the majority of them from countries facing acute food insecurity. The largest global food crisis in modern history is unfolding. Particularly, in the Horn of Africa, levels of hunger are alarmingly high, with countries edging close to famine. This article discusses why and how famine, which had declined in frequency and lethality, is resurging, using Somalia and Ethiopia as 'mini case studies', emblematic as they are of a broader trend. Technical and political aspects of food crises and their consequences on health are analysed. The article examines some of the most contentious issues around famine: the data challenges for declaring it and the use of starvation as a weapon of war. The article concludes with the claim that the elimination of famine is possible, but only through political action. Humanitarians can warn of an impending crisis and mitigate some of its consequences, but they are powerless in the face of an ongoing famine, like those described in Somalia and Ethiopia.

Health Care Organization in Poland in Light of the Refugee Crisis Related to the Military Conflict in Ukraine.

BACKGROUND: Poland is witnessing a migration crisis caused by the ongoing military conflict in Ukraine. In addition to housing and necessities, 1.8 million Ukrainians that had taken refuge in Poland must have access to medical care. We aim to propose a strategy for implementing the changes in the Polish health care system in response to the Ukrainian refugee crisis. METHODS: A literature review on organizational changes in the functioning of health care systems during the migration crises worldwide in recent years and brainstorming in order to develop a strategy for implementing changes in the Polish health care system in response to the Ukrainian refugee crisis. RESULTS: The proposed strategy for implementing the changes in the Polish health care system is based on building health care resilience and adaptation to different crises. The operational objectives of organization-related activities are: (1) preparation of medical facilities to provide help for refugees, (2) development and implementation of the communication system, (3) implementation of available digital solutions, (4) organization of the diagnostic and medical services, (5) and implementation of changes in the management of medical facilities. CONCLUSIONS: Urgent reorganization is required to respond to an unavoidable increase in the demand for health care services.

Long COVID prevalence and physiology-centered risks: population-based study in Ukraine.

AIM: Multifaceted long COVID caused by SARS-COV-2 affects all populations in the World and takes priority over any other research topics for health care. The purpose of study is to identify physiology-centered risks, prevalence, symptoms and laboratory findings in patients with long COVID in Ukraine. METHODS: A prospective, cohort study was carried out on 332 patients with long COVID after 4 weeks and more after acute infection COVID-19 from Jul 1, 2021, to Jul 1, 2022. Physiology-centered risks related to age, gender, body mass index (BMI), marital status and educational capacity, smoking, lifestyle, physical activity, and laboratory findings (before disease), and symptom distribution were analyzed. RESULTS: The cohort for the study consisted of 166 females and 107 males (mean age = 42; including young 18 (5.4%) and middle- and old-aged adults 314 (96.4%)). Increased BMI was in 61%, and less physical activity-65%. There were 4 clusters of symptoms related to physical, neurocognitive, pulmonary, and pain conditions. 95% of participants had ≥ 3 symptoms. The most common symptoms were fatigue (90%), muscular pain (85%), anosmia (70%), hair loss (70%), sleep disorders (70%), dyspnea (30%), and brain fog (25%). Among laboratory finding increased CRP (92.6%) and fibrinogen (82.7%) dominated. There are no differences between hospitalized and non-hospitalized patients in distribution symptoms. CONCLUSIONS: The prevalence of long COVID is 23%, and its physiology-centered risk factors are related to age more 38 years, female sex, unhealthy lifestyle, increased BMI, and increased inflammatory markers during COVID-19. The most common symptoms are associated with neurocognitive and pain clusters.

Education for Sustainable Development: Challenges for Postgraduate Programmes.

As the world faces progressive and interconnected global crises and conflicts, the educational expectations set out in the 2030 Agenda for Sustainable Development are in jeopardy. With the COVID-19 pandemic in its third year, the war in Ukraine has exacerbated the food, energy, humanitarian, and refugee crises, all against the backdrop of an unfolding climate emergency. The aim of this research is to analyse the challenges faced by postgraduate programmes in training human talent for sustainable development on the basis of Grounded Theory. To do so, we have used a dialogical intervention through the complementary experiences of authorities of higher-education institutions that live day by day for a fair, quality, and sustainable education. With a naturalistic qualitative method, where the hermeneutic analysis procedure is structured in five phases, and with data from key informants from 9 countries, 20 interviews are obtained with key informants in Latin American and Spanish universities during 2021, according to inclusion criteria such as: belonging to a higher-education institution, with a doctorate degree, with more than 10 years of experience in management, and training in postgraduate programmes. The data are processed through ATLAS.ti9, which allows for the analysis of the key informants' discourses. The findings show that the university institutions that currently offer postgraduate programmes are considering improving the quality of education; the first challenge is to redesign the curricula according to the demands of the current and future world, incorporating technological resources and knowledge of the environment; inter- and transdisciplinary curricula that form enterprising postgraduates with a solid ethical life project; critical, complex, and systemic thinking.

Chaplaincy, Judaism, Ukraine, COVID-19 and JORH Jubilee.

This first issue of JORH for 2023 considers (1) the ministry of chaplains, (2) Judaism, (3) the people of war-torn Ukraine, (4) the ongoing saga of COVID-19 and, on a happier note, (5) we celebrate a belated jubilee by presenting a bibliometric analysis of the Journal of Religion and Health (1961-2021). To conclude this issue, a book review is presented, "The Desperate Hours" by award winning journalist Marie Brenner, focusing on one hospital's fight to save New York City during COVID-19. A reminder is also provided to readers on the call for papers regarding a future issue on religion, spirituality, suicide and its prevention.

WHO Ukraine Country Office COVID-19 response report 2020–2021

The first case of COVID-19 was reported in Ukraine in March 2020. The Ukrainian Government led a nationwide response to combat the disease, engaging with a wide range of health partners. The WHO Country Office in Ukraine worked with the Government to help mobilize society and the entire health sector in the response. This report outlines WHO’s contribution to this work, which provided assistance specific to COVID-19, while also supporting health reform and maintaining essential health services, including in conflict-affected areas in the east of the country. WHO supported national coordination, risk communication, vaccination and other health interventions under the 10 pillars of Ukraine’s COVID-19 Country Preparedness and Response Plan. WHO continues to provide critical support on COVID-19 in Ukraine, at the time of Russian Federation invasion of Ukraine in 24 February 2022.