Captagon and conflict : drugs and war on the border between Jordan and Syria

Captagon is an illegal amphetamine that is widely used in the Middle East. Since the civil war started in 2011, Syria has become an international hub for Captagon production. A main Captagon trafficking route runs from Syria to the Arabian peninsula via Jordan. This has caused increasing domestic con-sumption of Captagon in Jordan. This article asks how Captagon trafficking and use in Jordan intersects with war in Syria and its wider impact. It illustrates how drug trafficking can be the product of violence and can also become a conduit for further violence. The article firstly analyses the drugs-conflict nexus in Syria and emphasizes Captagon trafficking as a new case study to this literature. It unpacks the role of the state in the crime-conflict nexus. The second half of the article draws on critical border studies literature to illustrate how the illegal Captagon trade has increased violence by contributing to an increasingly militarized border, with significant consequences for the communities who live and work there. The study concludes by considering the implications of Captagon trafficking for peace and stability in Syria and the region

Impact of COVID-19 on patient experience of kidney care:a rapid review

Introduction: In March 2020, a pandemic state was declared due to SARS-COV-2 (COVID-19). Patients with kidney disease, especially those on replacement therapies, proved more susceptible to severe infection. This rapid literature review aims to help understand how the pandemic impacted patient experience of kidney care. Methods: It was conducted in accordance with Cochrane Rapid Review interim guidance. Search terms, ‘coronavirus’, ‘kidney care’, and ‘patient-reported experience’ and terms with similar semantic meaning, identified 1,117 articles in Medline, Scopus, and Worldwide Science. Seventeen were included in the narrative synthesis. Results: The findings were summarised into three themes: remote consultation and telemedicine (n = 9); psychosocial impact (n = 2); and patient satisfaction and patient-reported experience (n = 6). Patients were mostly satisfied with remote consultations, describing them as convenient and allowing avoidance of hospital visits. Anxieties included missing potentially important clinical findings due to lack of physical examination, poor digital literacy, and technical difficulties. Psychosocial impact differed between treatment modalities—transplant recipients expressing feelings of instability and dread of having to return to dialysis, and generally, were less satisfied, citing reduced ability to work and difficulty accessing medications. Those on home dialysis treatments tended to feel safer. Findings focused on aspects of patient experience of kidney care during the pandemic rather than a holistic view. Conclusions: There was little direct evaluation of modality differences and limited consideration of health inequalities in care experiences. A fuller understanding of these issues would guide policy agendas to support patient experience during future public health crises. Graphical abstract: [Figure not available: see fulltext.

Impact of the COVID-19 pandemic on services for patients with chronic kidney disease: findings of a national survey of UK kidney centres

Background: Services for patients with kidney disease underwent radical adaptations in response to the COVID-19 pandemic. We undertook an online national survey of UK kidney centres to understand the nature, range, and degree of variation in these changes and to explore factors contributing to differing practice. Methods: The survey was designed by a multidisciplinary team of kidney professionals, service users and researchers. It enquired about centre services and staffing, including psychosocial provision, and changes to these in response to the COVID-19 pandemic. Links to the survey were sent to all 68 UK kidney centres and remained active from December 2021 to April 2022, and a revised version to nurses in late 2022 for additional data. Quantitative data were analysed descriptively. Content analysis on free-text responses identified common themes. Results: Analysable responses were received from 41 out of the 68 UK centres (60%), with partial data from an additional 7 (11%). Adaptations were system-wide and affected all aspects of service provision. Some changes were almost universal such as virtual consultations for outpatient appointments, with significant variation in others. Outpatient activity varied from fully maintained to suspended. Many centres reduced peritoneal dialysis access provision but in some this was increased. Centres considered that changes to transplant surgical services and for patients with advanced CKD approaching end-stage kidney disease had the greatest impact on patients. Few centres implemented adjustments aimed at vulnerable and underrepresented groups, including the frail elderly, people with language and communication needs, and those with mental health needs. Communication issues were attributed to rapid evolution of the pandemic, changing planning guidance and lack of resources. Staffing shortages, involving all staff groups particularly nurses, mainly due to COVID-19 infection and redeployment, were compounded by deficiencies in staffing establishments and high vacancy levels. Centres cited three main lessons influencing future service delivery, the need for service redesign, improvements in communication, and better support for staff. Conclusion: Kidney centre responses to the pandemic involved adaptations across the whole service. Though some changes were almost universal, there was wide variation in other areas. Exploring the role of centre characteristics may help planning for potential future severe service disruptions

Impact of COVID-19 on patient experience of kidney care: a rapid review.

In March 2020, a pandemic state was declared due to SARS-COV-2 (COVID-19). Patients with kidney disease, especially those on replacement therapies, proved more susceptible to severe infection. This rapid literature review aims to help understand how the pandemic impacted patient experience of kidney care. It was conducted in accordance with Cochrane Rapid Review interim guidance. Search terms, 'coronavirus', 'kidney care', and 'patient-reported experience' and terms with similar semantic meaning, identified 1,117 articles in Medline, Scopus, and Worldwide Science. Seventeen were included in the narrative synthesis. The findings were summarised into three themes: remote consultation and telemedicine (n = 9); psychosocial impact (n = 2); and patient satisfaction and patient-reported experience (n = 6). Patients were mostly satisfied with remote consultations, describing them as convenient and allowing avoidance of hospital visits. Anxieties included missing potentially important clinical findings due to lack of physical examination, poor digital literacy, and technical difficulties. Psychosocial impact differed between treatment modalities-transplant recipients expressing feelings of instability and dread of having to return to dialysis, and generally, were less satisfied, citing reduced ability to work and difficulty accessing medications. Those on home dialysis treatments tended to feel safer. Findings focused on aspects of patient experience of kidney care during the pandemic rather than a holistic view. There was little direct evaluation of modality differences and limited consideration of health inequalities in care experiences. A fuller understanding of these issues would guide policy agendas to support patient experience during future public health crises. [Abstract copyright: © 2023. The Author(s).

Book review: State violence, collusion and the Troubles: counter insurgency, government deviance and Northern Ireland

"State Violence, Collusion and the Troubles: Counter Insurgency, Government Deviance and Northern Ireland." Maurice Punch. Pluto Press. March 2012. --- State Violence, Collusion and the Troubles reveals disturbing unanswered questions about the use of state violence during the conflict in Ireland. Maurice Punch documents how the British government turned to desperate, illegal measures in a time of crisis, disregarding domestic and international law. He also broadens out his analysis to consider other cases of state violence against ‘insurgent groups’ in Spain and South Africa. Christina Steenkamp thinks this book is a sobering and overdue caution to democratic states facing terrorist threats

Post-accord crime and violence

This chapter addresses the counter-intuitive phenomenon of high levels of violence in post-peace accord societies. From South Africa to Northern Ireland, Colombia to Bosnia-Herzegovina, the evidence shows that many post-accord societies are at risk of becoming even more violent and insecure than during the war. This ubiquity of post-accord violence raises some important questions: what forms does the violence take; who is responsible for this violence, why does violence continue at such high levels and how does it affect post-war societies? The chapter argues that conditions which arose from both the preceding conflict and the peace process itself are responsible for generating the perpetrators, causes and types of violence which characterise post-accord societies. Continuing high levels of violence after war raises important questions about the quality of the ‘peace’ that is taking root and exposes the failure of many peace accords to progressively transform the daily life of civilians

The crime-terror nexus in Syria and Iraq

This chapter investigates the connection between the Islamic State of Iraq and Syria (ISIS) and organized crime in Iraq and Syria. It argues that the crime-terror nexus here is one where an organization whose primary aim is overwhelmingly political, largely develops its own use of organized crime methods to raise funds for its political and military aims – with some opportunistic cooperation with existing organized crime networks. The chapter outlines the involvement of ISIS in oil smuggling, the illegal trade in antiquities and human trafficking (including kidnapping). Its shows how three factors determine the nature of the nexus in this case:  pre-existing networks and practices of organized crime; the availability of valuable resources and lastly, ISIS’s objective of territorial control and state building. The chapter ends with a consideration of ISIS’s involvement in organized crime since the fall of the Caliphate

The impact of tunnels on conflicts in the Middle East

The battlefields in the contemporary conflicts in the Middle East are multi-level conflicts. They take place in the air and on the ground, but an important and often overlooked dimension of these conflicts is found under the surface. This article recognizes the usefulness of political geography's ‘volumetric turn’ as it examines the use of tunnels in conflict, particularly in the post-2001 conflicts in the Middle East. It asks questions about who uses tunnels, for which purposes and about the impact of tunnels on conflicts. It proceeds to show how tunnels are used by a range of actors (including states, insurgents, civilians and organized crime groups) for various, often overlapping purposes (including offensive, defensive and smuggling/economic purposes). The article argues that tunnels impact on conflicts by benefiting the weaker side in asymmetrical warfare, by directly affecting states’ military strategy, by either generating or challenging political legitimacy and lastly, by becoming central to the economic survival of civilians in conflict. A greater recognition of the subterranean dimension of contemporary Middle Eastern conflicts will provide a more nuanced understanding of the duration, intensity and consequences of these wars