Warlords into businessmen: the Afghan transition 2002-2005. Preliminary findings from a research trip, May 2005.

yesThe Afghan conflict changed significantly after the Soviet withdrawal and especially after the collapse of the communist regime in April 1992. External support, which at some point had been running to the tune of $3 billion a year to all sides, rapidly faded and the military commanders increasingly faced the problem of how to fund their armies in the face of a declining propensity of the civilian population to contribute to the war effort. The hold of the parties based in Pakistan and Iran over the field commanders rapidly weakened, even if some of the political leaders had been forward looking enough to accumulate financial resources through the hoarding of military supplies, which were then sold on the black market. The partial financial autonomy of some political leaders of the jihadi movement was not enough to stem the tide towards weaker and weaker links between parties and commanders, not least because the parties were reluctant to spend whatever resources they had accumulated, lest they lose their leverage in the future

Thrombotic complications in patients with COVID-19 : pathophysiological mechanisms, diagnosis, and treatment

Introduction Emerging evidence points to an association between severe clinical presentation of COVID-19 and increased risk of thromboembolism. One-third of patients hospitalized due to severe COVID-19 develops macrovascular thrombotic complications, including venous thromboembolism, myocardial injury/infarction and stroke. Concurrently, the autopsy series indicate multiorgan damage pattern consistent with microvascular injury. Prophylaxis, diagnosis and treatment COVID-19 associated coagulopathy has distinct features, including markedly elevated D-dimers concentration with nearly normal activated partial thromboplastin time, prothrombin time and platelet count. The diagnosis may be challenging due to overlapping features between pulmonary embolism and severe COVID-19 disease, such as dyspnoea, high concentration of D-dimers, right ventricle with dysfunction or enlargement, and acute respiratory distress syndrome. Both macro- and microvascular complications are associated with an increased risk of in-hospital mortality. Therefore, early recognition of coagulation abnormalities among hospitalized COVID-19 patients are critical measures to identify patients with poor prognosis, guide antithrombotic prophylaxis or treatment, and improve patients’ clinical outcomes. Recommendations for clinicians Most of the guidelines and consensus documents published on behalf of professional societies focused on thrombosis and hemostasis advocate the use of anticoagulants in all patients hospitalized with COVID-19, as well as 2-6 weeks post hospital discharge in the absence of contraindications. However, since there is no guidance for deciding the intensity and duration of anticoagulation, the decision-making process should be made in individual-case basis. Conclusions Here, we review the mechanistic relationships between inflammation and thrombosis, discuss the macrovascular and microvascular complications and summarize the prophylaxis, diagnosis and treatment of thromboembolism in patients affected by COVID-19

The Reintegration of Ex-Combatants and Post-Conflict Violence. An Analysis of Municipal Crime Levels in Colombia

Violent crime in Colombia is analyzed following the demobilization of ex-combatants using municipal-level data. The main findings are that an increased presence of ex-combatants does not systematically increase homicides, but may increase robberies. Reintegration programs are shown to matter. Former paramilitaries who are not in a reintegration program increase crime. Former guerillas increase robberies, regardless of whether they are in or out of reintegration, but homicides decrease for guerrillas in reintegration. Ex-combatants often settle in municipalities with more crime. Controlling for reverse causality, ex-combatants only increase crime if they are not in reintegration, while in reintegration they may reduce crime

Organised crime and international aid subversion: evidence from Colombia and Afghanistan

Scholarly attempts to explain aid subversion in post-conflict contexts frame the challenge in terms of corrupt practices and transactions disconnected from local power struggles. Also, they assume a distinction between organised crime and the state. This comparative analysis of aid subversion in Colombia and Afghanistan reveals the limits of such an approach. Focusing on relations that anchor organised crime within local political, social and economic processes, we demonstrate that organised crime is dynamic, driven by multiple motives, and endogenous to local power politics. Better understanding of governance arrangements around the organised crime-conflict nexus which enable aid subversion is therefore required

Fatal flaws in the UK asylum decision-making system: an analysis of Home Office refusal letters

The process of deciding who is in need of international protection is well established most western liberal democracies, and has been subject to critical scrutiny for decades. And yet asylum seekers remain vulnerable to serious and ongoing flaws in that system. In this paper, based on research conducted in Afghanistan 2012–2018, Schuster explores a number of shortcomings in the asylum decision-making process, specifically with regard to the rejection of claims from Afghans. The analysis of Reasons for Refusal Letters, allows Schuster to examine the use of key tools in that process (previous cases and country of origin reports). Schuster argues that the current adversarial approach, which seeks to prove an applicant is not credible or does not need protection, undermines the legitimacy of the asylum and risks refusing protection to those in need and or condemning others to years of damaging appeals before they are granted asylum. She concludes by arguing for a shift to a more investigative approach, one that seeks to identify those in need of protection, rather than to keep numbers low

Laparoscopic anterior gastropexy for chronic recurrent gastric volvulus: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gastric volvulus is an uncommon clinical entity, first described by Berti in 1866. It is a rotation of all or part of the stomach through more than 180°. This rotation can occur on the longitudinal (organo-axial) or transverse (mesentero-axial) axis. This condition can lead to a closed-loop obstruction or strangulation. Traditional surgical therapy for gastric volvulus is based on an open approach. Here we report the case of a patient with chronic intermittent gastric volvulus who underwent a successful laparoscopic treatment.</p> <p>Case presentation</p> <p>A 34-year-old woman presented with multiple episodes of recurrent upper abdominal pain associated with retching and vomiting, treated unsuccessfully with intramuscular metoclopramide. Endoscopic examination of the upper digestive tract showed a suspected rotation of the stomach, and a chronic recurrent gastric volvulus was revealed by barium meal. The patient was operated on successfully, with an anterior laparoscopic gastropexy performed as the first surgical approach.</p> <p>Conclusion</p> <p>Experience with laparoscopic anterior gastropexy is limited only to a few described cases. Our patient was clinically and radiologically followed-up for 2 years with no evidence of recurrence, either radiological or symptomatic. Based on this result, laparoscopic gastropexy can be seen and considered as an initial 'gold standard' for the treatment of gastric volvulus.</p

Sustainability of bridge maintenance

Bridge maintenance activities are important to consider within sustainable development due to the cost and environmental impact associated with various maintenance activities. Comparisons have been made between different bridge structural forms, based on materials, components and construction method, but less information is available on bridge maintenance activities to help decide a sustainable structural form. Typical maintenance aspects of the predominant forms of bridge structure (i.e. concrete, steel and masonry bridges) were considered in this study to reveal their sustainability in terms of materials, energy, transportation, human health and ecosystems. The results indicate that concrete and steel bridge maintenance activities have an average impact of 42% and 46% compared with 12% for masonry bridge maintenance activities. It is concluded that the component parts of concrete and steel bridges should be revised as they play an integral role in the selection of maintenance options

Learning in the chaos: A political economy analysis of education in Afghanistan

© 2018, The Author(s) 2018. Afghanistan is often characterised as a ‘failed’ or ‘fragile’ state in terms of state ‘functionality’, lacking in capacity to provide security and wellbeing to its citizens and failing to prevent violent conflict and terrorism. Since 2001, education has become a major victim of Afghanistan’s protracted crisis that involves international military interventions, fragile democracy and growing radicalisation. Drawing upon qualitative interviews with educational officials and practitioners in Afghanistan and critically examining the literature in education and conflict, we argue that Afghanistan’s education is caught in the nexus between deteriorating security conditions, weak governance and widespread corruption, resulting in rebel capture of educational spaces for radicalisation and violent extremism. More broadly, we contend that education faces the risk of capture for radicalisation in contexts where state fragility and fundamentalism intersect. Finally, we highlight some critical issues relating to educational programming in conflict-affected contexts

High tie versus low tie of the inferior mesenteric artery: a protocol for a systematic review

In anterior resection of rectum, the section level of inferior mesenteric artery is still subject of controversy between the advocates of high and low tie. The low tie is the division and ligation to the branching of the left colic artery and the high tie is the division and ligation at its origin at the aorta. We intend to assess current scientific evidence in literature and to establish the differences comparing technique, anatomy and physiology. The aim of this protocol is to achieve a meta-analysis that tests safety and feasibility of the two procedures with several types of outcome measures