The consequences of communist crimes and the importance of economic reforms in transitional justice

The crimes of the Albanian communist regime included the violation of civil and political rights as well as economic, social and cultural rights. The consequences of these crimes extended to several generation and are present even today, over 30 years since the end of the communist regime. This study aims to document the accounts of the survivors and their descendent on the developments and impact of existing transitional justice mechanisms in Albania. The study combines qualitative approaches (27 interviews) with quantitative approaches (130 surveys). The analysis of the data shows that the survivors of the dictatorship and their descendants believe that economic compensation (and redress) are one the most important mechanisms of transitional justice. They believe that the economic compensation must have a wide scope and include addressing the impact of the violation of civil and political rights as well as economic, social and cultural rights. Compensation must recognise the loss of family members, time and work in prison, the denial of the right to education, pension, contributions at work, housing, healthcare, loss of property, and denial of right to family, political, social and cultural life. Krimet e diktatures komuniste në Shqipëeri përfshinë shkeljen e të drejtave civile dhe politike si dhe të drejtave ekonomike, sociale dhe kulturore. Pasojat e këtyre krimeve shtrihen në breza dhe janë të pranishme edhe sot, mbi 30 vjet pas rënies së regjimit komunist. Ky studim synon të hedhë dritë mbi perceptimet e të mbijetuarve të krimeve te diktatures dhe pasardhesve të tyre mbi zhvillimet e drejtësisë tranzitore në Shqipëri. Ai bazohet në ndërthurjen e metodologjisë cilësore (27 intervista) me atë sasiore (130 pyetësorë). Analiza e të dhënave tregoi se të mbijetuarit e krimeve komuniste dhe pasardhesit e tyre vlerësojnë dëmshpërblimin ekonomik si një nga aspektet më të rëndësishme të drejtësisë tranzitore. Sipas tyre, dëmshpërblimi per krimet e kryera duhet të ketë një natyrë të gjërë dhe te përfshijë pasojat qe vijuan nga shkeljet e të drejtave civile dhe politike si dhe të drejtave ekonomike, sociale dhe kulturore: humbjet e familjarëve, kohëqëndrimin dhe punën në burg, mohimin e te drejtes se arsimimit, pensioneve, banimit, kujdesit shëndetësor, sekuestrimin e pronës si dhe pjesëmarrjen në jeten familjare, politike, sociale dhe kulturore

The dictatorship from the victims' perspective. the role of the families

This chapter explores the psychological impact of dictatorial crimes. It focuses on the impact of lack of justice, redress and societal recognition for one's group suffering has on mental health. The chapter presents findings from two studies (a qualitative and quantitative one) where it documents in detail the human rights violation and suffering experienced at family level during the dictatorship in Albania. Punimi sjell një këndvështri psikologjik të pasojave të dhunës diktatoriale. Mungesa apo shkelja e të drejtave të njeriut gjatë dhe pas diktaturës apo konflikteve etnike ndikon negativisht në shëndetin mendor të të prekurve. Studimet mbi traumën shqyrtojnë rolin e ndryshimeve pas diktaturës apo konflikteve. Studimi vë në dukje ndikimin negativ që ushtron te të mbijetuarit mungesa e mjedisit shoqëror ku të shprehen për atë çfarë kanë përjetuar [Albanian]

Doing research in immigration removal centres: ethics, emotions and impact

Immigration Removal Centres (IRCs) are deeply contested institutions that rarely open their doors to independent research. In this article we discuss some of the complications we faced in conducting the first national study of everyday life in them. As we will set out, research relationships were difficult to forge due to low levels of trust, and unfamiliarity with academic research. At the same time, many participants had unrealistic expectations about our capacity to assist while most exhibited high levels of distress. We were not immune from the emotional burden of the field sites. Such matters were compounded by the limited amount of published information about life in IRCs and a lack of ethical guidelines addressing such places. Drawing on related literature from prison sociology, we use our experiences in IRCs to set out a methodological account of understanding, ethics, and impact within these complex sites

Psychological morbidity and health related quality of life after injury: multicentre cohort study

Purpose To demonstrate the impact of psychological morbidity 1 month post-injury on subsequent post-injury quality of life (HRQoL) in a general injury population in the UK to inform development of trauma care and rehabilitation services. Methods Multicentre cohort study of 16–70-year-olds admitted to 4 UK hospitals following injury. Psychological morbidity and HRQoL (EQ-5D-3L) were measured at recruitment and 1, 2, 4 and 12 months post-injury. A reduction in EQ-5D compared to retrospectively assessed pre-injury levels of at least 0.074 was taken as the minimal important difference (MID). Multilevel logistic regression explored relationships between psychological morbidity 1 month post-injury and MID in HRQoL over the 12 months after injury. Results A total of 668 adults participated. Follow-up rates were 77% (1 month) and 63% (12 months). Substantial reductions in HRQoL were seen; 93% reported a MID at 1 month and 58% at 12 months. Problems with pain, mobility and usual activities were commonly reported at each time point. Depression and anxiety scores 1 month post-injury were independently associated with subsequent MID in HRQoL. The relationship between depression and HRQoL was partly explained by anxiety and to a lesser extent by pain and social functioning. The relationship between anxiety and HRQoL was not explained by factors measured in our study. Conclusions Hospitalised injuries result in substantial reductions in HRQoL up to 12 months later. Depression and anxiety early in the recovery period are independently associated with lower HRQoL. Identifying and managing these problems, ensuring adequate pain control and facilitating social functioning are key elements in improving HRQoL post-injury

Longitudinal associations between family identification, loneliness, depression, and sleep quality

Objectives: The prevalence of depression and loneliness are increasing in Western nations, and both have been shown to cause poor sleep quality, with evidence suggesting that loneliness also predicts depression. The Social Cure perspective can shed light on these relationships, and thus informs the present study. Specifically, it was hypothesised that the extent of participants’ identification with a significant social group, their family, would positively predict sleep quality, and that this relationship would be mediated by loneliness and depression. Design: A two-wave longitudinal online survey was used. Methods: Participants completed an online survey at T1 (N = 387) and one year later at T2 (N = 122) assessing the extent to which they identified with their family. Their loneliness, depressive symptomology, and sleep quality/insomnia severity were also measured. Results: Consistent with predictions, cross-sectional and longitudinal serial mediation models indicated that family identification was a negative predictor of loneliness, which in turn was a positive predictor of depression, which predicted poor sleep quality/insomnia. Conclusions: This is the first Social Cure study to explore the mediated relationship between social identification and sleep quality. As well as advancing the Social Cure perspective, these results have implications for how health professionals understand, prevent, and treat sleep problems

The mental health benefits of community helping during crisis: coordinated helping, community identification and sense of unity during the COVID-19 pandemic

Communities are vital sources of support during crisis, providing collective contexts for shared identity and solidarity that predict supportive, prosocial responses. The COVID-19 pandemic has presented a global health crisis capable of exerting a heavy toll on the mental health of community members while inducing unwelcome levels of social disconnection. Simultaneously, lockdown restrictions have forced vulnerable community members to depend upon the support of fellow residents. Fortunately, voluntary helping can be beneficial to the well-being of the helper as well as the recipient, offering beneficial collective solutions. Using insights from social identity approaches to volunteering and disaster responses, this study explored whether the opportunity to engage in helping fellow community members may be both unifying and beneficial for those engaging in coordinated community helping. Survey data collected in the UK during June 2020 showed that coordinated community helping predicted the psychological bonding of community members by building a sense of community identification and unity during the pandemic, which predicted increased well-being and reduced depression and anxiety. Implications for the promotion and support of voluntary helping initiatives in the context of longer-term responses to the COVID-19 pandemic are provided. Please refer to the Supplementary Material section to find this article’s Community and Social Impact Statement

A qualitative exploration of the experiences of veterans who are serving sentences in custody

The focus on veterans in research is not a novel topic; however, the majority of studies are related to trauma, employment, mental health, suicide, and substance misuse. The Criminal Justice System involvement with veterans is a topic that has yet to be examined to a great extent. This study, conducted with adult male prisoners, elicited information from six veterans regarding their experiences of being in the armed forces, leaving the armed forces and becoming involved in the Criminal Justice System. Responses were evaluated using Interpretative Phenomenological Analysis (IPA) and three main themes were identified: “you’re baptised into the army”, ‘them and us,’ and ‘operational mind set’; each of which comprised a number of superordinate themes. The research highlights that, although it is important to acknowledge the heterogenic nature of this group, it is equally important to note that much of their thinking and behaviour may be similar to those that have not had these experiences. As such, there is a need to reduce the notion that they are separate and different to other prisoners, requiring different treatment. The study highlights that many of the Offending Behaviour Programmes and interventions already available to prisoners would be appropriate for this group. The current research supports the merit in creating a service in prisons that will allow for ex-servicemen to meet together and access the support that is available to them. The implications of the research are discussed further

Vocational rehabilitation to enhance return to work after trauma (ROWTATE): protocol for a non-randomised single arm mixed-methods feasibility study

Background: Traumatic injuries are common amongst working-age adults. Survivors often experience physical and psychological problems, reduced quality of life and difficulty returning to work. Vocational rehabilitation improves work outcomes for a range of conditions but evidence of effectiveness for those with traumatic injuries is lacking. This study assesses feasibility of delivering a vocational rehabilitation intervention to enhance return to work and improve quality of life and wellbeing in people with at least moderate trauma to inform design of a definitive randomised controlled trial (RCT). Methods: Non-randomised, single-arm, multi-centre mixed-methods feasibility study with nested case studies and qualitative study. The case studies comprise interviews, observations of clinical contacts and review of clinical records. The qualitative study comprises interviews and/or focus groups. Participants will be recruited from two UK major trauma centres. Participants will comprise 40 patients aged 16–69 with an injury severity score of > 8 who will receive the intervention and complete questionnaires. Interviews will be conducted with 10 patients and their occupational therapists (OTs), clinical psychologists (CPs), employers and commissioners of rehabilitation services. Fidelity will be assessed in up to six patients by observations of OT and CP—patient contacts, review of patient records and intervention case report forms. OT and CP training will be evaluated using questionnaires and competence to deliver the intervention assessed using a team objective structured clinical examination and written task. Patients participating in and those declining participation in the study will be invited to take part in interviews/focus groups to explore barriers and facilitators to recruitment and retention. Outcomes include recruitment and retention rates, intervention fidelity, OT and CP competence to deliver the intervention, experiences of delivering or receiving the intervention and factors likely to influence definitive trial delivery. Discussion: Effective vocational rehabilitation interventions to enhance return to work amongst trauma patients are urgently needed because return to work is often delayed, with detrimental effects on health, financial stability, healthcare resource use and wider society. This protocol describes a feasibility study delivering a complex intervention to enhance return to work in those with at least moderate trauma

The impact of psychological factors on recovery from injury: a multicentre cohort study

Purpose Unintentional injuries have a significant long-term health impact in working age adults. Depression, anxiety and post-traumatic stress disorder are common post-injury, but their impact on self-reported recovery has not been investigated in general injury populations. This study investigated the role of psychological predictors 1 month post-injury in subsequent self-reported recovery from injury in working-aged adults. Methods A multicentre cohort study was conducted of 668 unintentionally injured adults admitted to five UK hospitals followed up at 1, 2, 4 and 12 months post-injury. Logistic regression explored relationships between psychological morbidity 1 month post-injury and self-reported recovery 12 months post-injury, adjusting for health, demographic, injury and socio-legal factors. Multiple imputations were used to impute missing values. Results A total of 668 adults participated at baseline, 77% followed up at 1 month and 63% at 12 months, of whom 383 (57%) were included in the main analysis. Multiple imputation analysis included all 668 participants. Increasing levels of depression scores and increasing levels of pain at 1 month and an increasing number of nights in hospital were associated with significantly reduced odds of recovery at 12 months, adjusting for age, sex, centre, employment and deprivation. The findings were similar in the multiple imputation analysis, except that pain had borderline statistical significance. Conclusions Depression 1 month post-injury is an important predictor of recovery, but other factors, especially pain and nights spent in hospital, also predict recovery. Identifying and managing depression and providing adequate pain control are essential in clinical care post-injury

Methods of connecting primary care patients with community-based physical activity opportunities:A realist scoping review

Funding: NHS Fife Endowment Fund (Grant Number(s): FIF142).Deemed a global public health problem by the World Health Organization, physical inactivity is estimated to be responsible for one in six deaths in the United Kingdom (UK) and to cost the nation's economy £7.4 billion per year. A response to the problem receiving increasing attention is connecting primary care patients with community-based physical activity opportunities. We aimed to explore what is known about the effectiveness of different methods of connecting primary care patients with community-based physical activity opportunities in the United Kingdom by answering three research questions: 1) What methods of connection from primary care to community-based physical activity opportunities have been evaluated?; 2) What processes of physical activity promotion incorporating such methods of connection are (or are not) effective or acceptable, for whom, to what extent and under what circumstances; 3) How and why are (or are not) those processes effective or acceptable? We conducted a realist scoping review in which we searched Cochrane, Medline, PsycNET, Google Advanced Search, National Health Service (NHS) Evidence and NHS Health Scotland from inception until August 2020. We identified that five methods of connection from primary care to community-based physical activity opportunities had been evaluated. These were embedded in 15 processes of physical activity promotion, involving patient identification and behaviour change strategy delivery, as well as connection. In the contexts in which they were implemented, four of those processes had strong positive findings, three had moderately positive findings and eight had negative findings. The underlying theories of change were highly supported for three processes, supported to an extent for four and refuted for eight processes. Comparisons of the processes and their theories of change revealed several indications helpful for future development of effective processes. Our review also highlighted the limited evidence base in the area and the resulting need for well-designed theory-based evaluations.Publisher PDFPeer reviewe