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      Real-time sensing of war’s effects on wellbeing with smartphones and smartwatches

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          Abstract

          Background

          Modern wars have a catastrophic effect on the wellbeing of civilians. However, the nature of this effect remains unclear, with most insights gleaned from subjective, retrospective studies.

          Methods

          We prospectively monitored 954 Israelis (>40 years) from two weeks before the May 2021 Israel-Gaza war until four weeks after the ceasefire using smartwatches and a dedicated mobile application with daily questionnaires on wellbeing. This war severely affected civilians on both sides, where over 4300 rockets and missiles were launched towards Israeli cities, and 1500 aerial, land, and sea strikes were launched towards 16,500 targets in the Gaza Strip.

          Results

          We identify considerable changes in all the examined wellbeing indicators during missile attacks and throughout the war, including spikes in heart rate levels, excessive screen-on time, and a reduction in sleep duration and quality. These changes, however, fade shortly after the war, with all affected measures returning to baseline in nearly all the participants. Greater changes are observed in individuals living closer to the battlefield, women, and younger individuals.

          Conclusions

          The demonstrated ability to monitor objective and subjective wellbeing indicators during crises in real-time is pivotal for the early detection of and prompt assistance to populations in need.

          Plain language summary

          This study investigated the impact of the May 2021 Israel-Gaza war on the wellbeing of Israeli civilians. To do so, 954 Israelis over the age of 40 were monitored for six weeks before and after the war using smartwatches and a mobile application that asked daily wellbeing questions. The researchers found that during the war, people experienced spikes in heart rate, decreased sleep quality and duration, and increased screen time. These changes were more significant in people living closer to the battlefield, women, and younger individuals. However, after the ceasefire, wellbeing indicators returned to baseline levels. The study shows that monitoring wellbeing in real-time during crises can help identify and assist populations in need.

          Abstract

          Mofaz et al. prospectively monitor older Israeli participants, from two weeks before the May 2021 Israel-Gaza war until four weeks after the ceasefire, using smartwatches and wellbeing questionnaires in a mobile app. They identify changes in wellbeing indicators during missile attacks and throughout the war, that fade in most after it is over.

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          Most cited references35

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          A power primer.

          One possible reason for the continued neglect of statistical power analysis in research in the behavioral sciences is the inaccessibility of or difficulty with the standard material. A convenient, although not comprehensive, presentation of required sample sizes is provided here. Effect-size indexes and conventional values for these are given for operationally defined small, medium, and large effects. The sample sizes necessary for .80 power to detect effects at these levels are tabled for eight standard statistical tests: (a) the difference between independent means, (b) the significance of a product-moment correlation, (c) the difference between independent rs, (d) the sign test, (e) the difference between independent proportions, (f) chi-square tests for goodness of fit and contingency tables, (g) one-way analysis of variance, and (h) the significance of a multiple or multiple partial correlation.
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            New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis

            Summary Background Existing WHO estimates of the prevalence of mental disorders in emergency settings are more than a decade old and do not reflect modern methods to gather existing data and derive estimates. We sought to update WHO estimates for the prevalence of mental disorders in conflict-affected settings and calculate the burden per 1000 population. Methods In this systematic review and meta-analysis, we updated a previous systematic review by searching MEDLINE (PubMed), PsycINFO, and Embase for studies published between Jan 1, 2000, and Aug 9, 2017, on the prevalence of depression, anxiety disorder, post-traumatic stress disorder, bipolar disorder, and schizophrenia. We also searched the grey literature, such as government reports, conference proceedings, and dissertations, to source additional data, and we searched datasets from existing literature reviews of the global prevalence of depression and anxiety and reference lists from the studies that were identified. We applied the Guidelines for Accurate and Transparent Health Estimates Reporting and used Bayesian meta-regression techniques that adjust for predictors of mental disorders to calculate new point prevalence estimates with 95% uncertainty intervals (UIs) in settings that had experienced conflict less than 10 years previously. Findings We estimated that the prevalence of mental disorders (depression, anxiety, post-traumatic stress disorder, bipolar disorder, and schizophrenia) was 22·1% (95% UI 18·8–25·7) at any point in time in the conflict-affected populations assessed. The mean comorbidity-adjusted, age-standardised point prevalence was 13·0% (95% UI 10·3–16·2) for mild forms of depression, anxiety, and post-traumatic stress disorder and 4·0% (95% UI 2·9–5·5) for moderate forms. The mean comorbidity-adjusted, age-standardised point prevalence for severe disorders (schizophrenia, bipolar disorder, severe depression, severe anxiety, and severe post-traumatic stress disorder) was 5·1% (95% UI 4·0–6·5). As only two studies provided epidemiological data for psychosis in conflict-affected populations, existing Global Burden of Disease Study estimates for schizophrenia and bipolar disorder were applied in these estimates for conflict-affected populations. Interpretation The burden of mental disorders is high in conflict-affected populations. Given the large numbers of people in need and the humanitarian imperative to reduce suffering, there is an urgent need to implement scalable mental health interventions to address this burden. Funding WHO; Queensland Department of Health, Australia; and Bill & Melinda Gates Foundation.
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              Mental health consequences of war: a brief review of research findings.

              Among the consequences of war, the impact on the mental health of the civilian population is one of the most significant. Studies of the general population show a definite increase in the incidence and prevalence of mental disorders. Women are more affected than men. Other vulnerable groups are children, the elderly and the disabled. Prevalence rates are associated with the degree of trauma, and the availability of physical and emotional support. The use of cultural and religious coping strategies is frequent in developing countries.
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                Author and article information

                Contributors
                shmueli@tau.ac.il
                Journal
                Commun Med (Lond)
                Commun Med (Lond)
                Communications Medicine
                Nature Publishing Group UK (London )
                2730-664X
                17 April 2023
                17 April 2023
                2023
                : 3
                : 55
                Affiliations
                [1 ]GRID grid.12136.37, ISNI 0000 0004 1937 0546, Department of Industrial Engineering, , Tel-Aviv University, ; Tel-Aviv, Israel
                [2 ]GRID grid.430432.2, ISNI 0000 0004 0604 7651, School of Behavioral Sciences, , The Academic College of Tel Aviv-Yafo, ; Tel-Aviv, Israel
                [3 ]GRID grid.12136.37, ISNI 0000 0004 1937 0546, School of Zoology and Sagol School of Neuroscience, , Tel-Aviv University, ; Tel-Aviv, Israel
                [4 ]GRID grid.12136.37, ISNI 0000 0004 1937 0546, Center for Combating Pandemics, , Tel-Aviv University, ; Tel-Aviv, Israel
                [5 ]GRID grid.116068.8, ISNI 0000 0001 2341 2786, MIT Media Lab, ; Cambridge, MA USA
                Author information
                http://orcid.org/0000-0001-7533-2737
                http://orcid.org/0000-0001-7025-5541
                http://orcid.org/0000-0002-5224-3341
                http://orcid.org/0000-0003-3193-5768
                Article
                284
                10.1038/s43856-023-00284-y
                10109229
                37069232
                fe2d8a3f-8d94-48bb-91f7-d84781056786
                © The Author(s) 2023

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 23 August 2022
                : 31 March 2023
                Funding
                Funded by: FundRef https://doi.org/10.13039/501100003977, Israel Science Foundation (ISF);
                Award ID: 3409/19
                Award ID: 3409/19
                Award ID: 3409/19
                Award ID: 3409/19
                Award Recipient :
                Categories
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                © The Author(s) 2023

                public health,biomarkers
                public health, biomarkers

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