Search Results (10)

Background and Objectives: Maxillofacial trauma represents a significant global health challenge with substantial physical, psychological, and socioeconomic consequences. Materials and Methods: This narrative review analyzed 112 articles published between 2000 and 2024 examining epidemiology, prevention, economics, and outcomes of maxillofacial trauma in critical care settings. Results: Road traffic accidents remain the primary cause globally, followed by interpersonal violence and occupational injuries. Effective prevention strategies include seat belt laws, helmet legislation, and violence prevention programs. Economic burden encompasses direct healthcare costs (averaging USD 55,385 per hospitalization), productivity losses (11.8 workdays lost per incident), and rehabilitation expenses (USD 3800–18,000 per patient). Surgical management has evolved toward early intervention, minimally invasive approaches, and advanced techniques using computer-aided design and 3D printing. Complications affect 3–33% of patients, with significant functional disabilities and psychological sequelae (post-traumatic stress disorder in 27%, depression/anxiety in 20–40%). Conclusion: Maxillofacial trauma management requires multidisciplinary approaches addressing both immediate treatment and long-term rehabilitation. Despite technological advances, disparities in specialized care access persist globally. Future efforts should implement evidence-based prevention strategies, reduce care disparities, and develop comprehensive approaches addressing physical, psychological, and socioeconomic dimensions through collaboration among healthcare professionals, policymakers, and community stakeholders. Full article

The American Civil War has been commemorated with a great variety of monuments, memorials, and markers. These monuments were erected for a variety of reasons, beginning with memorialization of the fallen and later to honor aging veterans, commemoration of significant anniversaries associated with the conflict, memorialization of sites of conflict, and celebration of the actions of military leaders. Sources reveal that during both the Jim Crow and Civil Rights eras, many monuments were erected as part of an organized propaganda campaign to terrorize African American communities and distort the past by promoting a “Lost Cause” narrative. Through subsequent decades, to this day, complex and emotional narratives have surrounded interpretive legacies of the Civil War. Instruments of commemoration, through both physical and digital intervention approaches, can be provocative and instructive, as the country deals with a slavery legacy and the commemorated objects and spaces surrounding Confederate inheritances. Today, all of these potential factors and outcomes, with internationally relevance, are surrounded by swirls of social and political contention and controversy, including the remembering/forgetting dichotomies of cultural heritage. In this article, drawing from the testimony of scholars and artists, I address the conceptual landscape of approaches to the presentation and evolving participatory narratives of Confederate monuments that range from absolute expungement and removal to more restrained ideas such as in situ re-contextualization, removal to museums, and preservation-in-place. I stress not so much the academic debate but how the American public is informed about and reacts to the various issues related to Confederate memorialization. My main point, where my premise stands out in the literature, is that, for the sake of posterity, and our ability to connect and engage with a tangible in situ artifact, not all Confederate statues should be taken down. Some of them, or remnants of them, should be preserved as sites of conscience and reflection, with their social and political meanings ongoing and yet to be determined in the future. The modern dilemma turns on the question: In today’s new era of social justice, are these monuments primarily symbols of oppression, or can we see them, in select cases, alternatively as sites of conscience and reflection encompassing more inclusive conversations about commemoration? What we conserve and assign as the ultimate public value of these monuments rests with how we answer this question. Full article

In February 2023, an oil tanker carrying 5660 bbl of industrial fuel oil sank off Naujan in the Philippines, causing an oil spill in the waters of Oriental Mindoro and nearby provinces. The disaster affected fishing communities as well as marine ecosystems including the Verde Island Passage, which is at the “center of the world’s marine biodiversity”. This study assessed the immediate social and economic impacts of this oil spill on various communities of the Naujan coast. We conducted semi-structured interviews and employed a narrative analysis to explore the lived experiences of fisherfolk after the oil spill and to understand the socioeconomic impacts. With the prohibition of fishing and other aquatic activities, the participants lost up to USD 1300 of income per week from fishing. The participants had no other source of income due to the lack of other skills or an opportunity for an alternative livelihood in the community. While the government provided food packs and financial assistance, the participants found these insufficient to sustain their basic family needs including food, utilities, education, and health. Traces of oil were also found in the sources of potable water affecting their daily household activities. The fisherfolk, who live in communities that are vulnerable to natural and human-made hazards, had their subsistence, food security, and human well-being highly compromised. The findings provided recommendations for government interventions to mitigate the impacts of an oil spill and other future disasters, considering social, economic, and human ecological perspectives. Full article

Despite newly available therapies for acute stroke and innovative prevention strategies, stroke remains the third leading cause of disability-adjusted life-years (DALYs) lost worldwide, mostly because more than half of stroke survivors aged 65 and over exhibit an incomplete functional recovery of the paretic limb. Given that a repeated sensory input is one of the most effective modulators of cortical motor and somatosensory structures, focal muscle vibration (fMV) is gaining growing interest as a safe, well-tolerated, and non-invasive brain stimulation technique to promote motor recovery after stroke with a long-lasting and clinically relevant improvement in strength, step symmetry, gait, and kinematics parameters. In this narrative review, we first summarize the structural (neural plasticity) and functional changes (network relearning) triggered by the stroke lesion and carried out at a brain and spinal cord level in an attempt to recover from the loss of function. Then, we will focus on the fMV’s plasticity-based mechanisms reporting evidence of a possible concurrently acting multisite plasticity induced by fMV. Finally, to understand what the most effective fMV rehabilitation protocol could be, we will report the most recent evidence regarding the different clinical approaches and timing of the fMV treatment, the related open issues, and prospects. Full article

Black creators who tell Harriet Tubman’s story engage in an ongoing rhetorical battle over historical memory with regard to slavery and the Civil War. This essay examines the challenges Tubman’s story poses to a Lost Cause narrative that took root in the nineteenth-century and manifests in the work of celebrated children’s author Robert Lawson. Reading Ann Petry’s YA biography Harriet Tubman: Conductor on the Underground Railroad (1955), Jacob Lawrence’s picture book Harriet and the Promised Land (1968), and Kasi Lemmons’ film Harriet (2019) together, and within the context of Lawson’s award-winning They Were Strong and Good (1940) and his historical primer Watchwords of Liberty: A Pageantry of American Quotations (1943) offers an opportunity to assess the rhetorical firepower of creative work about a historical figure who continues to fascinate people of all ages. Such reading also underscores the extent to which the apartheid in and of children’s literature limits the imaginations of critics, thereby hindering efforts to promote social justice. Full article

Background: Small cigarette pack sizes contain less than 20 cigarette sticks in a pack. Smaller packs may suggest lower costs, increasing affordability among lower-income users, especially the younger generation, which could lead to tobacco-related diseases and economic costs, including human capital lost results from tobacco-attributable morbidity and mortality. This concern has caused many countries to ban the sale of single cigarette sticks or kiddie packs. However, small cigarette pack sizes were proposed recently to be reintroduced by the tobacco industry with an excuse to prevent consumers from buying illicit cigarettes. This would demean efforts in combating tobacco consumption based on the existing tobacco control policies to prevent minors from purchasing cigarettes. Given the competing influences of affordability and availability of tobacco on consumption and the dearth of evidence-based review on the impact of pack size on smoking, this systematic review was conducted to identify the link between kiddie packs and smoking specifically on the initiation of smoking, urge/tendency to buy cigarettes among the general population and attempt to reduce cigarette consumption and prevalence of smoking using kiddie packs among current smokers. Methods: We include all studies except for reviews, guidelines, conference papers, commentaries, editorials, or opinion pieces. A database search was conducted in PubMed, EMBASE, CENTRAL, Web of Science and Scopus on 27 November 2021. The results were presented in the form of narrative synthesis under four groups: initiation of smoking; urge/tendency to buy cigarettes; the prevalence of smoking, and attempt to reduce cigarette consumption. The literature search identified 1601 articles, of which 21 articles had met the inclusion criteria. The methodological quality of all included articles was determined using a validated 16-item quality assessment tool (QATSDD). The average quality score for all papers was 34.8%. Discussion: Given the diverse study settings of the articles and despite the challenges of the methodological quality of some articles, this review provides some evidence that kiddie packs may increase the urge/tendency to buy cigarettes and mixed evidence on the attempt to reduce cigarette consumption. This review also found some evidence that kiddie pack purchasing among teenage smokers was higher compared to adults. However, we are uncertain about the link between kiddie packs and smoking initiation. Nevertheless, since most studies were of low quality, further high-quality studies are needed to conclude about the impact of kiddie packs on smoking to assist the policymakers and stakeholders in formulating new policies and strengthening existing strategies related to the kiddie packs. Full article

Periodontitis is a destructive disease of the tooth-surrounding tissues. Infection is the etiological cause of the disease, but its extent and severity depend on the immune–inflammatory response of the host. Immune cells use reactive oxygen species to suppress infections, and there is homeostasis between oxidative and antioxidant mechanisms during periodontal health. During periodontitis, however, increased oxidative stress triggers tissue damage, either directly by activating apoptosis and DNA damage or indirectly by activating proteolytic cascades. Periodontal treatment aims to maintain an infection and inflammation-free zone and, in some cases, regenerate lost tissues. Although mechanical disruption of the oral biofilm is an indispensable part of periodontal treatment, adjunctive measures, such as antibiotics or anti-inflammatory medications, are also frequently used, especially in patients with suppressed immune responses. Recent studies have shown that probiotics activate antioxidant mechanisms and can suppress extensive oxidative stress via their ability to activate nuclear factor erythroid 2-related factor 2 (Nrf2). The aim of this narrative review is to describe the essential role of Nrf2 in the maintenance of periodontal health and to propose possible mechanisms to restore the impaired Nrf2 response in periodontitis, with the aid of probiotic and postbiotics. Full article

Food waste (FW) is a current, complex, and widely debated issue in various spheres of society. Globally, about 2.6 trillion dollars per year is lost because of wasted food. Part of FW is preventable, and it is necessary to identify where it occurs. In most cases, FW occurs at the end of the production chain (meal preparation and distribution). Identifying the main food service failures on FW is important for developing efficient strategies for reducing them. Therefore, this study aimed to perform a narrative review of the impacts caused by FW in food services considering the three dimensions of sustainability (social, economic, or environmental). Multiple reasons were identified in this review that impacts those three dimensions, such as the cost of wasted raw material, use of cleaning material, the energy consumption, salary of food handlers, the water footprint, the amounts of rest-intake, production waste, energy density wasted, use of organic food, and food donation. Identifying these aspects can contribute to reduce FW impacts for better sustainable development, develop tools to measure FW, and assist food service managers in minimizing FW. Full article

Earlier scholarship provides important insights into the relationship of individual stories and narratives. Interactions with healthcare professionals and the healthcare system can often subsume the individual’s authority/agency. The patient’s narrative often gets lost in the elaborate web of doctor visits, referrals, medical records, case notes, etc. Online spaces such as Facebook, however, provide individuals with a platform through which they can understand, craft, and communicate their own personal illness narratives. Realizing this, this paper examines how the narratives of illness shared in illness-related Facebook groups help individuals make sense out of the disruption caused by their personal experience while residing in the ‘kingdom of the ill.’ To observe the construction and communication of these narratives, the researchers observed the activity of an online pulmonary embolism and deep-vein thrombosis survivor support group for one year. In this online space, individuals gained agency and authority in the construction of their own illness narratives. The findings of the research demonstrated both the importance of narrative in an individual’s health/illness journey as well as the need to further explore avenues that establish and bolster patient agency within the medical system. Full article

For public health policy and planning it is important to understand the relative contribution of environmental noise on health compared to other environmental stressors. Air pollution is the primary environmental stressor in relation to cardiovascular morbidity and mortality. This paper reports a narrative review of studies in which the associations of both environmental noise and air pollution with health have been examined. Studies of hypertension, myocardial infarction, stroke, mortality and cognitive outcomes were included. Results suggest independent effects of environmental noise from road traffic, aircraft and, with fewer studies, railway noise on cardiovascular outcomes after adjustment for air pollution. Comparative burden of disease studies demonstrate that air pollution is the primary environmental cause of disability adjusted life years lost (DALYs). Environmental noise is ranked second in terms of DALYs in Europe and the DALYs attributed to noise were more than those attributed to lead, ozone and dioxins. In conclusion, in planning and health impact assessment environmental noise should be considered an independent contributor to health risk which has a separate and substantial role in ill-health separate to that of air pollution. Full article