Search Results (119)

Patients with respiratory tract malignancies who undergo tracheostomy often experience profound psychosocial challenges related to visible anatomical changes and altered communication. The aim of this study was to evaluate psychosocial barriers and perceived social acceptance in patients living with a tracheostomy, compared with patients treated for similar cancers without requiring a tracheostomy. A matched case–control study with frequency matching at the group level was conducted including 150 patients with permanent tracheostomies and 150 matched controls treated with organ-preserving approaches. Groups were frequency-matched at the group level based on age, sex, primary tumor site, and disease stage at diagnosis. Participants completed a study-specific questionnaire assessing social withdrawal, self-consciousness, and perceived reactions of others using a five-point Likert scale. A composite Psychosocial Barrier Score was calculated, and subgroup analyses examined differences according to gender and age. Patients with tracheostomies demonstrated significantly higher psychosocial burden than controls, with markedly elevated composite scores and higher endorsement of stigma-related items. Female and younger patients within the tracheostomy group reported the greatest psychosocial difficulties, including increased social avoidance and reduced confidence in public settings. In contrast, gender- and age-related differences were minimal in the control group. These findings indicate that tracheostomy is strongly associated with heightened psychosocial barriers and perceived social stigma, particularly among younger and female patients. Integrating targeted psychosocial support into routine post-treatment care may be essential to improve social reintegration and quality of life in this population. Full article

Sustainable Development (SD) is a key concept of the modern era, presenting significant challenges for policymakers worldwide. Due to its holistic and complex nature, the empirical assessment of people’s perceptions about SD, as well as their dependence on different demographic variables such as gender, may become a difficult research task. This work first aimed at assessing the validity and reliability of data regarding adult perceptions about SD and subsequently at examining for gender differences by taking the case of Greek civil servants. Data collection was accomplished via the use of the Greek version of the Sustainability Consciousness Questionnaire (SCQ-GR), an instrument originally applied among Swedish young adults (18–19 years old). The sample consisted of 631 adults serving in the Greek public sector. The data showed excellent overall internal reliability by maintaining all 50 items of the original instrument. For testing data validity, the conduction of exploratory factor analysis (EFA) resulted in four main components, which collectively account for 69.41% of the total variance. Component 1, comprising 19 items, refers to “attitudes and behaviors” regarding SD. Component 2, comprising 18 items, refers to “beliefs” regarding SD. Component 3, comprising 8 items, pertains to “social-environmental activism” for SD. Finally, Component 4, comprising 5 items, refers to “attachment” to SD. The four components identified with EFA were used as input for conducting confirmatory factor analysis (CFA). The performance of CFA resulted in a model exhibiting a good fit to the data, thus providing strong additional evidence for its validity. Subsequently, evidence for configural, metric, scalar, as well as strict measurement invariance was obtained, thus allowing for meaningful comparisons between genders. Females were shown to outperform males in all components (with Cohen’s d effect sizes ranging between 0.216 and 0.383) except for the component referring to social–environmental activism, for which no statistically significant gender difference was observed. The good psychometric qualities of SCQ-GR provide strong support for its use in obtaining valid assessments of perceptions regarding sustainable development and possible influencing variables (such as gender) among Greek civil servants and potentially other adult groups as well. Full article

This perspective advances a psychoanalytic—embodiment account of the “libido of generativity” (LoG)—future-oriented reorganization of erotic desire that links embodied arousal with caregiving, legacy, and shared projects. We define LoG along four axes (direction of investment: dyad↔triad; temporal horizon: immediacy↔future; outcome modalities: procreative, creative–sublimative, community-forming; affective regulation: shame/guilt↔pride/gratitude). Integrating interoception, body ownership/agency, and self-compassion with reproductive mentalizing, we specify three proximal levers—embodiment, affect regulation, and representation—through which sexual mindfulness can recalibrate bodily salience, blunt shame-based self-objectification, and expand triadic representations (self–partner–child/symbolic offspring). We then translate these mechanisms into a brief, practice-ready relationship guidance (RG) curriculum (6–8 sessions) combining somatic mindfulness, compassion micro-practices, reproductive-mentalizing dialogs, communication skills, and generative rituals. We articulate falsifiable propositions (e.g., mindfulness → ↑couple satisfaction via ↓body-image self-consciousness and ↑reproductive mentalizing) and a sex/gender-attentive reporting plan (SAGER). Primary outcomes include sexual functioning/satisfaction and couple satisfaction/communication; secondary mechanistic endpoints index interoceptive accuracy/awareness (including heartbeat-evoked potentials), self-compassion, and reproductive mentalizing. By aligning contemplative practices with couple-skills training and equity-focused implementation, the LoG framework offers a testable bridge from psychoanalytic theory and embodiment science to measurable improvements in sexual health and couple well-being. Full article

This study examines the deconstruction of the Targum to Song of Songs, focusing on how binary oppositions and traditional interpretive frameworks are both challenged and reconfigured. While the targumists aim to prevent a potentially ‘sinful reading’ of the text, their interventions paradoxically recreate the possibility of a reading that could be considered ‘sinful’. They break down the boundaries between the spiritual and the physical, and question the identity, number, and gender of the participants in the love relationship. In the Targum, the classical narrative structure is also deconstructed. Chronology and causality yield to traditional memory and consciousness, producing a repetitive, fragmented, mosaic-like pattern unlike conventional narratives. Moreover, a semantic layer already shaped by context and in dialogue with the meaning of the textual antecedent enters the interpretive horizon of tradition, reinforcing the prominence of ambiguity—similarly to the base poetic text. The targumic deconstruction illuminates the relativity of concepts and meanings and highlights the flexible interpretive possibilities inherent in tradition. It not only liberates the conceptions within the text but also frees the reader from constraints imposed by binary hierarchies of value. The conceptual liberation leads to the realization that God and the relationship with God cannot be approached or described in earthly terms. Full article

Scholars have long shown that post-separation abuse continues through legal channels and that legal institutions often reinforce existing social relations. Nevertheless, little is known about how abused mothers’ legal experiences shape their understanding of legality and how this dynamic may function to perpetuate coercive control. Drawing on in-depth interviews with 32 Israeli mothers co-parenting with abusive ex-partners, this study offers a phenomenological account of how post-separation abused mothers experience family law proceedings, based on a feminist imperative to bring their voices to center stage. The analysis reveals a dialectical legal consciousness comprising three interconnected orientations—characterized by internal contradictions and tensions that paradoxically serve to maintain rather than disrupt existing power relations: Institutional Trust and Disillusionment in the law’s protective promise, Institutional Asymmetry as experienced from the abused mothers’ perspective, and Recognizing Entrapment—the realization that legal processes reproduce the very dynamics they sought to escape. Abused mothers thus describe a paradoxical relationship with the law of both needing and distrusting a system that mandates continued contact with their abusers. Caught in a second-order abusive relationship, they feel compelled to comply with processes they perceive as harmful. We term this Entrapped Legal Consciousness—a form of legal subjectivity shaped by institutional norms that reconfigure resistance and reinscribe coercive control. This study offers empirical and theoretical insight into how legality may become a mechanism for cultivating continued control. Full article

Objectives: Hearing aids (HAs) are the most common intervention recommended for hearing loss (HL). Many adults with HL do not seek HA rehabilitation. Several studies have attempted to identify barriers and facilitators to using HAs. Different bureaucratic processes for acquiring HAs may lead to different barriers and facilitators. In addition, studies have not yet explored the factors influencing compliance with a recommendation for an HA consultation. This study focuses on the stage prior to consultation in a context where HAs are heavily subsidized. Methods: 148 patients who had undergone a hearing test during 2022 at Hadassah University Medical Center and received a recommendation to undergo a hearing aid consultation were contacted for a telephone survey. Seventy-two adults, 48 male and 24 female, aged 25–85 years, with HL ranging from slight to profound, responded to a telephone questionnaire. The questionnaire, based on two previously published English questionnaires and translated and adapted into Hebrew, was used to assess the main reasons a person did or did not comply with the recommendation to pursue an HA consultation. Results: HL was more severe in those who sought hearing rehabilitation. The main reasons for seeking hearing rehabilitation are the need and desire to hear better and pressure from others. The foremost reasons for not pursuing hearing rehabilitation are feeling that there is currently no need, esthetics, lack of time, and self-consciousness. No significant gender- or age-based differences were found. Conclusions: There are additional barriers to seeking HAs aside from cost and accessibility. Understanding the reasons for avoidance of hearing rehabilitation may help in developing strategies that encourage people to seek hearing rehabilitation and use HAs when the need exists. Full article

Background/objectives: Maternal adiposity is a known risk factor for adverse pregnancy outcomes, yet routine antenatal care primarily relies on body mass index (BMI), which has limitations. This study aimed to explore the acceptability of incorporating a broader range of adiposity measurements into early pregnancy antenatal care, assessing pregnant women’s perceptions to inform implementation strategies. Methods: A qualitative study using semi-structured interviews was conducted with 14 pregnant women purposively sampled to capture variation in BMI, age, and parity. Interviews occurred approximately 4–5 months post-measurement experience. The Theoretical Framework of Acceptability (TFA) guided thematic analysis of transcribed data, with independent coding to ensure rigour. Results: Participants generally viewed the current reliance on BMI as outdated and expressed neutral to positive attitudes toward the use of more detailed adiposity measurements. Most reported little emotional discomfort with the process. However, some reflected likelihood of more body self-consciousness had it been their first pregnancy. Time involved in measurements was not seen as burdensome, however waiting between procedures was a minor inconvenience. Self-assessing body shape was described as difficult. Women emphasised the importance of choice, autonomy, and informed consent, especially in relation to partner involvement, the gender of the anthropometrist, and the nature of the procedures. Clear, advance communication and supportive explanations during appointments were seen as essential to ensuring a positive experience. Conclusions: Expanding adiposity assessments in early pregnancy is acceptable to women if implemented ethically, prioritising consent, privacy, emotional safety, and effective communication. Integration into routine care requires staff training and pre-appointment guidance. Full article

Background: The purpose of this study was to quantify the incidence of polytrauma cases at a single-center county hospital in Croatia and evaluate the therapeutic approaches currently in use. Methods: Patient data for 54 individuals diagnosed with polytrauma between 2019 and 2022 were retrospectively reviewed using the hospital’s medical records system. The analysis encompassed several aspects, including injury mechanisms, injury timing, Glasgow Coma Scale scores, alcohol levels, therapies, triage classifications, and hospital stay durations. Results: In this study, patient age was not significantly associated with clinical presentation, treatment approach, or outcomes. However, gender showed significant associations with GCS, triage category, and discharge status, with female patients presenting more frequently with severe impairment (GCS 3–8) and higher triage urgency. Blood alcohol levels were more frequently elevated in male patients but showed no association with clinical severity or outcomes. Additionally, lower GCS scores were significantly linked to poorer outcomes, including higher in-hospital mortality, while surgical intervention was associated with longer hospital stays. Conclusions: Collectively, gender and level of consciousness significantly influenced triage urgency and outcomes, highlighting the need for targeted prevention and management strategies. Full article

Background: Animal-assisted activities (AAA) are participative interventions, designed to lower hospitalization-related stress and anxiety, enhance communicative readiness, improve quality of life and encourage human–animal interaction. The aim of the present study was to evaluate AAA effects in the context of intensive rehabilitation of patients with spinal cord injury (SCI), traumatic brain injury (TBI), stroke. Methods: AAA in this study were structured by a local specialized association, for small groups of patients (5/7 a time), biweekly; each session lasted 60 min. Each patient participated in 10 sessions of AAA. Evaluation rating scales were administered at T0 (before the first session) and T1 (after the last session, five weeks later) as follows: Neurobehavioral Rating Scale (NRS) in case of patient with stroke/TBI without disorder of consciousness; Hospital Anxiety and Depression Scale (HADS) for SCI patients. Results: A total of 50 patients concluded the study. NRS score for joined TBI and stroke populations varied from a T0 mean value of 32.34 [C.I. 26.83–37.35] to 17.21 [C.I. 12.66–21.76] (46.7%); this difference proved to be statistically significant (p = 0.000). Stroke patients had a 57.6% NRS lowering by mean 28.10 [C.I. 20.55–35.65] points to 12 [C.I. 6.6–17.36], which was significant (p = 0.000); similarly, TBI patients showed a mean decrease of 35.8% points from the initial 41.6 points [C.I. 37.29–45.93] to 26.76 [C.I. 21.94–31.59] (p = 0.002). As for HADS scores a smaller improvement was found in the cohort of SCI patients: anxiety registered a 1 mean point decrease at T1 (21.5%), from the initial 6.5 points [C.I. 3.80–9.34] to 5.1 ones [C.I. 3.17–7.11]. This variation was near the threshold of significance (p = 0.05). Depression domain, instead, improved by 2.35 mean points (37%), from the 6.35 initial points [C.I. 3.45–9.26] to the final 4 [C.I. 2.15–5.98] with reaching of a significant p value (p = 0.03). ANCOVA did not confirm this last value and showed no influence of age and gender on outcome variations. Discussion: AAA showed preliminary evidence to decrease neurobehavioral disorders in patients with high-complexity neurological diseases, particularly stroke and TBI. The role of AAA in SCI patients remains unclear. Future studies should address confounders’ role for these populations, particularly severity of disease. Furthermore, AAA interventions will have to be studied on larger samples, deepening the exact phase to introduce AAA for neurological patients. Lastly, qualitative studies are needed to explore patients’ lived experiences. Full article

Corporate boards play a pivotal role in shaping firms’ environmental strategies, yet the influence of board demographics, particularly director age, on sustainability outcomes remains insufficiently understood. This study investigates how the age profile of board members affects corporate environmental performance, including greenhouse gas emissions. Analyzing a comprehensive panel of 1843US publicly listed firms (17,218 firm-year observations) from 1996 to 2018, primarily through panel regressions with firm and year fixed effects, we find consistent evidence that firms with older boards tend to exhibit poorer environmental performance and higher direct, indirect and value chain greenhouse gas emissions. We argue that this relationship is driven by age-related differences in risk tolerance, time horizons, and sensitivity to environmental concerns. Additionally, the study explores moderating factors such as poor governance oversight (board co-option), pressure for profitability from institutional ownership, CEO social and environmental consciousness (CEO gender), and managerial ability, revealing that these governance dynamics significantly influence the strength of the director age–environmental performance link. The results, robust to endogeneity concerns, underscore the importance of considering age diversity and board refreshment in corporate governance to foster more effective environmental stewardship. These insights offer valuable implications for board members, corporate leaders, and policymakers aiming to advance sustainable business practices, but also open up opportunities for further exploration in alternative institutional contexts. Full article

Black gay and bisexual older men face numerous barriers across the life course that can contribute to negative health and well-being as they age. Drawing on strengths-based social determinants discussed in the health literature and literature on intersectionality, justice, and critical consciousness, this study examines qualitative data from seventeen Black gay and bisexual older men about sources and strategies of resilience and thriving amidst intersecting systems of power and oppression that shape health inequities. The findings revealed an evolution of positive support networks across their life courses, including biological family and families of choice such as “houses” and support groups. Early and ongoing negative experiences relating to intersecting positionalities (e.g., race, gender, sexual orientation) also provided sources of strength and resilience. Participants identified three strategies for building resilience and thriving: naming external ignorance, acknowledging common struggles, and reconciling contradictions. These strategies reflected various levels of critical consciousness that helped them navigate complex and intersecting systems of power that they encountered as Black gay men across the life course. Overall, the findings underscore the importance of considering intersecting systems of power and critical consciousness when examining resilience and social determinants of health and contribute new insights on a vastly understudied population. Full article

Background: It is estimated that in Italy, there were 364,000 new diagnoses of neoplasms each year and that the overall incidence of blood cancers was 10% of these. Leukemia and lymphomas represented the ninth and eighth places, respectively, among the causes of death from neoplasia. Hematopoietic stem cell transplantation represented an effective treatment option for many of these malignancies, and not only that: benign and congenital diseases could also be treated. Objective: To assess knowledge among the Apulian population regarding stem cell donation and factors that could influence this choice, focusing especially on the knowledge of the residents of Puglia, Italy on how stem cells were harvested and their functions, their reasons for joining the National Registry, and the reasons that hold them back from making such a choice. Study Design: An observational and cross-sectional study was conducted, through snowball sampling methodology, until data saturation. An online survey was conducted, which included several Italian associations. The questionnaire administered contained five main sections, such as sociodemographic data, knowledge of the existence of National Registries and their adherence, the nationwide presence of various associations that promote donation, knowledge with respect to the structure, use and functions of stem cells, sources of procurement, such as bone marrow, peripheral blood and umbilical cord, and related procedures, beliefs, attitudes, values, and opinions of the Italian population regarding the topic, and degree of information and education regarding bone marrow donation. Results: A total of 567 Apulian citizens were enrolled. Of these, 75.3% were female and 96.8% were aged between 18 and 65 years. Most of participants were single (46.9%) and married (47.3%) and had a diploma (44.4%), and less had a degree (35.8%). Significant differences were recorded between gender, singles, and married participants, and participants with a diploma or a degree and the items proposed. Conclusions: A true culture of donation in our region was not clearly spread. Although something has been accomplished in recent years in terms of deceased donor donation, still a great deal needs to be achieved for living donation, which encountered a great deal of resistance. It has been deemed necessary to seek winning solutions to this issue in terms of communication and information campaigns, raising awareness and empowering citizens to express consciously their concerns about organs and tissues and to stand in solidarity with those who suffered. Full article

The decline in colorectal cancer (CRC) due to screening success in the U.S. is inconsistent across populations and age groups. CHamorus (Chamorros) and Filipinos constitute minorities in the U.S. but comprise over 70% of the population in Guam where steep increases in CRC incidence occur before the age of 50, and only 53.9% of persons have met national screening standards. This preliminary study explored knowledge, cultural beliefs, and age-specific recommendations associated with CRC and screening. Five focus groups segregated by age and gender were conducted with persons aged 40 and above. Data were collected on knowledge, attitudes, beliefs, and screening education recommendations. Focus group participants (n = 25) were predominantly CHamoru (60%), Filipino (32%), and female (56%). The mean age was 55. Participants preferred interventions that integrated storytelling from CRC survivors with emphasis on family education rather than limiting to screening-age adults. Multicoders performed an iterative collaborative analysis for the main themes: knowledge of CRC/screening primarily derives from family experiences; increased outreach is needed for men; use of personal narratives; and screening is motivated by family values and intergenerational consciousness. Findings can inform future studies on age- and culturally-tailored early detection strategies to improve CRC screening participation in Pacific populations. Full article

The Druze community has survived for a thousand years, during which it witnessed the emergence of female political and religious leaders. However, the Isma‘ili foundations of the Druze religion favored women without offering them considerable rights. This study describes the political actions of women leaders who are considered unique and outstanding leaders in the history of Druze society. The women discussed in this article share some features: all came from an elite social background; all were endowed with outstanding leadership qualities, which gave them status and prestige in the community; and, in keeping with Druze female leadership, all were identified with female sanctity and spirituality. Additionally, these women were portrayed in folk stories and biographies as women characterized by boldness, courage, leadership, and especially charisma to lead in the public sphere and not just the private one, in contrast to what is expected of Druze women as belonging to the private sphere, the family. This article argues that the combination of the level of positive consciousness toward women in the Druze religion and the elite status of these women, in addition to being unique charismatic personalities in Druze society and in their era, explains how they acquired their leadership role in the Druze community. Furthermore, while engaging in social and political activism, these women never employed their privileged status to promote gender equality in their societies. Full article

Objectives: Direct innominate artery cannulation is a viable and effective alternative for arterial inflow during thoracic aorta surgery, applicable in elective and emergent cases. This technique ensures reliable circulatory control. Methods: A single-center retrospective study of 208 cases that underwent thoracic aortic surgery between January 2010 and December 2021 was performed. The primary outcomes were in-hospital and remote mortality and the secondary outcomes were adverse neurologic events. Results: The median age of the patients was 69 years. The male gender accounted for 63.9% of the cases. The most represented surgical interventions consisted of hemiarch replacement in 105 cases (50.5%) and ascending aorta and aortic valve replacement (wheat procedure) in 71 cases (34.1%). The operative mortality rate was 5.3%, with six cases attributed to aortic-type dissection. The overall remote mortality rate at five years was 7.7. Postoperatively, 70 patients experienced alterations in the level of consciousness, with 12 of these cases belonging to the dissection group. Six patients with permanent neurologic symptoms had a positive computed tomography scan. Of the eleven patients with negative brain computed tomography scans, nine experienced temporary neurological deficits, while two suffered from permanent neurological damage. Conclusions: Direct innominate artery cannulation represents a safe and effective method for providing arterial inflow during cardiopulmonary bypass, offering an outstanding alternative to traditional sites for both planned and urgent surgical interventions. Full article