Search Results (139)

Background/Objectives: This systematic review addresses the disproportionate impact of the opioid epidemic on American Indian and Alaska Native (AI/AN) populations by examining the socio-ecological and social network factors that influence opioid use and misuse. While previous reviews have largely focused on treatment modalities or structural determinants such as socioeconomic status and rurality, few studies have explored the role of social networks as risk or protective factors, particularly within AI/AN communities. Methods: Applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, the review synthesized findings from three scholarly databases (PubMed, EBSCOhost, ProQuest), six institutional repositories (e.g., Indigenous Studies Portal), and one academic search engine (Google Scholar). Studies that examined the influence of social network domains on opioid misuse in AI/AN populations in the United States, reported quantitative or qualitative data, and were published between 2010 and 2022 were included in this review. Study quality was assessed with the JBI Checklists for Analytical Cross Sectional Studies and Qualitative Research. Of the 817 articles initially identified, 7 met the inclusion criteria, with most studies focusing on AI/AN adolescents and young adults, a demographic shown to be especially susceptible to opioid misuse. Results: The review identified several social network domains that significantly affect opioid use patterns, including familial relationships, peer associations, community dynamics, educational influences, cultural traditions, social media engagement and the effect of historical and intergenerational trauma. These domains can function either as protective buffers or as contributing factors to opioid misuse. Conclusions: The findings underscore the necessity for future longitudinal research to elucidate the causal pathways between these social network factors and opioid behaviors, particularly concerning trauma and digital media exposure. Furthermore, the study highlights the importance of culturally grounded, evidence-based prevention strategies that address the multifaceted social environments of AI/AN individuals. Such approaches are critical to fostering resilience and mitigating the opioid crisis within these historically marginalized populations. Full article

Historical legacies of enslavement and apartheid structural violence underpin the societal fabric of Cape Town. Walking through the city of Cape Town, colonial reminders and bastions of white supremacy remain evident in statues, street names and the continued spatial apartheid present in the public space. Sites of intergenerational trauma remain scattered through the city, retraced and reclaimed through the efforts of community members, activists, artists and museums. This paper focuses on how race and memory are represented, resisted and challenged within popular culture in Cape Town, South Africa. Through considering museums and music as sites of public memory, this paper highlights how collective memory is being constructed in post-apartheid South Africa in ways that challenge white supremacist and colonial memory. Focusing on two case studies, the Iziko Slave Lodge and Youngsta CPT’s song YVR, this paper shows how colonial and apartheid conceptualisations of race are constantly being contested in post-apartheid popular culture to resist colonial memory and recreate new public memories. Full article

Background: Rib fractures are among the most common thoracic injuries following blunt trauma and are associated with significant morbidity, particularly in elderly and polytrauma populations. Historically managed non-operatively, recent advances have redefined the role of surgical stabilization of rib fractures (SSRF) in improving patient outcomes. The objective of this narrative review is to evaluate current evidence surrounding the management of rib fractures, with a focus on indications for SSRF, surgical techniques, special populations, and future directions in care. Methods: A narrative review of the literature was conducted, incorporating relevant randomized controlled trials, cohort studies, clinical guidelines, and expert consensus statements. Emphasis was placed on patient selection criteria, surgical strategies, multimodal analgesia, and emerging technologies. Results: SSRF has demonstrated benefits in short- and long-term outcomes, including improved pain control, reduced ventilator dependence, shorter ICU and hospital stays, and better functional recovery. These outcomes are most evident in patients with flail chest, severe displacement, or failure of conservative therapy. Minimally invasive techniques and 3D-printed implants represent promising innovations. Despite growing evidence, SSRF remains underutilized due to variability in institutional protocols and access to trained personnel. Conclusions: The management of rib fractures continues to evolve with increasing support for surgical intervention in select patients. Wider implementation of SSRF, guided by standardized protocols and advanced technologies, may improve outcomes and reduce complications in this high-risk trauma population. Full article

The aims of the current study included gathering cultural knowledge and stories regarding parenting young children within a Tribal community and learning community members’ perspectives on key components of a promising parenting prevention program. Qualitative data were drawn from a focus group including seven participants and semi-structured phone interviews with 21 additional participants, all of whom were parenting children in the community. Hybrid coding and applied thematic analysis revealed five themes: (1) Desire to Learn and Gain Parenting Skills; (2) Relationships and the Caregiver Role; (3) Culture and Caregiving, which included subthemes of Diversity Among Tribal Bands, Intergenerational Knowledge Sharing, and Reconnection and Revitalization; (4) Historical Trauma and Behavioral Health; and (5) Curriculum Terminology Considerations. The information gathered collectively informed the development of the culturally grounded stim’ aspuʔús (What’s in Your Heart?) parenting program. This addresses the great need for culturally grounded interventions to support trauma healing within Indigenous families. The development process and implications for program development by and for Indigenous communities is discussed. Full article

This paper examines a previously unknown anonymous Hebrew letter inserted into a postwar edition of Shem HaGedolim, found in the library of the Jewish University in Budapest. The letter, composed in Győr in 1947, consists almost entirely of passages copied from Tiferet Chayim, a hagiographic genealogy of the Sanz Hasidic dynasty. Although derivative in content, the letter’s form and placement suggest it was not meant for transmission but instead served as a private act of mourning and historiographical preservation. By situating the letter within the broader context of post-Holocaust Jewish and Hasidic memory practices, including yizkor books, rabbinic memoirs, and grassroots commemorative writing, this study proposes that the document constitutes a “micro-yizkor”: a bibliographic ritual that aimed to re-inscribe lost tzaddikim into sacred memory. Drawing on theories of trauma, religious coping, and bereavement psychology, particularly the Two-Track Model of Bereavement, the paper examines the letter as both a therapeutic and historiographical gesture. The author’s meticulous copying, selective omissions, and personalized touches (such as modified honorifics and emotive phrases) reflect an attempt to maintain spiritual continuity in the wake of communal devastation. Engaging scholarship by Michal Shaul, Lior Becker, Gershon Greenberg, and others, the analysis demonstrates how citation, far from being a passive act, functions here as an instrument of resistance, memory, and redemptive reconstruction. The existence of such a document can also be examined through the lens of Maurice Rickards’ insights, particularly his characterization of the “compulsive note” as a salient form of ephemera, materials often inserted between the pages of books, which pose unique challenges for interpreting the time capsule their authors sought to construct. Ultimately, the paper argues that this modest and anonymous document offers a rare window into postwar Ultra-orthodox religious subjectivity. It challenges prevailing assumptions about Hasidic silence after the Holocaust and demonstarates how even derivative texts can serve as potent sites of historical testimony, spiritual resilience, and bibliographic mourning. The letter thus sheds light on a neglected form of Hasidic historiography, one authored not by professional historians, but by the broken-hearted, writing in the margins of sacred books. Full article

Romantic poetry is known to have engendered a potent discursive space in 19th-century Europe, wherein national aspirations, personal tragedies, and mythic narratives coalesced. This study examines the recurring images of the “galloping horse” and the “self-sacrificing cavalryman” in 19th-century Romantic poetry in the context of a common poetic myth shaped around the themes of national identity, spiritual transcendence, and historical destiny. The present study focuses on Adam Mickiewicz’s “Faris” and Nikoloz Baratashvili’s “Merani”, employing a comparative literary and philosophical approach to analyze these two works. This study reveals that “Faris” presents a messianic call around the ideal of freedom of the Polish nation, while “Merani” is structured as an individual tragedy and inner journey. Both poems are positioned within a broader poetic paradigm that can be called the “Faris” Cycle, and they can be compared thematically and imaginatively with the works of Goethe, Petőfi, Sully Prudhomme, and Vazha-Pshavela. This study explores the aesthetic and intellectual dimensions of intercultural interaction by analyzing the poetic transitions between the two poles of the Romantic paradigm: collective hope and individual melancholy, action, and inner intuition. By tracing the interplay between national poetics and universal archetypes, this manuscript investigates how such interaction facilitates the symbolic transformation of historical traumas. Full article

The management of penetrating rectal trauma has evolved from a historic 4-D algorithm (Divert, Drain, Direct repair, and Distal washout) to a more selective approach. This case report describes a patient with multiple wounds, including a high-grade extraperitoneal rectal injury resulting from a pelvic explosive injury. The patient was successfully treated with intraluminal vacuum therapy (ILVT). This case highlights ILVT as a novel method for managing complicated blast-related rectal injuries. While there are limited publications on combat-related penetrating rectal injuries that provide evidence-based guidelines, we suggest an aggressive surgical approach combined with negative pressure wound therapy for optimal patient outcomes. Full article

This article examines Marcel Janco’s Holocaust drawings, positioning them within the broader discourse of Holocaust representation, trauma, and avant-garde aesthetics. Created in response to the Bucharest Pogrom of January 1941, these works resist both forensic realism and pure abstraction, instead embodying rupture, instability, and fragmentation. Janco’s grotesque distortions neither document events with the precision of testimony nor dissolve into conceptual erasure; rather, they enact the instability of Holocaust memory itself. This essay argues that Janco’s Holocaust works, long overshadowed by his modernist and Dadaist contributions, challenge dominant frameworks of remembrance. Through comparative analysis with artists, such as David Olère, Anselm Kiefer, and George Grosz, it situates Janco’s approach at the limits of witnessing, exploring how his figures embody violence rather than merely depict it. While Olère reconstructs genocide through forensic detail and Kiefer engages with the material traces of memory, Janco’s grotesque forms share an affinity with Grosz’s politically charged distortions—though here, fragmentation serves not as critique but as testimony. Furthermore, the study interrogates the institutional and critical neglect of these works, particularly within Israeli art history, where they clashed with the forward-looking ethos of abstraction. By foregrounding Janco’s Holocaust drawings as both aesthetic interventions and acts of historical witnessing, this article repositions them as crucial yet overlooked contributions to Holocaust visual culture—demanding recognition for their capacity to unsettle, resist closure, and insist on the incompleteness of memory. Full article

Between 1871 and 1969, Native Americans (American Indians) endured the U.S. Federal Indian Boarding School system, while Chinese Americans faced enduring impacts from the Chinese Exclusion Act (1882–1943). Drawing on historical sources, this paper examines literary works by and about Native Americans and Chinese Americans, focusing on their sufferings under forced isolation policies. Through works like Ceremony and Gardens in the Dunes by Leslie Marmon Silko and Eat a Bowl of Tea by Louis Chu, this study illustrates how systematic oppression, characterized by erasure of cultural identity, manifested through institutions such as “boarding school” and “bachelor society”. It explores how forced policies (like assimilation and isolation) and institutional oppression, through cultural erasure and the severing of family ties, dismantled family structures, weakened cultural transmission, and led to identity crises, inter-generational alienation, and psychological trauma in marginalized communities. These ethnic narratives not only document histories of oppression but also highlight the ethnic groups’ resilience and their efforts to reconstruct multicultural identity through cultural heritage and community ties under multifaceted pressures. Full article

This article offers insights into conceptualizing a different angle of cultural heritage in its intangible form and generational inheritance, in relation to migrant community bonds and their impacts on embodied stories of trauma and healing. This article aims to contribute to understanding how cultural and historical knowledge of heritage is passed from one generation to the next, with deep emotional impacts, whether trauma or self-development. While engaging in an interdisciplinary dialogue with Bion’s work, we explore nodes of divergence and convergence in how gendered and embodied migrant sexuality/identity stories of trauma and healing exemplify the call for research to engage with perspectives of social and cultural differences. This understanding of contested cultural heritage and how belonging can be achieved links to ethnic–ancestral/national consciousness, as well as the struggle to belong among first- and second-generation migrants. The empirical data draws from extensive ethnographic, multi-method, multi-sited, comparative, and narrative research conducted with first- and second-generation migrants. The analysis is situated within Bion’s theory and articulated through an interpretative interdisciplinary framework aiming to unravel the complexity of the phenomena of mobility and identity construction. This analysis exemplifies the power dynamics inherent in migrant inter/intragenerational relations shaped by cultural heritage. Full article

This review aims to summarize the evolution of surgical techniques for periacetabular metastatic cancer, assess their strengths and limitations, and clarify the corresponding indications. We conducted a comprehensive literature review on periacetabular metastatic cancer, summarizing surgical techniques involving both open and minimally invasive approaches. Additionally, we evaluated the indications for different minimally invasive techniques and proposed potential combinations of these techniques. Our review underscores the benefits of minimally invasive surgery, including reduced surgical trauma, improved patient mobility, lower complication rates, and expedited recovery times, facilitating earlier initiation of systemic cancer therapies. These techniques show substantial potential for broader application in the future. Despite the historical reliance on open surgery as the standard treatment, minimally invasive approaches are emerging as a promising alternative, particularly for managing osteolytic metastases around the acetabulum. This review provides insights into the optimal integration of these techniques, aiming to support evidence-based clinical decision-making and improve patient outcomes. Full article

Background: The term “medical mistrust” has increased in literary usage within the last ten years, but the term has not yet been fully conceptualized. This article analyzes the usage of the term “medical mistrust” in the extant literature in order to articulate its antecedents, attributes, and consequences. The aim of this article is to provide a preliminary conceptual definition and conceptual figure for medical mistrust. Methods: Walker and Avant’s method of conceptual analysis was used to extract concept attributes, antecedents, and consequences and define empirical referents. The databases PubMed, CINAHL, Scopus, and PSYCinfo and the Google search engine were used. Results: Medical mistrust is a social determinant of health fueled by a fear of harm and exploitation and is experienced at both the interpersonal, intergenerational, and institutional levels, reinforced by structural racism and systemic inequalities. Medical mistrust is antedated by historical trauma, socioeconomic disparities, medical gaslighting, traumatic medical experiences, maladaptive health beliefs and behaviors, and individual minority identities and is transmitted intergenerationally and culturally. The consequences of medical mistrust include the underutilization of health services, delays in diagnosis and care, poor treatment adherence, poor health outcomes, negative psychological effects, and an increase in the uptake of medical misinformation and maladaptive health behaviors. Conclusions: The findings of this concept analysis have important implications for healthcare providers, healthcare systems, and researchers, as well as healthcare policy makers. Full article

This study analyzes the award-winning documentary film Searching for Rodakis, directed by Kerem Soyyilmaz, produced in 2023. The aim of this study is the historic comprehension and analysis of this filmic narrative in the field of social–semiotic literacy and its utilization in historical studies for approaching issues of conflict in modern history, otherness, collective experience and trauma, and collective memory. The research material is the documentary Searching for Rodakis (produced by Denmark, Turkey 2023; screenplay/director, Kerem Soyyilmaz; duration, 57’), which received the following awards: Adana Golden Boll FF 2023 Turkey | Best Documentary, Thessaloniki International Doc. Festival 2023 Greece, Greek Film Festival Los Angeles 2023 USA, and Istanbul Documentary Days 2023 Turkey. As regards the historic context, the year of production, 2023, coincides with the 100th anniversary of the signing of the Treaty of Lausanne, where Turkey’s current borders were set and the “population exchange” legally sealed, i.e., the violent expulsion of 400,000 Muslims, citizens of Greece, many of whom spoke only Greek, and 200,000 Orthodox citizens of Turkey, who in the majority spoke Turkish. At the same time, the Treaty of Lausanne ratified and finalized the expulsion of approximately one million Orthodox who were forced to leave the Ottoman Empire, as well as 120,000 Muslims who had fled Greece since the beginning of the Balkan Wars (1912–1913). About two million people were deported and lost their citizenship and property, in the context of “national homogeneity” (which connotes an ethnic cleansing), with the official states ignoring the criticisms of lawyers and academics who spoke of violations of constitutional rights. Mohammedan Greeks, estimated at around 190,000 as early as 1914, based on ecclesiastical statistics in the Pontus region, did not receive attention from the provisions of the Treaty of Lausanne, even though linguistically and culturally (origin, customs, culture and traditions) they did not differ in any way from the Orthodox Greeks. In Turkey, there was general indifference to the thousands of desperate people who arrived, with the exception of a few academics and the Lausanne Exchange Foundation. The filmic scenario is as follows: as a Greek tombstone of unknown origin is discovered underneath the floorboards in an old village house in Turkey, an almost forgotten story from the country’s creation unravels—the forced population exchange between Greece and Turkey in 1923. The engraved Greek letters tell of a woman, Chrysoula Rodaki, who died in 1887. Thus the search for her descendants begins. It leads director Kerem Soyyilmaz to local archives, where his own family’s role in history is laid bare; to abandoned ghost towns, and through the memories of older villagers—all while Soyyilmaz meets massive support for his quest from Greeks on the other side of the border. The stone becomes a portal to the past—and for a while, the trauma becomes redeemed when the previous owners of the village house return. Searching for Rodakis is a movie that reconnects people, culture, and the stories that were discarded in order to build a strong, nationalist state—told through the director’s personal experiences. The research questions, as they arise from the cinematographic material itself, are as follows: How is the historical memory of traumatic events of the previous century, such as the exchange of populations according the Treaty of Lausanne, recorded in the cinematographic narrative? What are the historical sources? To what extent did the origin, ethnicity, and geographical location of the narrators as participants influence the preservation of historical memory and the historical research? What are the criteria of the approach of the creator, and what are the criteria of the participants? Methodologically, we apply historic and socio-semiotic analyses in the field of public and digital history. The results: The types of historical sources found in filmic public discourse include the oral narration of testimonies, of experiences and of memories, as well as the director’s historical research in state archives, the material cultural objects, and the director’s digital research. Thus, historic thematic categories occur, such as the specific persons and actions in Turkey/Greece, actions on-site and in online research, and the types of historical sources, such as oral testimonies, research in archives, and objects of material culture. Sub-themes such as childhood, localities and kinship also emerge. These cinematic recordings of biographical oral narratives as historical and sociological material help us understand the political ideologies of the specific period, between the years 1919 and 1923. The multimodal film material is analyzed to provide testimonies of oral and digital history; it is utilized to approach the historical reality of “otherness”, seeking dialogue in cross-border history in order to identify differences, but above all the historic and cultural similarities against sterile stereotypes. The historic era and the historic geography of the Greek and Turkish national histories concern us for research and teaching purposes a hundred years after the Treaty of Lausanne which set the official borders of the countries. Full article

Perioperative neurocognitive disorders (PNDs), including postoperative delirium, delayed neurocognitive recovery, and long-term postoperative neurocognitive disorders, present significant challenges for older patients undergoing surgery. Inflammation is a protective mechanism triggered in response to external pathogens or cellular damage. Historically, the central nervous system (CNS) was considered immunoprivileged due to the presence of the blood–brain barrier (BBB), which serves as a physical barrier preventing systemic inflammatory changes from influencing the CNS. However, aseptic surgical trauma is now recognized to induce localized inflammation at the surgical site, further exacerbated by the release of peripheral pro-inflammatory cytokines, which can compromise BBB integrity. This breakdown of the BBB facilitates the activation of microglia, initiating a cascade of neuroinflammatory responses that may contribute to the onset of PNDs. This review explores the mechanisms underlying neuroinflammation, with a particular focus on the pivotal role of cytokines in the pathogenesis of PNDs. Full article

Knee post-traumatic osteoarthritis (PTOA) often develops in younger populations following anterior cruciate ligament (ACL) rupture, accounting for 12% of all symptomatic osteoarthritis (OA). The current literature implicates gait asymmetry in late-stage knee OA progression; however, early-knee PTOA development involvement is ill defined. This study explored gait asymmetry involvement in early-stage knee PTOA following ACL ruptures. Gait asymmetry, measured as asymmetry in duty factor (relative contact time), and joint loading data were collected, using infrared-camera motion capture and Kistler force plates for participants exhibiting either historical ACL ruptures (ACL+; n = 4) or no previous joint trauma (ACL−; n = 11). Joint loading measures included external knee adduction moment (EKAM) and external knee flexion moment (KFM), early (peak 1; EKAMp1 and KFMp1) and late (peak 2; EKAMp2 and KFMp2), stance peaks (Nm/kg), and respective time integrals (Nm·ms/kg; iEKAMp1, iEKAMp2, iKFMp1, and iKFMp2). ACL+ exhibited greater asymmetrical duty factor (78% difference) and greater joint load differences: EKAMp1 (26%), EKAMp2 (49%), KFMp1 (37%), iKFMp1 (44%), and iKFMp2 (60%). Significant relationships were found between duty factor asymmetry and both KFMp2 (R² = 0.665) and iKFMp2 (R² = 0.504). These preliminary data suggest gait asymmetry-induced joint loading may contribute to knee PTOA progression, but further research with increased sample sizes and the quantitative assessment of cartilage status is required. Full article