Search Results (119)

Existing research has predominantly framed defensive silence as an avoidance response to interpersonal mistreatments. Moving beyond this view, this study theorizes defensive silence as a proactive strategy for managing interpersonal relationships through the lens of sociometer theory. We posit that workplace ostracism will reduce employees’ organization-based self-esteem (OBSE), which in turn increases their subsequent defensive silence to avert further damage to relationships. In addition, we also expect a moderating role of the sense of power in mitigating the negative impact of workplace ostracism on OBSE. Based on the multi-wave, multi-source data of 345 employees and their 82 immediate supervisors, we tested all the hypotheses. Results from multilevel modeling indicated that OBSE mediated the indirect effect of workplace ostracism on defensive silence, and also supported the moderation role of sense of power. Our theoretical model provides a novel perspective that deepens the understanding of defensive silence and suggests implications for managerial practices. Full article

Healthcare abuse is a critical human rights and public health issue, particularly impacting medical interns and trainees who are vulnerable to mistreatment during their formative professional years. This cross-sectional study, conducted from February to June 2024, evaluated the prevalence and psychological impact of harassment and discrimination among 463 healthcare interns in Saudi Arabia from various specialties, including medicine, nursing, pharmacy, and dentistry. Using a self-administered online questionnaire, we found that mistreatment was widely reported, with female interns experiencing significantly higher rates of sexual harassment and gender-based discrimination. Common perpetrators included residents, lecturers, professors, nurses, and patients, with incidents most frequently occurring in surgical and internal medicine departments. Despite high prevalence, only 9% of interns reported the abuse due to mistrust in reporting systems or failure to recognize the behavior as abuse. These experiences were associated with significant psychological distress, including frustration, reduced motivation to learn, and higher DASS scores, particularly among female interns. The study underscores the need for institutional reforms, including policy development, cultural change, and effective reporting systems to ensure a safe and supportive learning environment for future healthcare professionals. Addressing abuse in medical training is essential for individual well-being and the sustainability and integrity of healthcare systems. Full article

Viral conjunctivitis is a highly contagious ocular condition that significantly impacts patient quality of life and healthcare resources. Despite its self-limiting nature, the condition remains a significant public health concern due to its high transmissibility, prolonged symptoms, and potential complications such as subepithelial infiltrates (SEIs). This review aimed to synthesize and evaluate current management strategies for adenoviral conjunctivitis and provide an evidence-based treatment framework. A systematic literature search of PubMed and the Cochrane Library was conducted, identifying 25 eligible studies published between 2009 and 2024 that focused on clinical interventions including supportive care, antiseptics, corticosteroids, antivirals, and immune modulators. The findings indicate that while supportive therapy and hygiene measures remain central to care, antiseptic agents, specifically povidone–iodine, and topical steroids offer additional benefit in reducing symptom duration and complications. Combination therapies integrating antiseptics, corticosteroids, and immunomodulators show promise for more severe cases, especially those complicated by SEIs. This review proposes an evidence-based comprehensive, multimodal approach management algorithm while highlighting the need for future research in antiviral development and diagnostic innovation to avoid mistreatment and unnecessary antibiotic use. Full article

The prevalence of stroke in patients with migraine is higher than in the general population, suggesting certain shared mechanisms of pathogenesis. Migrainous infarction is a pronounced example of the migraine–stroke connection. Some cases of migraine with aura may be misdiagnosed as stroke, with subsequent mistreatment. Therefore, it is important to identify these shared mechanisms of pathogenesis contributing to the migraine–stroke connection to improve diagnosis and treatment. Sirtuins (SIRTs) are a seven-member family of NAD⁺-dependent histone deacetylases that can epigenetically regulate gene expression. Sirtuins possess antioxidant properties, making them a first-line defense against oxidative stress, which is important in the pathogenesis of migraine and stroke. Mitochondrial localization of SIRT2, SIRT3, and SIRT4 supports this function, as most reactive oxygen and nitrogen species are produced in mitochondria. In this narrative review, we present arguments that sirtuins may link migraine with stroke through their involvement in antioxidant defense, mitochondrial quality control, neuroinflammation, and autophagy. We also indicate mediators of this involvement that can be, along with sirtuins, therapeutic targets to ameliorate migraine and prevent stroke. Full article

Interpersonal workplace mistreatment (IWM) is a pervasive issue with varied co-worker reactions. Despite significant growth in IWM research, understanding co-workers’ responses remains challenging due to scattered research streams and a focus on isolated components. Therefore, this integrative review synthesizes the existing literature to examine when and how co-workers respond to IWM. We identify key factors influencing both the intention and actual behavior of co-workers when initially witnessing IWM. These factors are categorized into eight overarching individual (perceived responsibility, emotion and affect, personal characteristics) and contextual themes (social relationships, risks and costs considerations, workplace characteristics, target characteristics, characteristics of the perpetrator and the act of IWM). By integrating these factors into a comprehensive framework drawing on dual processing accounts, we highlight the complex interplay between cognitive and affective processes in shaping co-worker responses. Understanding these dynamics is crucial for designing effective intervention programs that encourage co-workers to counteract IWM. Our findings offer valuable theoretical insights and practical implications for fostering a more supportive and just workplace environment. Full article

Donkeys were traditionally used as draft animals for transporting cargo, as a means of transportation, and for riding purposes before the advent of mechanization. Following this historical shift, their economic significance declined, making them targets for other industries, such as Chinese industries that use donkey skin to extract gelatin (ejiao). Since donkey slaughter is not a regulated activity in Brazil, the welfare and survival of donkeys are increasingly at risk as demand for their skins rises. Complaints filed by public agencies in Brazil have raised concerns about the donkey slaughter chain in the country, questioning whether this production system operates under regulated standards or follows an extractive model. The objective of this study was to evaluate the production system of donkeys destined for slaughter in Brazil through physical and hematological assessments, aiming to identify potential systemic failures that may compromise animal welfare. To achieve this, physical and hematological evaluations were conducted on a group of 104 abandoned donkeys. The physical assessments aimed to determine the animals’ sex, estimate their age, and evaluate their body condition score (BCS). These were conducted through examination of the genital organs and dental arcades, with the neck evaluated using a scale from 0 to 4 and the body condition assessed using a scale from 1 to 9, respectively. Hematological assessments included the measurement of hematocrit (HT), total plasma protein (TPP), and plasma concentration of fibrinogen. Most of the donkeys were entire males (n = 50–48.08%), with a median age of 15.1 years. The body condition score was 2 or 3 (n = 36, 52%), and the neck condition score was 1 (n = 3, 37.5%). The majority of animals had hematocrit levels above 25%, total plasma protein levels below 7.5 g/dL, and fibrinogen levels exceeding 400 mg/dL. Based on the data analysis, the animals were characterized as being in poor health, since all groups exhibited altered body and neck condition score, plasma fibrinogen concentration, and total plasma protein. These parameters may be indicative of malnutrition and systemic inflammation, even though other laboratory results showed no signs of disease. Activities characterized by mistreatment contribute to an unsustainable extractive model. Full article

Work is a key social determinant of mental health, and adverse organizational conditions in healthcare settings increase psychosocial risks. Leadership influences workplace well-being, yet its impact on mental health and gender inequalities remains underexplored. Despite the feminization of the health sector, disparities persist in leadership access, role expectations, and work–family reconciliation, exacerbating occupational stress. Aims: This study examines leadership practices in public hospitals, focusing on their relationship with mental health, organizational dimensions (recognition and role stress), and gender disparities. It explores the perspectives of both workers and managers to understand how leadership shapes workplace conditions and well-being. Methods: A qualitative, cross-sectional study was conducted as part of the FONDECYT project 1220547. Semi-structured interviews were conducted with 64 workers from public hospitals in Santiago, Chile, including clinical and administrative staff. The analysis supported by Grounded Theory identified key categories: constructive and destructive leadership, recognition, role stress, and gender disparities in leadership. Results: Constructive leadership—characterized by communication, fairness, and recognition—was linked to a healthier work environment and improved well-being. In contrast, destructive leadership (characterized by abuse of power and imposition, or inaction, lack of support, and absence of effective direction) contributed to role stress, workplace mistreatment, and job dissatisfaction. Recognition was a crucial but insufficient motivator, as the lack of formal mechanisms led to frustration. Role stress emerged as a significant risk for well-being, with subordinates experiencing overload, ambiguity, and conflicting expectations. Gender inequalities persisted as women faced more tremendous barriers to leadership and difficulties balancing work and family responsibilities. Workers and managers had differing perspectives, with subordinates prioritizing fairness and recognition while managers emphasized operational constraints. Conclusions: Leadership training should emphasize trust, equity, and recognition to enhance workplace well-being. Institutional policies must address role stress, strengthen formal recognition systems, and promote gender equity in leadership. Future research should integrate quantitative methods to explore leadership’s impact on organizational conditions and mental health outcomes. Full article

Loneliness is one of the most prevalent problems faced by older nursing homes (NHs) residents. Technical Directors (TDs) of NHs can play an important role in combating loneliness, so it is important to understand how they perceive this phenomenon. This study aimed to describe the perceptions of TDs about factors associated with loneliness and relevant areas of training and intervention. A total of 163 TDs (mean age = 42 years; 90% female) filled an online survey. The main NHs factors related to loneliness were residents’ mental and physical health problems; mistreatment in care provision; poor relationships between residents, with staff and family/friends; loss of loved ones; and family members’ work schedules and their geographical distance. Intervention domains that need to be improved were the policy of greater proximity to families and community, partnerships with the outside world, civic participation by residents, technical team diversity, and increase of staff/resident ratio. Dementia care, stress management, crisis intervention, person-centered care, and coping with death/bereavement were identified as relevant themes in professional training. This study appears as a relevant contribution to the deepening of knowledge not only about the phenomenon of loneliness among older residents in NHs, but also about the perceptions of TDs regarding this problem. Full article

In the United States (U.S.), Latina transgender women (LTW) are highly burdened by HIV and are prioritized for pre-exposure prophylaxis (PrEP). This study explored intersectional barriers and facilitators to PrEP uptake among LTW. Between February–November 2022, in-depth interviews were conducted with 27 LTW in the LITE Study. Participants were purposively sampled from 196 LTW in the cohort based on PrEP uptake (PrEP-naïve n = 8, PrEP-eligible and not user n = 5, current PrEP user n = 6, previous PrEP user n = 8). We conducted content analysis guided by a Modified Social Ecological Model and Intersectionality Framework. The mean age of participants was 32.3 (SD = 12.9). Themes were: (1) Intrapersonal: Medical distrust, acceptability of PrEP modalities, and concerns about long-term health; (2) Interpersonal: Mistreatment in healthcare, discrimination-related healthcare avoidance, difficulty finding trans-competent providers, language barriers, and shame and stigma; and (3) Structural: PrEP in the context of limited access to gender-affirming care and widespread silicone use, immigration status, economic marginalization, lack of community outreach, transphobia and anti-transgender legislative contexts, and xenophobia. This study found multilevel intersectional barriers influence PrEP uptake and persistence. Culturally tailored HIV prevention efforts are needed to address LTW-specific barriers, provide information on programs subsidizing PrEP, and implement policy change to ensure equitable PrEP access. Full article

Background: Sandifer’s syndrome is an uncharacteristic symptom of gastroesophageal reflux disease (GERD). It is often misdiagnosed as epilepsy. Paramedics can play a crucial role in recognising the differences between Sandifer’s syndrome and epilepsy. Therefore, education is important to reduce the likelihood of misdiagnosis and the mistreatment of patients. This purpose of this study is to provides information and guidelines for collecting patients’ medical history and identifying the most common symptoms, which support pre-hospital suspicion of Sandifer’s syndrome. Methods: The study consisted of a clinical case study, concerning the management of the emergency team, in a 7-week-old child with symptoms indicative of an epileptic seizure. Results: The clinical case analysis showed that a thorough examination of the patient helped to rule out epilepsy in the child and observed the characteristic symptoms of Sandifer syndrome. While assisting the child, a rare symptom of apnoea was also observed. Conclusions: The role of the paramedics in diagnosing Sandifer’s syndrome can be crucial. Their experience and knowledge of emergency situations, as well as correctly conducted tests during and immediately after ailment symptoms, can provide medical teams with key information that can help in making a correct diagnosis. The presented framework can be helpful. In the majority of cases, a correct diagnosis leads to the complete cessation of symptoms and lowers the risk of side effects from unnecessarily applied anti-epilepsy medication. Full article

Background/Objectives: Child protection from any form of physical or mental abuse or mistreatment is a fundamental right. The scientific literature supports that evidence-based interventions, such as the “Zero Violence Brave Club”, contribute to reducing school bullying by promoting a culture of zero tolerance for violence in diverse educational contexts, regardless of socioeconomic or cultural characteristics. This research aims to analyze how the prevention model, supported by evidence-based interventions with social impacts, is implemented in six schools and to evaluate its impact on child protection and its positive effects on children’s health. This study focuses on schools that adopt a clear stance against violence and implement prevention measures aligned with evidence-based guidelines, such as those established by the recent MeToo Schools movement. Methods: To achieve this, fieldwork was conducted, including in-depth interviews with 13 educational community members. Results: The findings show that the studied schools applying SESI-based interventions prevent violence, strengthen child protection, and enhance the health and well-being of children. Conclusions: This research highlights the importance of implementing evidence-based programs such as the Zero Violence Brave Club (ZVBC), contributing not only to the prevention of violence but also to the improvement of students’ health and well-being, offering schools a tool to position themselves as a safe space for children. Full article

Background/Objectives: Acute Limb Ischemia (ALI) is a vascular emergency which is accompanied by a significant risk of limb loss or even death. Rapid restoration of arterial perfusion using surgical and/or endovascular techniques is crucial for limb salvage. Undeniably, an accurate and prompt diagnosis is the first step to improve patient prognosis. The typical clinical presentation is not always present and the variety of symptoms may result in non-vascular specialists missing the diagnosis. Methods: In this single-center retrospective descriptive study, we reviewed all patients hospitalized between January 2018 and January 2024 for ALI. Patients who were initially misdiagnosed, causing a delayed diagnosis > 24 h, and who therefore did not receive timely treatment, were identified. Moreover, patients with a timely diagnosis of ALI who were treated in our institution during the same time period were collected. Results: Among 280 ALI patients, 14 were initially misdiagnosed. The median time from initial symptoms to definite diagnosis was 38.8 days (range 1.5–365). Several specialties such as orthopedic surgeons, neurologists, and general practitioners were involved in patients’ initial assessment. Three patients underwent primary amputation due to irreversible ALI, while nine underwent revascularization and one conservative treatment. Thirty-day limb salvage rate was 9/14 and thirty-day mortality was observed in one patient. Secondary interventions were needed in 65% of these cases. Patients with a delayed ALI diagnosis, when compared to those with a timely diagnosis, presented a significantly lower limb salvage rate (65% vs. 89%, p-value = 0.02) and a significantly higher rate of reinterventions (65% vs. 18%, p-value < 0.001). Conclusions: Many patients with ALI are primarily referred to non-vascular specialties. Misdiagnosed and mistreated ALI negatively affects outcomes. Full article

Due to harmful narratives within child welfare and child protection services and systems, mothers in contact with these services who aim to meet the symbolic representation of the ‘ideal mother’ frequently find themselves being portrayed as the ‘bad mother’, even when their referral is ‘non-traditional’ (i.e., not specifically due to their perceived harmful actions or inactions). Through ‘ideal mother’ symbolism and narratives, there is disenfranchisement of service-engaged mothers; they are mistreated by services, which is normalised by wider discourses around motherhood. Mothers within these child welfare systems consistently experience judgement, the problematising of their parenting practices, and disempowerment despite not being the direct cause of harm to their children. This creates a sense of shame and makes the injustice of mothers’ experiences within child welfare systems invisible. This is a conceptual paper combining data generated from previously published work and a lived experience example (work with young mothers; mothers in contact with the criminal justice system; mothers with children who cause harm; and those with children experiencing extra-familial harm) using qualitative, participatory, and action-based approaches, and through emancipatory interview processes, disenfranchised mothers described their contact with child welfare and child protection systems as a source of structural, political, and/or societal injustice. Thus, such qualitative emancipatory work provides ways to acknowledge mothers in contact with child welfare services due to non-traditional harms, as they are a disadvantaged group who are too often disempowered to action change. Thus, we argue that participatory and action-based research should be a preferred method of exploring mothers’ experiences of child welfare systems, opening routes for reforming, as well as understanding systematic potential of services as oppressive and problematising rather than supportive and empowering. Full article

This article focuses on a little-studied short story from Jewish American writer Cynthia Ozick, “What Happened to the Baby?” It explores the narrative elaboration of a distinctly feminine trauma—that of a mother in mourning whose grief is not acknowledged in a patriarchal context. My approach uses close readings and psychoanalytical insights to understand the female protagonist’s voiceless rage. The narrator of the framing narrative is a young woman trying to understand a mysterious family trauma—how little Henrietta, the daughter of her uncle Simon and his ex-wife, Essie, died. The starting point of the story is a distorted version of the accident, told to the narrator by her mother, Lily, and according to which it is Essie’s mistreatment that caused the little girl’s death. Through the narrative, the narrator encourages Essie to tell her own side of the story. In the embedded narrative, the mother reveals that it was in fact the father’s negligence that caused the death of their child. Father and mother subsequently develop differing models of mourning. Simon, a linguist, creates a whole new idiom enabling him to keep commemorating the dead child. In contrast, Essie, the mother, is determined to destroy any discourse that might account for her trauma, and to undermine the father’s very public mourning process. The narrator acts as a kind of therapist, allowing Essie’s discourse on loss to emerge after decades of repression. On the masculine/feminine, father/mother binary axis, I will observe, based on the study of this fascinating short story, that the father’s mourning involves mastering language, while the mother experiences loss through the sheer inability to speak up—at least until the narrator, Vivian, empowers her by giving her a voice. Full article

Background: Exposure to traumatic experiences has been positively associated with college students’ academic difficulties and psychological distress. However, little is known about the traumatic events experienced by Hispanic college students. This study examined the types of lifetime traumatic events experienced by Hispanic college students, including immigration enforcement-related events, and the association between events and psychological distress. Methods: College students (N = 1112) completed self-reported measures assessing lifetime traumatic experiences, post-traumatic stress disorder (PTSD) symptoms, and depression symptoms. Results: Most participants (81%) were born in the US, and most (84%) reported that at least one parent was foreign born. Hispanic students reported similar types of traumatic events reported by the general population of college students in previous studies. In addition, many students reported immigration-related potentially traumatic events. The following types of traumatic events were most strongly associated with greater levels of psychological distress: sexual assault or molestation, life-threatening illnesses or accidents, verbal abuse, physical or verbal bullying or mistreatment, directly experienced immigration enforcement events, and having witnessed physical or verbal abuse of someone close. Conclusions: It is important that clinicians use a broad definition of potentially traumatic events in the identification and treatment of Hispanic college students who may have experienced PTSD or depression symptoms following major life events, including immigration enforcement events. Full article