Search Results (329)

Intergenerational trauma significantly affects the health and mental health of African American families, particularly women whose lives are shaped by systemic inequities and historical oppression. This scoping review examines how trauma and resilience are transmitted across generations in African American communities, with a focus on dyads such as mother–child and mother–daughter relationships and a conceptual grandmother–mother–daughter triad. The review aims to identify mechanisms of trauma transmission and resilience and to inform culturally responsive, multigenerational interventions. Peer-reviewed studies published between 2012 and 2025 were identified that included African American caregivers and children and addressed biological, psychological, social, cultural, and resilience dimensions of intergenerational processes. Data were synthesized using a dimensional conceptual analysis approach. Findings indicate that intergenerational trauma is perpetuated through chronic stress and discrimination, maternal mental health challenges, family structure and caregiving strain, and cultural narratives about strength and self-reliance. At the same time, resilience is transmitted through sensitive caregiving, spirituality and faith, social and kin support, racial socialization, and economic survival strategies that draw on cultural and historical knowledge. These results underscore the importance of addressing intergenerational trauma holistically by integrating dyadic evidence within a broader conceptual triadic framework. Culturally responsive, multigenerational interventions that leverage family and community strengths and make space for emotional vulnerability are essential for interrupting cycles of trauma and fostering healing within African American families. Full article

For the Simeulue community, trauma does not remain a source of fear or psychological burden. Instead, it becomes a guideline for their survival. This study explores how societies reconstruct themselves through memory by examining smong, the local knowledge of the Simeulue community in Indonesia, as a cultural mechanism that transforms disaster experience into social resilience. Using a qualitative ethnographic approach, the research utilizes interviews, nandong and song lyrics, field notes, and historical documentation. The findings indicate that smong operates through interconnected layers of communicative and cultural memory: it is preserved in family stories, bedtime stories, artistic expressions, commemorative practices, and symbolic markers such as monuments and grave inscriptions. Through these processes, traumatic experiences are reframed as moral instructions and actionable knowledge that guide rapid evacuation, mutual aid, and collective vigilance during earthquakes and tsunamis. This study demonstrates that the reconstruction of the Simeulue community is driven not by a formal disaster management system but by practices rooted in culture. Past disaster experiences are continuously reinterpreted and integrated into everyday life. This highlights the importance of memory-based strategies for strengthening community resilience and offers directions for future research on intergenerational knowledge transmission, cultural adaptation, and disaster preparedness in oral societies. Full article

Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment disorder, with a lifetime prevalence estimated at approximately 10%. This narrative review explores the historical evolution, current management strategies, and emerging trends in CTS diagnosis and treatment. Early recognition of CTS led to the development of conservative interventions, including splinting, corticosteroid injections, and physical therapy, aimed at alleviating median nerve compression and associated symptoms. The advent of open carpal tunnel release established surgery as the definitive treatment for moderate-to-severe CTS, with subsequent refinements—such as mini-open and endoscopic techniques—focused on minimizing tissue trauma and expediting recovery. Comparative studies demonstrate similar long-term efficacy between surgical modalities, though endoscopic approaches often provide faster short-term recovery. Advances in diagnostic imaging, including high-resolution ultrasound, have improved early detection and dynamic assessment of median nerve compression. Emerging therapies, such as regenerative biologics, neuromobilization, and minimally invasive surgical innovations, offer promising adjuncts to current care. Despite substantial progress, further research is needed to clarify optimal patient selection, refine minimally invasive techniques, and explore regenerative interventions. This review underscores the importance of individualized, evidence-based, and patient-centered approaches to CTS management, integrating both established and emerging strategies to optimize functional outcomes and quality of life. Full article

Oxidative stress (OS) has gained substantial relevance due to its involvement in the pathogenesis of numerous systemic diseases. It is characterized by an imbalance between the production of reactive oxygen species (ROS) and the capacity of endogenous antioxidant systems to neutralize them. Various factors, including trauma, immunological alterations, and psychological stress, may contribute to this condition. The aim of this narrative review was to analyze OS markers and total antioxidant capacity (TAC) in asymptomatic and pericoronitis-associated impacted mandibular third molars (ITMs). This review examines the relationship between OS and impacted ITMs, highlighting the importance of timely clinical management to prevent chronic tissue damage. Current evidence indicates that OS biomarkers such as myeloperoxidase (MPO), malondialdehyde (MDA), uric acid (UA), and nitric oxide (NO) are elevated in patients with ITMs, including those classified as asymptomatic, and that a reduction in total antioxidant capacity (TAC) has been observed. The surgical removal of ITMs can effectively reduce OS levels. Following the procedure, oxidative markers typically return to normal within a relatively short period of time, and there is often a significant improvement in TAC. Full article

Background: Submacular hemorrhage (SMH) is a vision-threatening condition most associated with neovascular age-related macular degeneration (nAMD), although it may also arise from polypoidal choroidal vasculopathy, pathological myopia, retinal vascular diseases, trauma, and systemic factors. Rapid management is essential because subretinal blood induces photoreceptor toxicity, clot organization, and fibroglial scarring, leading to irreversible visual loss. The choice and urgency of treatment depend on hemorrhage size, duration, and underlying pathology, and the patient’s surgical risk category, which can influence the invasiveness of the selected procedure. This review aims to provide an updated synthesis of recent advances in the surgical and pharmacological management of SMH, focusing on evidence from the past five years and comparing outcomes across major interventional approaches. Methods: A narrative review of 27 recent clinical and multicentre studies was conducted. The included literature evaluated pneumatic displacement (PD), pars plana vitrectomy (PPV), subretinal or intravitreal recombinant tissue plasminogen activator (rtPA), anti-VEGF therapy, and hybrid techniques. Studies were analyzed about indications, surgical methods, timing of intervention, anatomical and functional outcomes, and complication and patient risk stratification. Results: Outcomes varied depending on the size and duration of hemorrhage, as well as the activity of underlying macular neovascularization. PD with intravitreal rtPA was reported as effective for small and recent SMH. PPV combined with subretinal rtPA, filtered air, and anti-VEGF therapy demonstrated favorable displacement and visual outcomes in medium to large hemorrhages or those associated with active nAMD. Hybrid techniques further improved clot mobilization in selected cases. Across studies, delayed intervention beyond 14 days correlated with reduced visual recovery due to blood organization and photoreceptor loss. Potential risks, including recurrent bleeding and rtPA-associated toxicity, were reported but varied across studies. Conclusions: Management should be individualized, considering hemorrhage characteristics and surgical risk. Laser therapy, including PDT, may serve as an adjunct in the perioperative or postoperative period, particularly in PCV patients. Early, tailored intervention typically yields the best functional outcomes. Full article

Objectives: Telemedicine has rapidly expanded in oral and maxillofacial surgery (OMFS), especially during the COVID-19 pandemic, but its specific roles and limitations across the care pathway remain unclear. This narrative review aimed to map telemedicine modalities and indications in OMFS, summarize reported outcomes, and identify priorities for future research. Methods: A narrative synthesis was undertaken after a systematic search of medical and engineering databases to 10 October 2025. Studies applying telemedicine, telehealth, telepresence or teleradiology to OMFS practice were eligible, including trials, observational cohorts, technical reports and surveys. Data were extracted in duplicate and organized thematically; heterogeneity precluded meta-analysis. Results: Fifty studies met the inclusion criteria. Telemedicine was mainly used for preoperative consultation and triage, postoperative follow-up, trauma teleradiology and tele-expertise, oncologic and oral medicine follow-up, temporomandibular disorders, and education or humanitarian work. In low-risk outpatient and postoperative settings, remote consultations showed high concordance with in-person plans, similar complication or reattendance rates, reduced travel, and high satisfaction. In trauma networks, telemedicine supported timely triage and reduced unnecessary inter-hospital transfers. Evidence in oral oncology and complex mucosal disease was more cautious, favouring hybrid models and escalation to face-to-face assessment. Data on cost-effectiveness and impacts on equity were limited. Conclusions: Telemedicine in OMFS has moved from niche innovation to a pragmatic adjunct across the clinical pathway. Current evidence supports its use for selected pre- and postoperative care and trauma triage within risk-stratified hybrid models, while underscoring the need for stronger comparative and implementation studies, clear governance on equity and data protection, and alignment with wider digital and AI-enabled health systems. Full article

Dark tourism communication in Eastern Europe remains insufficiently examined, despite the region’s complex post-authoritarian memory landscape and the growing use of storytelling in tourism marketing. This study aims to clarify how Romanian dark tourism campaigns construct meaning through narrative structures and affective framing. Using a qualitative multi-method design, the analysis integrates ten promotional campaigns and six semi-structured interviews with professionals from tourism, memorial institutions, and cultural organizations. Results reveal four recurrent narrative–affective clusters, sacral-memorial, historical-didactic, spectral-sensational, and hybrid commercial, each shaped by trauma referentiality, emotional framing, and specific calls-to-action. These configurations map consistently onto Stone’s thanatological spectrum and highlight how practitioners negotiate authenticity and ethical boundaries. The study contributes a transferable narrative–affective model for dark tourism communication and underscores the need for transparency, contextual sensitivity, and responsible storytelling in the marketing of trauma-related heritage. Full article

First Nations children remain dramatically over-represented in Australia’s Out-of-Home Care (OOHC) system, particularly in New South Wales (NSW), which continues to report the highest numbers nationally. This narrative review, grounded in a relational First Nations Standpoint Theory and decolonising research paradigms, to critically examine the systemic, structural, and historical factors contributing to these disproportionalities. Drawing on interdisciplinary evidence across law, criminology, education, health, governance studies, and public policy, the analysis centres Indigenous-authored scholarship and contemporary empirical literature, including grey literature, inquiries, and community-led reports. Findings reveal that the OOHC system reproduces the colonial logics that historically drove the Stolen Generations. Macro-level structural drivers—including systemic racism, Indigenous data injustice, entrenched poverty and deprivation, intergenerational trauma, and Westernised governance frameworks—continue to shape child protection policies and practices. Micro-level drivers such as parental supports, mental health distress, substance misuse, family violence, and the criminalisation of children in care (“crossover children”) must be understood as direct consequences of structural inequality rather than as isolated individual risk factors. Current placement and permanency orders in NSW further compound cultural disconnection, with ongoing failures to implement the Aboriginal and Torres Strait Islander Child Placement Principle (ATSICPP). Contemporary cultural rights and Indigenous Cultural and Intellectual Property (ICIP) frameworks highlight the urgency of restoring Indigenous authority in decision-making processes. The literature consistently demonstrates that cultural continuity, kinship networks, and ACCO-led models are sort to produce stronger long-term outcomes for children. The review concludes that genuine transformation requires a systemic shift toward Indigenous-led governance, community-controlled service delivery, data sovereignty, and legislative reform that embeds cultural rights and self-determination. Without acknowledging the structural drivers and redistributing genuine power and authority, the state risks perpetuating a cycle of removal that mirrors earlier assimilationist policies. Strengthening First Peoples governance and cultural authority is therefore essential to creating pathways for First Nations children to live safely, remain connected to family and kin, and thrive in culture. Full article

Fishing is a widely practiced recreational activity that offers psychological, physical, and social benefits, but it also poses risks such as acute trauma and chronic overuse injuries. This narrative review aims to (1) synthesize current evidence on the musculoskeletal disorders, psychological outcomes, and environmental factors associated with recreational and sport fishing; (2) identify the physical, mental, and social health benefits reported across different angling disciplines; (3) characterize acute and chronic injury risks, including overuse syndromes and environment-related hazards; and (4) highlight gaps in the literature to guide future research directions in public health, rehabilitation, and preventive medicine. Materials and Methods: A narrative review was conducted in accordance with SANRA guidelines. A structured search of PubMed, Scopus, Web of Science and Google Scholar identified studies published between 2000 and 2025. Eligible sources included population surveys, clinical studies, therapeutic angling programs, epidemiological reports, and case studies addressing physical, psychological, or injury-related outcomes in recreational or sport fishing. Studies on commercial or occupational fishing were excluded. Evidence was synthesized thematically across benefit and risk domains. A total of 565 records were identified across four databases (PubMed, Scopus, Web of Science, Google Scholar). After screening, duplication, and full-text assessment, 41 studies met the eligibility criteria and were included in the narrative synthesis. The evidence indicates significant psychological benefits of fishing, including reductions in stress, improved mood, and clinically meaningful decreases in Post-Traumatic Stress Disorder (PTSD) symptoms reported in therapeutic fly-fishing programs. Musculoskeletal outcomes were more heterogeneous: chronic conditions such as low back pain and repetitive strain injuries of the shoulder, elbow, and wrist were commonly reported among regular anglers, particularly in physically demanding disciplines. Ice and sea fishing were associated with distinct environmental risks, including hypothermia, frostbite, and rare but documented fatal incidents. The results of this narrative review highlight the therapeutic potential of both recreational and sport fishing. However, they also point to the need for greater awareness of the risk of injury and environmental hazards associated with this type of fishing. Full article

Materiality has emerged as a significant theme in Holocaust literature as well as in Holocaust studies scholarship, highlighting the pivotal role of physical objects. This materiality has been conceptualized in various ways in recent scholarship, including «testimonial objects», «objects of return», and «artifacts of memory». Building on this conceptual framework, the article analyzes the ways in which transgenerational memory transmission is thematized in Monica Csango’s memoir Fortielser. Min jødiske familiehistorie («Concealments. My Jewish Family History», 2017), investigating what memorial functions material places and objects—in particular inherited objects—serve in the transmission and representation of memory within the narrative. The central question the article addresses is: Which places and objects are central to the narrative’s representation of memory, and in what ways do they mediate memory and trauma? The article suggests that postmemory transforms physical objects and places spaces into sites of remembering and mourning, enabling transgenerational continuity and memory transmission in Fortielser. These findings underscore the central role of material and spatial mediums in sustaining intergenerational remembrance, suggesting that inherited artifacts and projected spaces constitute vital modes of memory transmission, or «acts of transfer», within parts of Jewish Norwegian second- and third-generation literature. Full article

Regarding Judah’s exilic realities and forced migration experience, this article proposes that the sage responsible for this poem functioned as a carrier group in articulating a narrative of collective trauma. The paper begins by summarizing key components of cultural trauma theory as developed by Jeffrey C. Alexander. It also situates the shared socio-historical context of the final textual forms of Jeremiah and Proverbs within the exilic/post-exilic realities of the Judahite community. It next traces the trope of wine inebriation across several Jeremiah texts, focusing especially on Jeremiah 25:15–29 to show how this motif is integrally woven into the book’s overarching themes of indictment, judgment, and exile. A conventional wisdom reading of Proverbs 23:29–35 yields a moralistic warning about the self-destructive cycle of wine intoxication of the fools in the book of Proverbs. But a cultural trauma hermeneutic of the poem—when paired with intertextual echoes of Jeremiah 25:15–29—opens the poem to a deeper reading. Within this framework, the sapiential poem emerges as a creative, dramatic and theologically rich act of trauma storytelling, depicting foolish Judah’s metaphorical intoxication as an embodiment of exilic indictment, woes and suffering, yet gesturing toward the possibility of healing and restoration through wisdom reflection and re-narration of their past. Full article

Background/Objectives: Biodegradable implants have emerged as a promising alternative to traditional metallic fixation devices in pediatric orthopedic surgery. Avoiding implant removal is especially advantageous in children, who would otherwise require a second operation with additional anesthetic and surgical risks. This study reviews the current use of poly(lactic-co-glycolic acid) (PLGA) implants in pediatric fracture fixation and evaluates how they address limitations associated with traditional hardware. Methods: A narrative review was conducted summarizing current evidence, clinical experience, and case examples involving PLGA-based devices used in pediatric trauma. Special emphasis was placed on the degradation mechanism of PLGA, its controlled hydrolysis profile, and the capacity of the material to provide temporary mechanical stability during bone healing before complete resorption. The review included studies of PLGA use in forearm, distal radius, ankle, and elbow fractures, comparing outcomes to those obtained with metallic implants. Results: Across multiple clinical reports and case series, PLGA implants demonstrated effective fracture healing, stable fixation, and complication rates comparable to traditional metallic devices. Patients treated with resorbable implants benefited from reduced postoperative morbidity, no requirement for implant removal, and improved imaging compatibility. Conclusions: PLGA-based bioabsorbable implants represent a safe and effective alternative to conventional metal fixation in children. Their favorable degradation kinetics and clinical performance support their growing use in pediatric trauma surgery, while ongoing advances in polymer design and bioresorbable alloys continue to expand future applications. Full article

The recognition of trauma-induced coagulopathy (TIC) as an endogenous response to traumatic injuries rather than a consequence of therapeutic interventions has shifted the clinical approach toward an early and physiologically based hemostatic resuscitation. Prompt identification and correction of fibrinolysis and fibrinogen level derangements, dysregulated thrombin generation, and platelet dysfunction represent the cornerstones of the treatment strategies. Currently available viscoelastic hemostatic assays (VHAs) are point-of-care devices able to rapidly assess the phases of clot initiation, propagation, stabilization, and degradation, as well as isolate the contribution of specific elements—e.g., fibrinogen—to the coagulation process in fully automated analyses by multi-channel single-use cartridges. As a result, in the last decade, VHAs have been widely investigated as tools to implement individualized protocols of hemostatic resuscitation. Current guidelines support their use to optimize transfusion load in a goal-directed strategy. Nevertheless, contrasting evidence has emerged regarding the improvement in main clinical outcomes induced by the VHA-based algorithm of hemostatic resuscitation compared with those guided by conventional coagulation tests, and their place in the management of this peculiar population is still a matter of debate. We propose a narrative review ranging from TIC physiopathology as a proper substrate for viscoelastic diagnostic technique, through the strengths and weaknesses of VHAs, to their application in clinical practice. Full article

Background: Adolescents’ engagement with social media and emerging metaverse platforms has become nearly universal, creating environments rich in opportunities for learning, creativity, and social connection. However, these same spaces also enable a range of risky behaviors (RBs) with potential impacts on mental health, safety, and development. Recent research (2022–2025) has documented rising concerns over cyberbullying, online sexual exploitation, self-harm content, problematic use, and new risks specific to immersive VR. Aims: This Perspective uses a narrative synthesis of recent empirical and theoretical literature, including four key articles provided by the author and over 40 additional peer-reviewed and institutional sources, to (i) map the most prevalent and emergent RBs in adolescent social media and metaverse use, (ii) clarify the neurodevelopmental and socio-technical mechanisms that link these behaviors to individual and contextual factors, and (iii) propose a multi-level framework for intervention, policy, and future research aligned with adolescent development. Methods: A narrative synthesis approach was adopted, which is appropriate for integrating heterogeneous study designs and rapidly evolving evidence. The review emphasizes studies published from 2022 to 2025, with a focus on large-scale surveys, longitudinal cohorts, systematic reviews, and scoping reviews relevant to adolescent online risk. Results: Evidence indicates small but consistent associations between high-intensity platform use and internalizing symptoms, with gendered pathways and cultural moderators. Algorithmic amplification contributes to the spread of harmful content, while immersive environments increase the salience and emotional impact of interactions. Certain groups—those with prior trauma, low SES, or marginalized identities—face heightened vulnerability. Conclusions: RBs in digital spaces emerge from the interplay of adolescent neurodevelopment, platform affordances, and socio-cultural context. This Perspective synthesizes recent evidence via narrative review to articulate these mechanisms and to inform an integrated, multi-level framework for harm mitigation that aligns research, platform design, and policy with adolescent developmental needs, while preserving the benefits of digital engagement. Full article

Patients with multiple traumas, particularly those with traumatic brain injury (TBI), are among the most challenging cases in intensive care medicine. Although early orotracheal intubation and invasive mechanical ventilation (IMV) are essential for airway protection and neurological treatment, they significantly increase the risk of lower respiratory tract infection (LRTI), including ventilator-associated pneumonia (VAP) and ventilator-associated tracheobronchitis (VAT). These complications are particularly prevalent among neurocritical patients due to the distinctive interaction between the brain, lungs and immune system. This narrative review examines the current evidence on the mechanisms underlying the brain–lung–immune axis; the diagnostic challenges in identifying respiratory infections in mechanically ventilated TBI patients; and optimal approaches to empirical or quasi-targeted antimicrobial therapy based on diagnostic algorithms and rapid molecular techniques. Severe TBI induces neurogenic inflammation, autonomic dysregulation, and immunosuppression, thereby increasing susceptibility to pulmonary infections. The ‘triple hit hypothesis’ best explains this cascade: sympathetic hyperactivity (first hit), iatrogenic ventilatory injury (second hit), and intestinal dysbiosis with systemic immune dysregulation (third hit). VAP diagnosis remains challenging due to the lack of universal criteria, the overlap with systemic inflammatory response syndrome, and the low specificity of radiological and clinical signs. VAT may represent an intermediate stage within a continuum of ventilator-associated infection. Recent evidence supports the selective use of nebulized antibiotics for VAT, advocating an individualized, locally adapted empirical approach to VAP treatment. Syndromic molecular panels can accelerate the identification of pathogens, enabling the earlier and more appropriate selection of antimicrobials and improving outcomes while preserving stewardship. Understanding the brain–lung–immune axis and improving diagnostic accuracy are essential to enhancing the treatment of respiratory infections in neurocritical care. Integrating clinical assessment, biomarkers and rapid microbiological testing enables timely, targeted therapy and reduces the misuse of antimicrobials. Full article