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European Journal of Psychotraumatology 2024Police officers encounter various potentially traumatic events (PTEs) and may be compelled to engage in actions that contradict their moral codes. Consequently, they...
Police officers encounter various potentially traumatic events (PTEs) and may be compelled to engage in actions that contradict their moral codes. Consequently, they are at risk to develop symptoms of Posttraumatic Stress Disorder (PTSD), but also moral stress or moral injury (MI). To date, MI in police officers has received limited attention. The present study sought to identify classes of MI appraisals and PTSD symptoms among police officers exposed to PTEs, while also investigating potential clinical differences between these classes. For this study, 421 trauma-exposed police officers were assessed on demographics and several clinical measurements including MI appraisals (self-directed and other-directed), PTSD severity, and general psychopathology. Latent class and regression analyses were conducted to examine the presence of different classes among trauma-exposed police officers and class differentiation in terms of demographics, general psychopathology, PTSD severity, mistrust, guilt, self-punishment, and feelings of worthlessness. The following five classes were identified: (1) a 'Low MI, high PTSD class' (28%), (2) a 'High MI, low PTSD class' (11%), (3) a 'High MI, high PTSD class' (17%), (4) a 'Low MI, low PTSD class' (16%), and (5) a 'High MI-other, high PTSD class' (27%). There were significant differences between the classes in terms of age, general psychopathology, PTSD severity, mistrust, guilt, and self-punishment but no differences for gender and feelings of worthlessness. In conclusion, we identified five classes, each exhibiting unique patterns of cognitive MI appraisals and PTSD symptoms. This underscores the criticality of measuring and identifying MI in this particular group, as it allows for tailored treatment interventions.
Topics: Humans; Stress Disorders, Post-Traumatic; Police; Male; Female; Adult; Latent Class Analysis; Morals; Middle Aged
PubMed: 38904156
DOI: 10.1080/20008066.2024.2365030 -
Frontiers in Psychology 2024This study investigated the resource allocation of Chinese sixth-graders and the role of peer relationship in different resource conditions ( = 132, M = 11. 35 years, SD...
This study investigated the resource allocation of Chinese sixth-graders and the role of peer relationship in different resource conditions ( = 132, M = 11. 35 years, SD = 0.60). We designed the resource quantity as a between-group variable, with one group participating in a resource-limited experiment and another group in a resource-abundant experiment. Both groups of children allocated token resources to three types of peers relationships: good friends, disliked individuals, and strangers. Based on our experimental hypotheses, we presupposed three experimental outcomes: selfish allocation, equal allocation, and altruistic allocation. To analyze the data, we employed multivariate unordered regression analysis and performed two rounds of regression analyses using both selfish and altruistic allocations as reference categories to enhance the statistical power of regression model. Our results reveal that the resource quantity had a significant hindering effect on children's allocation behaviors, as the amount of available resources for allocation increased, so did their willingness to allocate selfishly. It was also found that an increase in resources led to a decrease in the proportion of children allocating equally. Nonetheless, the results still revealed generalized peer relationship preferences: children tended to allocate more resources to friends than to individuals they disliked. But when faced with disliked individuals, they were relatively more likely to allocate equally. Finally, we observed the proportion of equal allocation and discussed the similar impact of inequality aversion, different allocation contexts, and children's theory of mind on equitable allocation among sixth-graders.
PubMed: 38903462
DOI: 10.3389/fpsyg.2024.1368224 -
Medical Education Online Dec 2024In the United States, sexual, reproductive, and perinatal health inequities are well documented and known to be caused by a history of systemic oppression along many...
In the United States, sexual, reproductive, and perinatal health inequities are well documented and known to be caused by a history of systemic oppression along many axes, including but not limited to race, ethnicity, gender, socioeconomic position, sexual orientation, and disability. Medical schools are responsible for educating students on systems of oppression and their impact on health. Reproductive justice advocates, including lay persons, medical students, and teaching faculty, have urged for integrating the reproductive justice framework into medical education and clinical practice. In response to medical student advocacy, we developed introductory didactic sessions on social and reproductive justice for preclinical medical students. These were created in a team-based learning format and include pre-course primer materials on reproductive justice. During the sessions, students engaged with hypothetical clinical vignettes in small groups to identify oppressive structures that may have contributed to the health outcomes described and potential avenues for contextually relevant and level-appropriate advocacy. The sessions took place in November 2019 (in-person) and 2020 (virtually) and were well attended by students. We highlight our experience, student feedback, and next steps, including further integration of reproductive health equity into medical school curricula in concert with department-wide education for faculty, residents, nursing, and allied health professionals. This introduction to social and reproductive justice can be adapted and scaled across different medical school curricula, enhancing the training of a new generation of physicians to become critically aware of how oppressive structures create health inequities and able to mitigate their impact through their roles as clinicians, researchers, and advocates.
Topics: Humans; Health Equity; Reproductive Health; Curriculum; Students, Medical; Education, Medical, Undergraduate; Social Justice; United States
PubMed: 38903002
DOI: 10.1080/10872981.2024.2364984 -
Substance Abuse Treatment, Prevention,... Jun 2024Sub-Saharan Africa is important to the future of alcohol and global health because the alcohol market there is expanding rapidly in a relatively young population. This...
BACKGROUND
Sub-Saharan Africa is important to the future of alcohol and global health because the alcohol market there is expanding rapidly in a relatively young population. This entails a corresponding contest about whether the policy measures adopted will be shaped by scientific evidence or by industry interference in alcohol policy. This study examines how alcohol industry actors use social media.
METHODS
Uganda was selected for study because of high levels of alcohol harm and recent alcohol policy debates. Data on the X (formerly Twitter) activity of the Ugandan companies of AB InBev and Diageo, who are the two main brewers, and the trade association including both, were collected, coded and thematically analysed.
RESULTS
X is used overwhelmingly by alcohol industry actors in Uganda to promote corporate social responsibility (CSR) and alcohol policy framing content. There is little direct product marketing. The framing of policy problems and solutions, and of the actors involved in policymaking and CSR resembles that used elsewhere in the political strategies of the transnational alcohol corporations. Content which appears more emphasised in Uganda includes material on farmers, illicit trade and contribution to the economy. As elsewhere, it avoids giving attention to the policy measures which would make a difference to the levels of alcohol harms endured by Uganda. Rhetorically, X is thus used to create a parallel universe, in which the actual harms and what is known about how to reduce them are conspicuous by their absence.
CONCLUSIONS
The alcohol industry presents itself as indispensable to Uganda's future and appears to have developed relationships with politicians, partnerships with government, and built a coalition with farmers. This means the alcohol industry may be well positioned to oppose public health policy measures, even though their arguments lack substance and are at odds with the evidence.
Topics: Uganda; Humans; Social Responsibility; Alcoholic Beverages; Social Media; Marketing; Food Industry; Health Policy; Policy Making; Alcohol Drinking
PubMed: 38902800
DOI: 10.1186/s13011-024-00611-z -
BMC Psychology Jun 2024Dementia is an important public health and geriatric concern for sub-Saharan African countries, including Ghana. Evidence shows that persons living with dementia are...
BACKGROUND
Dementia is an important public health and geriatric concern for sub-Saharan African countries, including Ghana. Evidence shows that persons living with dementia are often supported and cared for by family caregivers in the community. In the execution of these services to the persons living with dementia, family caregivers are overwhelmed and experience heightened stress that results in serious repercussions. Therefore, the aim of this study was to explore family caregivers' experiences on coping in dementia care in Ghana.
METHODS
Adopting a descriptive phenomenological design, individual face-to-face interviews were conducted among thirty unpaid family caregivers of persons living with dementia in Ghana. Semi-structured interview guides were used. The data analysis process followed Clarke and Braun's framework analysis.
RESULTS
Six themes were generated from the textual data. These themes were captioned as: (1) empathy and perspective-taking; (2) family support and cohesion; (3) coaxing and pampering of persons living with dementia; (4) humour and positive communication; (5) spiritual support; and (6) ethical/moral consideration in dementia caregiving.
CONCLUSION
We conclude that unpaid family caregivers of persons living with dementia in Ghana adopt varied strategies to cope with the strains of caregiving. Healthcare facilities that provide services to persons living with dementia could incorporate caregiver preparatory training or education for family caregivers. This training should focus on briefing family caregivers about the potential strains that they are likely to encounter. Also, the training could focus on equipping family caregivers with the knowledge and skills to effectively communicate and care for the persons living with dementia using person-centered approaches. Key stakeholders such as the Ghana Health Service and Alzheimer's Ghana must raise awareness about the dangers of caregivers' violation of the autonomy and freedom of persons living with dementia as they navigate through the challenges of caregiving. Lastly, faith-based institutions need to be considered as key stakeholders in dementia interventions since they could play a critical role.
Topics: Humans; Caregivers; Ghana; Dementia; Male; Adaptation, Psychological; Female; Middle Aged; Aged; Adult; Qualitative Research; Family; Aged, 80 and over
PubMed: 38902797
DOI: 10.1186/s40359-024-01862-y -
BMC Nursing Jun 2024Medical error is a leading cause of disability and death in healthcare settings and reporting colleagues' medical errors is one of the main strategies for medical error...
BACKGROUND
Medical error is a leading cause of disability and death in healthcare settings and reporting colleagues' medical errors is one of the main strategies for medical error management and an ethical responsibility of all healthcare providers, including nurses. Most studies into reporting colleagues' medical errors used quantitative designs while it seems that using qualitative designs can provide better insight in this area.
PURPOSE
This study explored nurses' experiences of reporting the medical errors of their colleagues.
METHODS
This qualitative study was conducted using the conventional content analysis approach. Participants were 22 hospital nurses purposively selected in 2021-2022 from different cities in Iran. Twenty-two in-depth semi-structured interviews were held for data collection. The data were analyzed via Graneheim and Lundman's conventional content analysis and trustworthiness was maintained using the criteria proposed by Guba and Lincoln.
FINDINGS
The main categories of the study were burnout and intention to leave the profession and growth and development. The two subcategories of the first category were the experience of injury and the experience of violence and the two subcategories of the second category were sense of worthiness and sense of motivation. Moral distress was the most important experience of almost all participants.
CONCLUSION
Nurses mostly have negative experiences in terms of reporting their colleagues' medical errors. Negative experiences can act as the barriers to report colleagues' errors while positive experiences can act as its facilitators. Improvement of the patient safety culture in healthcare settings and interpersonal relationships among healthcare providers can reduce the negative experiences and promote the positive experiences of reporting colleagues' medical errors.
PubMed: 38902743
DOI: 10.1186/s12912-024-02092-8 -
BMC Medical Ethics Jun 2024While the number of emergency patients worldwide continues to increase, emergency doctors often face moral distress. It hampers the overall efficiency of the emergency...
BACKGROUND
While the number of emergency patients worldwide continues to increase, emergency doctors often face moral distress. It hampers the overall efficiency of the emergency department, even leading to a reduction in human resources.
AIM
This study explored the experience of moral distress among emergency department doctors and analyzed the causes of its occurrence and the strategies for addressing it.
METHOD
Purposive and snowball sampling strategies were used in this study. Data were collected through in-depth, semi-structured interviews with 10 doctors working in the emergency department of a tertiary general hospital in southwest China. The interview data underwent processing using the Nvivo 14 software. The data analysis was guided by Colaizzi's phenomenological analysis method.
STUDY FINDINGS
This study yielded five themes: (1) imbalance between Limited Medical Resources and High-Quality Treatment Needs; (2) Ineffective Communication with Patients; (3) Rescuing Patients With no prospect of treatment; (4) Challenges in Sustaining Optimal Treatment Measures; and (5) Strategies for Addressing Moral Distress.
CONCLUSION
The moral distress faced by emergency doctors stems from various aspects. Clinical management and policymakers can alleviate this distress by enhancing the dissemination of emergency medical knowledge to the general public, improving the social and economic support systems, and strengthening multidisciplinary collaboration and doctors' communication skills.
Topics: Humans; China; Qualitative Research; Physicians; Female; Male; Morals; Adult; Emergency Service, Hospital; Attitude of Health Personnel; Stress, Psychological; Communication; Physician-Patient Relations; Middle Aged; East Asian People
PubMed: 38902648
DOI: 10.1186/s12910-024-01074-4 -
Scientific Reports Jun 2024Acetaminophen (APAP) is a leading cause of acute liver failure. The effect of APAP metabolite's effects in the periphery are well characterized; however, associated...
Acetaminophen (APAP) is a leading cause of acute liver failure. The effect of APAP metabolite's effects in the periphery are well characterized; however, associated consequences in the brain remain poorly understood. Animal studies on this subject are few and reveal that frequent APAP intake can trigger cerebral abnormalities that vary depending on the subject's age. Alarmingly, experimental efforts have yet to examine associated consequences in elderly hosts, who correspond to the highest risk of medication overload, impaired drug clearance, and cognitive deficits. Here, we interrogated the cerebral and peripheral pathology of elderly mice submitted to monthly episodes of APAP intoxication since a young adult age. We found that weeks after the final episode of recurrent APAP exposure, mice exhibited worsened non-spatial memory deficit whereas spatial memory performance was unaltered. Interestingly, one month after the period of APAP intoxication, these mice showed increased glial burden without associated drivers, namely, blood-brain barrier disruption, cholesterol accumulation, and elevation of inflammatory molecules in the brain and/or periphery. Our experimental study reveals how recurrent APAP exposure affects the cognitive performance and cellular events in elderly brains. These data suggest that APAP-containing pharmacological interventions may foreshadow the elevated risk of neuropsychiatric disorders that afflict elderly populations.
Topics: Animals; Acetaminophen; Cognitive Dysfunction; Mice; Astrocytes; Microglia; Male; Brain; Mice, Inbred C57BL; Blood-Brain Barrier; Aging; Disease Models, Animal; Spatial Memory
PubMed: 38902507
DOI: 10.1038/s41598-024-65185-z -
Journal of Affective Disorders Jun 2024Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim...
BACKGROUND
Informal care is a common form of social support, which can vary greatly in its intensity. While views of aging have shown to be relevant to mental health before, we aim to analyze whether the association between views of aging and depressive symptoms is influenced by the provision of informal care and its intensity.
METHODS
Data of six waves of the Health and Retirement Study in the United States was used. The sample includes up to 41,058 observations pooled over six waves of community-dwelling adults aged ≥50 years. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CESD) and attitudes towards own aging (ATOA) with the Philadelphia Geriatric Center Morale Scale (higher score indicates positive attitudes); informal caregiving (no/yes) and caregiving intensity (moderate, intense) were surveyed. Adjusted fixed effects regression analysis with robust standard errors, and with caregiving as moderator variable were calculated.
RESULTS
Informal caregiving did not interact with ATOA. However, transitioning into intense caregiving significantly moderated the association between ATOA and depressive symptoms. Lower depressive symptoms were associated with better ATOA and this association was significantly stronger in the intense caregiving condition than in the non-caregiving condition. No significant interaction effects were found between any form of caregiving and subjective age.
LIMITATIONS
The possibility of reciprocal effects cannot be excluded.
CONCLUSION
Internalized ageism and depressive symptoms are more strongly related among caregivers who provide intense care. Thus, interventions to reduce internalized ageism could be helpful in particular among this vulnerable group of informal caregivers.
PubMed: 38901694
DOI: 10.1016/j.jad.2024.06.055 -
Global Health Research and Policy Jun 2024Little is known regarding economic impacts of intimate partner violence (IPV) in humanitarian settings, especially the labor market burden. Examining costs of IPV beyond...
BACKGROUND
Little is known regarding economic impacts of intimate partner violence (IPV) in humanitarian settings, especially the labor market burden. Examining costs of IPV beyond the health burden may provide new information to help with resource allocation for addressing IPV, including within conflict zones. This paper measures the incidence and prevalence of different types of IPV, the potential relationship between IPV and labor market activity, and estimating the cost of these IPV-associated labor market differentials.
METHODS
The association between labor market outcomes, IPV experience, and conflict exposure among women ages 15-49 in Nigeria were studied using the 2018 Nigeria Demographic and Health Survey and 2013-17 Uppsala Conflict Data Program data. Descriptive analysis was used to identify patterns of IPV and labor outcomes by region. Based on this, multivariable logistic regression models were used to estimate the association between labor market participation and lifetime IPV exposure. These models were combined with earnings data from the United Nations Human Development Report 2021/2022 and a top-down costing approach to quantify the impacts in terms of lost productivity to the Nigerian economy.
RESULTS
Substantial differences in IPV exposure and labor market outcomes were found between conflict and non-conflict-affected areas. Women with past year or lifetime exposure to physical, emotional, or "any" IPV were more likely to withdraw from the labor market in the past year, although no differences were found for sexual IPV or conflict-affected regions. We estimate an average reduction of 4.14% in the likelihood of working, resulting in nearly $3.0 billion USD of lost productivity, about 1% of Nigeria's total economic output.
CONCLUSIONS
Increased odds of labor market withdraw were associated with several measures of IPV. Withdrawal from the formal labor market sector has a substantial associated economic cost for all of Nigerian society. If stronger prevention measures reduce the incidence of IPV against women in Nigeria, a substantial portion of lost economic costs likely could be reclaimed. These costs underscore the economic case, alongside the moral imperative, for stronger protections against IPV for girls and women in Nigeria.
Topics: Humans; Nigeria; Intimate Partner Violence; Female; Adult; Adolescent; Young Adult; Middle Aged; Employment; Prevalence; Incidence
PubMed: 38898516
DOI: 10.1186/s41256-024-00362-1