This study examines the process of identity negotiation of 15 Muslim women who resisted severe abuse by their husbands and extended family by becoming mentally ill and thereafter, divorcing. Content analysis of the interview narratives shows that these women were poor, married young, and endured years of battering, isolation, and silencing for the sake of family honor and children's well-being. Entrapped within a web of sociocultural norms legitimizing wife beating, and abusive extended family relationships that annihilate their voice by branding them as maj'nuna/insane, these women explained that they were terrorized helpless victims fearing the stigma of being labeled insane and the resultant harm to their children. With the deterioration of their health, threat of annihilation, and imminent danger to themselves and their children, these women broke through the normative oppressive framework by becoming maj'nuna/mentally ill. Detached from the extended family and no longer caring to endorse a label that discredited what they said or did, these women overtly resisted by escaping to the family of origin and/or mental health clinic to reveal the abuse, divorce, and seek treatment. Severing all family ties, and now residing in public housing, these women felt safe to renegotiate a favorable identity and reclaim the right to live with dignity. Implications/recommendations: (1) The criminalization of battering and prosecution of batterers is not enough to deter when cultural norms sanction battering, (2) additional diagnostic categories are needed to identify the precursors of battering within the strategies of overt and covert resistance battered women adopt in collectivistic cultures such as mental and neurophysiological dysfunctions, and (3) it is necessary to transcend the individualistic model titling battered women within the false dichotomy of victimization or agency as it fails to reflect battered women's experience in collectivistic cultures and their resistant strategies to abuse in the extended family.
Healthcare workers may have different risk for severe outcomes compared with the general population during diverse crises. This paper introduces the concept of healthcare worker versus population hazard (HPH), the risk of an outcome of interest in active healthcare workers compared with the general population they serve. HPH can be expressed with relative risk (HPH(r)) and absolute risk difference (HPH(a)) metrics. Illustrative examples are drawn from infectious outbreaks, war, and the COVID-19 pandemic on death outcomes. HPH can be extreme for lethal outbreaks (HPH(r) = 30 to 143, HPH(a) = 8 to 91 per 1000 for Ebola deaths in 3 Western African countries in 2013-5), and modestly high in relative terms and very high in absolute terms for protracted, major armed conflicts (HPH(r) = 1.38 and HPH(a) = 10.2 for Syria during 2011-2024). Conversely, healthcare workers had 8-12-fold lower risk than the population they served for pandemic excess deaths (physicians in USA) or COVID-19 deaths (physicians in Ontario, healthcare workers in Finland), while healthcare workers in Indonesia did not have this advantage for COVID-19 deaths versus the general population. HPH is susceptible to data inaccuracies in numbers of at-risk populations and of outcomes of interest. Importantly, inferences about healthcare worker risk can be misleading, if deaths of retired healthcare workers contaminate the risk calculations- as in the case of misleading early perceptions of exaggerated COVID-19 risk for healthcare professionals. HPH can offer useful insights for risk assessment to healthcare professionals, the general public, and policy makers and may be useful to monitor for planning and interventions during crises.
Being racialized as Black in the United States has contributed to this population having to operate with a level of race-induced trauma, especially those who are darkly melanated. Historically, Black persons have been terrorized into colonization, and the cultural psychology of anti-Blackness has been entrenched in our society. Through the practice of racialization, the historical, social, and political processes of constructing racial identities and meanings have impacted the formation of understanding of the body and the rationalization of hierarchy. In addition, the internalization of these ideas of hierarchy and difference within power/knowledge relations that they (re)produce is pervasive among people in the United States. This article aims to explicitly highlight racism as trauma, address the relevance of radical self-care when disrupting anti-Black racism, and consider steps to promote trauma responsiveness when incorporating these practices.
Lethal microorganisms have terrorized man since the beginning of time, killing more human beings than anything else in history. The most infamous epidemic, the Black Death, wiped out almost half the population of Europe. To quote H.G. Wells, "adapt or perish, now as ever, is nature's inexorable imperative." Superbugs are nature's revenge on humans for their ingenuity. For decades antibiotics, which work by honing in on particular bacteria, have been the chief line of defense against infection. There is growing urgency for the judicious assessment of both conventional and innovative strategies with regard to antibiotic use, infection control, molecular detection of pathogens and adequate treatment of multidrug-resistant organisms in hospitals, especially critical care units. Financial restraints, changing demographics, an aging population and the limited introduction of new antibiotics have established an imperative for utilization of goal directed strategies in infection prevention and control. Research and development of both clinical and environmental weapons to combat these adversaries is essential if man is to adapt, not perish, in this fight for survival. This article will provide a snapshot of advances in infection prevention and control, including evidence based design, as they relate to the critical care environment.
In the 19th century, yellow fever thrived in the tropical, urban trade centers along the American Gulf Coast. Industrializing and populated, New Orleans and Memphis made excellent habitats for the yellow fever-carrying Aedes aegypti mosquitoes and the virulence they imparted on their victims. Known for its jaundice and black, blood-filled vomit, the malady terrorized the region for decades, sometimes claiming tens of thousands of lives during the near annual summertime outbreaks. In response to the failing medical community, a small, pronounced population of sick and healthy laypeople openly criticized the efforts to rid the Gulf region of yellow jack. Utilizing newspapers and cartoons to vocalize their opinions, these critics doubted and mocked the medical community, contributing to the regional and seasonal dilemma yellow fever posed for the American South. These sentient expressions prove to be an early example of patient distrust toward caregivers, a current problem in clinical heath care.
1. Because of more stringent civil commitment criteria, persons formerly hospitalized on a civil commitment now enter the system on criminal observation orders, having been arrested, booked, and often jailed for minor offenses such as vagrancy, shoplifting, or disorderly conduct. This represents a criminalization of the mentally ill. 2. In a single forensic system (Wisconsin) there was an increase of 73% in such commitments following court decisions and legislative revisions setting forth new commitment criteria. This increase was principally in criminal observations, although this rise was evident as well in "unable to stand trial" commitments. It was not present in "not guilty by reason of insanity" adjudications. 3. Aside from the obvious untoward effects per se of criminalizing mentally ill persons, other untoward effects occur in terms of prolonging hospitalization, depriving those persons of prompt treatment, and putting unnecessary and inhumane pressures on the family and the community, as well as on the mentally ill person himself. 4. The "freedom" to the penniless, helpless, ill, and finally arrested, jailed and criminally committed is not freedom at all--it's abandonment. The "right" to be demented, agonized and terrorized in the face of treatment which cannot, because of legal prohibition, be applied is no right at all--it's a new form of imprisonment. The "liberty" to be naked in a padded cell, hallucinating, delusional, and tormented, is not liberty--it is a folie à deux between pseudo-sophisticated liberals and an unrealizing public. The delusion is that if one changes the name of something to something else, or if one substitutes a jail for a hospital or a preoccupation with legal rites for honest concern over patients' rights, he has done something significant, useful and important, or at least something.
Dutch slave traders brought yellow fever to the Americas from Africa during the mid-seventeenth century. For the next two and a half centuries, the disease terrorized seaports throughout the Americas. Proof of the mosquito hypothesis was delayed because of two aspects of the disease: patients are viremic only during the first several days of clinical illness, and most mosquitoes require about 2 weeks of viral incubation before becoming infectious. Control of Aedes aegypti in urban centers failed to eliminate the disease because of its transmission by tree-hole-breeding mosquitoes that spend their winged lives mainly in forest canopies. Yellow fever continues to be a significant public health problem in parts of South America and Africa.
The recent Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak has originated from a failure in the national quarantine system in the Republic of Korea as most basic role of protecting the safety and lives of its citizens. Furthermore, a number of the Korean healthcare system's weaknesses seem to have been completely exposed. The MERS-CoV outbreak can be considered a typical public health crisis in that the public was not only greatly terrorized by the actual fear of the disease, but also experienced a great impact to their daily lives, all in a short period of time. Preparedness for and an appropriate response to a public health crisis require comprehensive systematic public healthcare measures to address risks comprehensively with an all-hazards approach. Consequently, discussion regarding establishment of post-MERS-CoV improvement measures must focus on the total reform of the national quarantine system and strengthening of the public health infrastructure. In addition, the Korea Centers for Disease Control and Prevention must implement specific strategies of action including taking on the role of "control tower" in a public health emergency, training of Field Epidemic Intelligence Service officers, establishment of collaborative governance between central and local governments for infection prevention and control, strengthening the roles and capabilities of community-based public hospitals, and development of nationwide crisis communication methods.
Using data from 92 interviews, this article examines the narratives of African Americans' experiences as children and young adults during Jim Crow in the Southeast and Southwest. It gives voice to the realities of sexual assaults committed by ordinary White men who systematically terrorized African American families with impunity after the post-Reconstruction south until the 1960s. The interviewees discuss the short- and long-term impact of physical, mental, emotional, and sexual assaults in their communities. We discuss the top four prevalent themes that emerged related to sexual assault, specifically (a) the normalization of sexual assaults, (b) protective measures to avoid White violence, (c) the morality of African American women, and (d) the long-term consequences of assaults on children.
The victims of bullying are subjected to being terrorized, annoyed, excluded, belittled, deprived of resources, isolated and prevented from claiming rights. The victims of bullying have decreased job satisfaction, work performance, motivation and productivity. Bullying also negatively affects victims' social relationships inside and outside the institution. This study was conducted as a cross-sectional and descriptive study for the purpose of assessing the workplace, bullying of nurses in Turkey and the effects it has on nursing practices. The sample was composed of 286 nurses, and all of the respondents were female. The research instrument was a questionnaire in five parts. The first section included the participants' demographic information; the other variables were measured in four categories: psychologically violent behaviours, workload, organizational effects and depression. Thirty-seven per cent of the nurses participating in the research had never or almost never encountered workplace bullying behaviour in the last 12 months, 21% of the nurses had been exposed to these behaviours. There were no differences between position and educational level in workplace bullying. Workplace bullying leads to depression, lowered work motivation, decreased ability to concentrate, poor productivity, lack of commitment to work, and poor relationships with patients, managers and colleagues. Workplace bullying is a measurable problem that negatively affects the psychology and performance of the nurses in this study.
Sexually transmitted diseases (STD) are as old as mankind and epidemics are mentioned already in the Old Testament. However, the perception of the conditions has changed over the centuries. In ancient times they were taken for an individual punishment for a blasphemic conduct of life or as a consequence of low sanitation and hygiene. In the medieval ages, the relation to sexual activities was recognized, but the diversity of clinical symptoms was seen as variations of one disease, depending on the stage of the disease and the general health condition of the diseased person. In the late 15th and 16th century a presumably "new plague" had been imported to Europe and was rapidly spread by soldiers. Misinterpretations of wrong experiments on the suspected identity of syphilis and gonorrhoea led to nosologic misconceptions in the 17th and early 19th century. The late 19th and beginning of 20st century due to the many achievements in microbiology and chemistry finally took the frightening threat from the STDs, which have terrorized millions of "normal" and "famous" people of all social classes over centuries and has been linked to many scandals. Moreover, the perception of STDs has turned from a "personal stroke of fate" into a collectively important issue of public health.
The most serious hazard to the physical and mental health of the majority rural poor black population in South Africa is caused by the ruling wealthy white minority's policy of apartheid. Forced removals and dumping of millions of people into small, disconnected, barren, poor reserve areas, bereft of adequate medical, psychiatric and public health services (the 'final solution' of the 'native problem') causes widespread malnutrition, infectious and other diseases, and high mortality and mental-illness rates. Blacks and progressive whites are banned, terrorized, detained without trial, tortured, and murdered by the state; the Africans are not only disfranchised but are now also being denationalized and deprived of their ancient birthright to this richly-endowed part of Africa. Acceptance of this modern version of Naziism by the World Psychiatric Association and the World Medical Association, in the face of adequate information provided by the United Nations, its agency the World Health Organization, the American Psychiatric Association, and numerous other agencies and reports, needs urgent examination and decisive action.
Spiritual abuse is the act of making people believe--whether by stating or merely implying--that they are going to be punished in this life and/or tormented in hell-fire forever for failure to live life good enough to please God and thus earn admission to heaven. Spiritual terrorism is the most extreme form of spiritual abuse and may cause serious mental health problems. Those people who have not been spiritually terrorized have not necessarily been spared from spiritual abuse and therefore may still be in need of competent, spiritual counseling. Spiritual abuse, which may be active or passive, can best be conceptualized on a continuum from terroristic to zero abuse. Severity is determined by intensity, age of onset, duration, and individual reaction. The underlying issue in all forms of abuse is control.
Intimate partner homicide suicide (IPHS) constitutes the most violent domestic abuse outcome, devastating individuals, families, neighborhoods and communities. This research used content analysis to analyze 225 murder suicide events (444 deaths) among dyads with at least one member 60 or older. Data were collected from newspaper articles, television news transcripts, police reports and obituaries published between 1999 and 2005. Findings suggest the most dangerous setting was the home and the majority of perpetrators were men. Firearms were most often employed in the violence. Relationship strife was present in some cases, but only slightly higher than the divorce rate for that age group. Illness was cited in just over half of the cases, but 30% of sick elderly couples had only a perpetrator who was ill. Evidence of suicide pacts and mercy killings were very rare and practitioners are encouraged to properly investigate these events. Suicidal men in this age range must be recognized as a potential threat to others, primarily their partner. Homicide was sometimes the primary motive, and the perpetrators in those cases resembled the "intimate terrorist." Victims in those cases were often terrorized before the murder. Clinicians are educated about the patterns of fatal violence in later life dyads and provided with strategies for prevention.