共找到 20 条结果
暂无摘要（点击查看详情）
Obesity is a chronic disease that is widespread worldwide. Its diagnosis is based on specific criteria, including a body mass index (BMI) ≥30 kg/m2 or waist circumference measurement. The consequences of obesity include type 2 diabetes mellitus, hypercholesterolemia, hypertension, an increased risk of infectious complications, cancer, and even death. Patients living with obesity are subjected to constant negative evaluation by society through the process of stigmatization. Available data suggest that people with obesity experience stigma in the workplace, at school, on the Internet, and in healthcare settings. Stigmatization is largely driven by a lack of understanding and knowledge about obesity and its underlying causes. People living with obesity are often judged as lazy and accused of having excessive body weight as a consequence of an inappropriate lifestyle. In Poland, the high level of stigmatization of patients with obesity is accompanied by a low level of knowledge about the disease. However, the willingness to help patients, as declared by medical professionals in Poland, offers hope that appropriate education may improve access to effective treatment. Well-designed educational interventions, social campaigns, and the activities of medical societies in developing guidelines, recommendations, and communication manuals for healthcare professionals working with patients living with obesity should constitute essential elements in the fight against stigma. In addition, cooperation with decision-makers to prevent the exclusion of patients with obesity from the healthcare system is necessary.
Organ donation represents a profound act of compassion and solidarity, offering hope to those grappling with end stage organ failure. While many families ultimately choose to proceed with organ donation, a significant portion remains hesitant or outrightly refuse. The ripples of the decision to donate organs are felt for a long time after the decision has been undertaken. To evaluate the aftereffects of organ donation decision. A qualitative descriptive study, conducted at a tertiary care hospital in North India, based on a semistructured questionnaire about the experiences of decision-makers post donation administered telephonically. The decisions leading to successful organ donation between July 2019 and June 2023 were considered. A purposive sample of 81 decision-makers participated in the study (response rate = 75%). Data were collected through telephonic interviews with family members using a semistructured questionnaire on postdonation experiences. Interviews were conducted in Hindi and/or English and analyzed using a thematic-content approach. Microsoft Excel (Manufactured by Microsoft Corporation, Redmond, Washington, United States of America (USA) was used for thematic content analysis. The consolidated criteria for reporting qualitative research (COREQ) guidelines were used for reporting. Positive reactions highlighted recognition and inspiration, showing how the decision can inspire others and promote broader understanding and acceptance of organ donation. However, families also faced significant criticism regarding the sanctity of the body, with some adhering to the empty body myths. Accusations and blame were common, leading to social stigma, ostracization, social isolation, and threats of legal action. The study provides a comprehensive analysis of the postdonation experiences of donor families, highlighting both positive and negative repercussions. Despite fears of societal criticism, the study found that most societal members appreciated the decision to donate organs.
Exposure to intimate partner violence (EIPV) in childhood can result in adverse outcomes. The objective was to determine if children exposed to intimate partner violence (IPV) have worse educational, judicial, or social outcomes compared to peers without EIPV. This retrospective, population-based cohort study of children (<18 years old) in Manitoba, Canada longitudinally followed children between three and twenty-two years. Children (n = 10,731) exposed to IPV between 2002 and 2019 were identified from population-based administrative data and matched to five randomly selected children without EIPV (n = 53,655). Social, educational, and judicial outcomes were extracted and hazard rates or risk rates were calculated. Children exposed to IPV were at increased risk of not meeting Grade 7 math expectations (RR: 1.26; 95% CI: 1.21, 1.31), Grade 8 reading and writing expectations (RR: 1.26; 95% CI: 1.12, 1.32) and withdrawing from high school (RR: 1.32: 95%CI: 1.24, 1.40) compared to children with no EIPV. EIPV increased the risk of being a victim (HR: 1.93; 95%CI: 1.82, 2.05), accused (HR: 1.49; 95%CI: 1.40, 1.59), or a witness of a crime (HR: 1.79; 95%CI: 1.65, 1.93) as young adults. EIPV increased the risk of being involved with Child and Family Services (HR: 4.50; 95%CI: 4.28, 4.73). Female children exposed to IPV had an increased the risk of having a teenaged pregnancy (HR: 1.59; 95% CI: 1.43, 1.76). Children exposed to IPV are at risk for adverse outcomes and require increased supports and social programming. Interventions to prevent IPV and to reduce negative outcomes are needed.
Informal pharmaceutical markets have become an issue of major concern for international agencies and national governments, including in Nigeria, due to reports about 'fake drugs'. These concerns have at times fostered severe regulatory responses, including violent crackdowns on informal markets. This study reimagines the regulation of informal pharmaceutical markets in ways that could promote drug quality and equitable access to drugs, drawing on the concepts of improvisation and pragmatic expertise, as well as on long-term ethnographic and interview-based research in two of South-Western Nigeria's major informal pharmaceutical markets (n = 82). Our data reveals conflicts between regulatory agencies (dominated by trained pharmacists) and informal market actors, characterised by attempts to control informal markets through re-spatialisation. Data also shows how claims about fake drugs in informal markets help to frame the key problematic of pharmaceutical markets as that of drug quality, thus upholding the role and powers of regulators and expert pharmacists. Informal market actors challenged accusations of fake drugs, emphasising the availability and affordability of essential drugs through their markets and self-regulation efforts, including through informal collaborations with state regulators. In contrast to recent policy initiatives and recent research, our findings show how institutional prioritisation of drug quality may unintentionally undermine other important health objectives, such as access to essential drugs, through regulatory processes that seek to contain informal markets within narrow institutional agendas. Our study reimagines the regulation of informal pharmaceutical markets by highlighting the importance of improvisation in regulatory approaches and the role of pragmatic expertise shared among regulators and informal market actors.
This review seeks to understand the global trends of contemporary witchcraft accusations and related harms against children and adolescents (0-18 years of age). Witchcraft-related violence against children and adolescents (children) reflects an alarming and understudied phenomenon of socio-culturally legitimated harm around the globe, particularly in sub-Saharan Africa. 'Witchcraft' explains the unexplainable, such as strokes of luck and/or misfortune. Witchcraft accusations are linked to illness, sudden death, financial misfortune, miscarriages, financial windfall, disability, birth abnormalities, or rare conditions. Religious entities also levy witchcraft accusations, referring to black magic, evil, works or malicious spirits, to profit off families while harming the accused. These accusations result in marginalization, alienation, slandered reputation, communal expulsion, and violence, causing disfiguration, disability, and death. Children are especially vulnerable to witchcraft-related violence, including human trafficking, and ceremonial and cultural sacrifice. This scoping review will examine witchcraft accusations and related harms against children and adolescents (0-18 years of age) globally from 1946 to 2024. This scoping review excludes articles that do not report specifics of the accusation, situation, result, age of the accused, or country of origin. This scoping review will follow the Joanna Briggs Institute's Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) Statement. Articles published from January 1, 1946 to December 31, 2024 will be collected across academic, grey literature and web-based databases. A systematic search strategy will be applied in each database, and all search results recorded. A bibliometric analysis will also be undertaken to systematically and rigorously review the extant literature. Findings of this review will identify areas of collaboration and gaps for further exploration. The literature analysis can raise awareness and inform resource development across health care, education, social work, government, and community sectors to better support victims of witchcraft-related harms.
BACKGROUND: Non-pharmaceutical interventions (NPIs) such as social distancing and quarantine were essential for containing COVID-19 transmission but had adverse effects on mental health and well-being. Migrants were often accused of non-adherence to NPIs, which was assumed to partly explain their higher infection rates compared to non-migrants. However, this perspective overlooked that migrants may have faced greater challenges adhering to interventions due to individual and structural barriers. Understanding these challenges is crucial for designing more inclusive, and effective public health strategies in future health crises. This study examines how perceived difficulty adhering to social distancing and quarantine evolved among migrants compared to non-migrants in Norway during the pandemic, examining contributing factors and disparities over time. METHODS: We conducted secondary analyses of data from the Bergen-In-Change study at three time points (March/April-2020, January-2021, March-2022). The sample comprised 25,418 participants, including 512 (2%) migrants from Asia, Africa, and Latin America (MAAL), and 1,253 (5%) migrants from other regions (MOR). Outcomes were difficulty adhering to social distancing and quarantine. We used descriptive statistics and generalized estimating equations to calculate incidence rate ratios (IRR) with 95% confidence intervals. Three models were run, adjusting for potential confounders and explanatory factors. RESULTS: Migrants reported difficulty adhering to social distancing less often than non-migrants (adjusted IRR: 0.79, CI: 0.70–0.90 for MAAL; 0.85 CI: 0.79–0.91 for MOR). In contrast, they were more likely to report difficulty adhering to quarantine (adjusted IRR: 1.68, CI: 1.17–2.42 and 1.66, CI: 1.31–2.11, respectively). MAAL reported increased difficulty with social distancing from 2020 to 2022, narrowing the gap with non-migrants. Difficulties adhering to quarantine also rose, particularly between 2020 and 2021 among MOR, widening disparities with non-migrants over time. Socioeconomic factors did not fully explain these differences. Living conditions and work type slightly attenuated the associations for quarantine, yet disparities remained after adjustments. CONCLUSION: Migrants reported difficulty adhering to social distancing less often, but more often reported difficulties with quarantine. Time trends pointed to increasing difficulties in adherence among migrants during the pandemic. The gaps persisted after adjusting for socioeconomic factors, suggesting an underlying role of migration-related factors that must be addressed to prevent inequities and social polarization in future health crises.
This study sought to understand the lived experiences and perspectives of men who inflict violence on their female intimate partners, given the nuances of Nigeria's individual, interpersonal, community, and societal factors. Eligible participants were male residents of Lagos State, Nigeria: (1) accused by their partner of perpetrating physical domestic violence (DV), (2) at least 21 years old, and (3) married. Nine men participated in the study and were purposively recruited from a governmental agency that provides on-site counseling and support to DV survivors and perpetrators. A semi-structured interview guide was used for data collection. The interview guide was designed to elicit information on perceptions of DV lived experiences, factors that increase the risk of DV perpetration, sources of help, and factors that can improve help-seeking behaviors among DV survivors/perpetrators. Four major themes were identified from the data and included values, premarital and marital expectations, DV definition and perception, and DV experiences. DV perpetuation was deeply rooted in men's childhood experiences of their fathers abusing their mothers and/or being exposed to other forms of violence early in life, sociocultural norms, economic pressures, and psychological factors. The findings from this study have implications for the development of DV interventions that are culturally tailored to address the unique challenges faced by families in Nigeria. Programs should focus on reshaping harmful gender norms, addressing economic/financial stressors, promoting healthy relationship dynamics, and early childhood DV prevention interventions. Campaigns that engage men while emphasizing the negative impacts of DV on families and communities could be instrumental in reducing victimization. Addressing modifiable risk factors earlier in the trajectory is critical in reducing the long-term incidence of DV. Our findings also underscore the importance of consistent enforcement of existing laws, such as the Violence Against Persons (Prohibition) Act, across Nigeria.
Performance comparisons are ubiquitous and natural at work and can be potent sources of social stress for employees. Drawing on social comparison and social self-preservation theories, the present research identifies perceived lower performance as a social stressor and investigates a dual mechanism through which individuals with relatively low performance engage in social self-preservation responses. We argue that perceived lower performance is likely to elicit social-evaluative threat, which, contingent on individuals' growth or fixed mindset, triggers either an upward assimilative or contrastive motive. Upward assimilative motive leads to self-improvement initiatives (i.e., learning from higher performers). Upward contrastive motive leads to self-protection strategies (i.e., withdrawal behavior, performance appraisal accusation). The results of a multitime survey (N = 371), an online experiment (N = 394), and a classroom-based observational study (N = 183) largely provide support for the hypotheses. Insights into theory, practice, and future research are addressed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Bacterial infection in root canals often persist despite thorough chemomechanical preparation. Conventional irrigants and medicaments reduce biofilms but have been accused of weakening dentin. Amorphous calcium phosphate nanoparticles showed promising results in enhancing dentin hardness, but the formula's anticmicrobial effect is yet to be evaluated in endodontic contexts. The aim of this study was to evaluate the feasibility of using 20% amorphous calcium phosphate nanoparticles loaded in chlorhexidine as an antibacterial intracanal medicament in endodontics. Forty four root dentin discs were prepared from human extracted teeth, sterilized and inoculated with E. faecalis to establish a 3-week-old standard monospecies bacterial biofilm model. After confirming biofilm establishment, forty specimens were randomly divided into four groups (n = 10) according to the medicament used: 20% amorphous calcium phosphate nanoparticles loaded in 2% chlorhexidine (NACP + CHX), 2% chlorhexidine (CHX), calcium hydroxide (Ca(OH)2), and a positive control group. After incubation, the specimens were stained and evaluated under the confocal laser scanning microscope (CLSM). Images were analyzed with Zen imaging software to quantify the percentage of live/dead bacterial cells. For multiple group comparisons, a one-way ANOVA was employed, and for pairwise comparisons, the Tukey post hoc test was used. Statistical significance was determined by a p-value < 0.05. All test groups showed a statistically significant bacterial reduction, ranging from 36.81% to 59.19% (p ≤ 0.001). CLSM analysis showed that NACP + CHX and CHX had the highest antibacterial effect without a significant difference between them (p ≈ 0.9). Ca(OH)2 demonstrated the least antibacterial effect amongst the test groups (p ≈ 0.01 × 10-6). The findings suggest that NACP + CHX when used as an intracanal medicament, demonstrates antibiofilm efficacy against E. faecalis biofilm.
BACKGROUND AND AIM: Cervical cancer, primarily caused by Human Papillomavirus, remains a significant global health concern. Despite vaccine availability, uptake rates are low in many conservative settings, including Iran, where context-specific factors influencing vaccination are often overlooked. This qualitative study aimed to explore and articulate the perceptions, experiences, and actionable recommendations of health and social experts concerning the barriers, facilitators, and the perceived family implications of Human Papillomavirus vaccination in Iran. METHODS: This qualitative inquiry employed Conventional Content Analysis. Using Maximum Variation Purposive Sampling, 18 female experts and professionals (Obstetricians/Gynecologists, health educators, laboratory staff, and academic researchers) were recruited from major medical universities in Tehran (January 2025 to September 2025). Data were gathered through five Focus Group Discussions (FGDs) and seven semi-structured In-depth Individual Interviews. Methodological rigor was ensured via techniques like Member Checking. Data were analyzed using MAXQDA 2020 software. RESULTS: Participants included 18 female experts (mean age 44 ± 10.7 years). Thematic analysis identified 13 sub-themes categorized into five domains: (1) family awareness and information sources; (2) family attitudes and beliefs; (3) family decision-making; (4) systemic and economic barriers; and (5) family wellbeing and policy. A central finding was the synergistic interplay between high economic costs and deep-seated social stigma. This linkage perpetuates low awareness and fuels moral misconceptions (e.g., vaccine as a “moral license”), which often lead to severe marital conflicts, infidelity accusations, and psychosocial distress within the family unit. CONCLUSION: From the Iranian experts’ perspective, vaccination uptake is primarily hindered by high cost, limited access, and deeply rooted social stigma associated with sexually transmitted infections. Key actionable recommendations include full insurance coverage, introducing affordable domestic vaccines, and implementing culturally tailored public health education to address moral concerns. These findings provide crucial evidence for policymakers to design targeted interventions that improve Human Papillomavirus vaccine coverage and protect family health in Iran.
The public is said to be misled by Internet fakery amplified by social media, which contributes to conspiracy belief among those on the political right who feel dispossessed and powerless. In fact, conspiracy belief is difficult to attribute to any one political complexion or social stratum. Uncritical social surveys, especially if taken too literally, easily misrepresent conservative respondents, and the consequent negativity towards them is often exaggerated. Those accusing others of conspiracy belief are at least equally susceptible to the alleged predisposing factor of motivated reasoning.
Dementia is an escalating public health concern in Sub-Saharan Africa (SSA), where over 60% of the global dementia burden is projected by 2050. Despite this, SSA remains underrepresented in dementia research, especially regarding stigma and cultural beliefs that shape the lives of people living with dementia and their caregivers. This scoping review systematically maps existing evidence on dementia-related stigma and cultural beliefs in SSA. The review followed the Arksey and O'Malley framework as refined by the Joanna Briggs Institute and adhered to PRISMA-ScR guidelines. A comprehensive search of PubMed, Scopus, CINAHL, PsycINFO, Web of Science, and African Journals Online (AJOL) was conducted for studies published between 2000 and 2025. Eligibility was guided by the Population-Concept-Context (PCC) framework, focusing on studies addressing dementia stigma and cultural beliefs in SSA. Data were charted using a template informed by the Integrated Framework for Normative Influence on Stigma (IFNIS) and synthesised thematically. Twenty-four studies from nine SSA countries were included. Most were qualitative, with few quantitative or intervention studies. Stigma was largely rooted in cultural beliefs linking dementia to witchcraft, curses, or ancestral punishment, leading to social exclusion, neglect, dispossession, and violence, especially targeting older women. Public stigma was reflected in negative stereotypes, discriminatory language, rejection, and avoidance. Structural stigma encompassed untrained health professionals, absent policies, and fragmented care pathways. Caregivers experienced courtesy stigma, isolation, and accusations of abuse. Direct perspectives from people living with dementia were limited. Evidence on stigma-reduction interventions was scarce. Dementia stigma in SSA is a complex cultural, social, and structural phenomenon. There is urgent need for stigma-informed policy, culturally sensitive education, caregiver support, health system strengthening, and robust intervention research.
Exonerations provide insight into how the criminal justice system sometimes fails. Exonerations in child sexual abuse (CSA) cases may be of particular interest as it is often impossible to tell if a crime has truly occurred, many cases lack corroborative evidence, and children's developmental capacity can at times evoke credibility concerns. Using the National Registry of Exonerations, we examined every known exonerated case of CSA in the United States (N = 339). We found these cases were similar to substantiated cases in many ways. Case features included a single victim (67.8%), victim recantation (49.0%), delayed disclosure (47.5%), alleged immediate family member or caregiver perpetration (47.2%), allegations of repeated abuse (47.2%), suggestive questioning (21.8%), custodial dispute issues (19.5%), and satanic ritual abuse allegations (15.0%). Several contained corroborative evidence (28.3%), a notable finding we discuss in detail. We found several case features became less common over time (e.g., satanic ritual abuse/hysteria, suggestive questioning, recantation). While policies guiding the interviewing of children have improved the ways we talk to children, exoneration evidence suggests there is still much to be learned about false accusations and room for improvement. Importantly, case characteristics appear quite similar for true and false allegations. This finding indicates that as interview and investigation protocols have improved in recent years, reducing the likelihood of clear indicators of false allegations, the issues leading to exoneration in CSA cases may now be subtler and more nuanced. As such, case characteristics are not necessarily clear indicators for allegation veracity and every case requires careful attention to detail.
United States seeks to debar Ralph Baric for misleading NIAID on old coronavirus studies, which he disputes.
Child sexual abuse cases present unique challenges for conviction and exoneration due to the typical reliance on the child's testimony as the primary source of evidence. Yet, little empirical research has examined wrongful convictions and exonerations in such cases. In this study, we analyzed the largest sample of child sexual abuse exonerations to date (N = 326), drawing on cases documented by the National Registry of Exonerations between 1989 and 2024. Descriptive results revealed several patterns unique to child sexual abuse exonerations. Unlike other types of crimes, perjury or false accusation was the most frequent contributor to wrongful convictions, while mistaken eyewitness identifications and false confessions were rare. Physical and forensic evidence were presented at many of the original trials, yet in most cases this evidence was later determined to be false or misleading. Post-conviction witness recantation was the most common factor contributing to exoneration, whereas few exonerations were based on DNA evidence or actual perpetrator identification. Case narratives highlight the influential role of family members and authorities in prompting children's false allegations. These findings provide novel insights to inform investigative, prosecutorial, and adjudicative approaches in child sexual abuse cases and reduce risk for future miscarriages of justice.
In this article we theorize ordinary possession as a form of self-estrangement through which tension, kinship pressure, and dissociative states are negotiated in everyday life in Pakistan. Rather than treating jinns as episodic intrusions, we show how their presence is apprehended as part of a relational field in which the boundaries of the self are routinely unsettled. We show how possession makes visible crises of authority and belonging within joint households. Ordinary possession thus names a psycho-ethical process in which the self becomes unfamiliar to itself in ways that allow suffering or resentment to be voiced without direct accusation.
Background and Clinical Significance: Human Herpesvirus 8-associated multicentric Castleman disease is a rare, lymphoproliferative disorder characterized by recurrent episodes of systemic inflammation. The disease is predominantly observed in human immunodeficiency virus-positive patients, but there is evidence of its occurrence in negative individuals. Its pathogenesis is driven by dysregulated cytokine activity, particularly interleukin 6. Additionally, these individuals have an increased risk of developing Kaposi Sarcoma, which may present simultaneously. Case Presentation: The current paper presents a case of a 58-year-old male patient admitted to the Hematology Department of the Emergency City Hospital in Timisoara, Romania, in October 2024, accusing fever, night sweats, palpitations, weight loss and general deterioration, approximately three months prior, with gradual progression. Clinical examination revealed bilateral lymphadenopathy in the cervical and inguinal regions. No cutaneous lesions were observed initially. Laboratory tests showed elevated inflammatory markers, pancytopenia, hypergammaglobulinemia and hyponatremia. HIV serology had negative results. CT imaging revealed extensive lymphadenopathy and splenomegaly. Further excisional biopsy of the inguinal and cervical lymphadenopathies was performed. Following the microscopic examination, the final diagnosis of Human Herpesvirus 8-associated multicentric Castleman disease concurrent with Kaposi Sarcoma was established. Conclusions: Human Herpesvirus 8-associated multicentric Castleman disease is predominantly observed in HIV-positive patients, but there is evidence of its occurrence in human immunodeficiency virus-negative individuals, presenting distinct epidemiological and pathological characteristics. Early and precise diagnosis is essential, as the disease can progress rapidly and may lead to severe or fatal outcomes.
Non-fatal strangulation (NFS) occurs in various contexts. Victims of NFS may face barriers to disclose, resulting in underreporting and subsequent police charges not proceeding. This study aims to explore the relationship between the court outcomes, the forensic medical examination findings, and the provision of a medicolegal report in patients who are referred by police to a forensic medical service in NFS cases that do not involve sexual assault. This is an exploratory case series of 167 non-sexual assault patients aged 14 and over who reported NFS following referral by Australian Capital Territory Police (ACTP). The cases were retrospectively examined by the ACT Director of Public Prosecutions and legal outcomes were incorporated. Statistical comparisons were performed using linear regression to calculate p-values via t-tests for continuous variables and Pearsons Chi-squared test for binary and categorical variables. Conviction for any offence occurred in 73.9% of NFS cases. Early presentation within 12 h was common (65.8%) and associated with conviction (p 0.04). Physical injuries to the face or legs significantly increased the association with conviction. Medicolegal reports were written in 112/167 (67%) cases and forensic images taken in 160/167 (95.8%). There was no statistically significant association between requesting a medicolegal report and conviction. Most accused were current or former partners, and a substantial proportion had a history of prior strangulation incidents. Early presentation to a forensic medical service was associated with conviction, highlighting the importance of timely assessment and comprehensive documentation. Medicolegal reports, while not independently increasing conviction rates, remain a valuable source of evidence that inform the legal system's understanding of NFS. These findings point to the need for system level responses including structured case review, interagency collaboration, and specialised NFS training to improve consistency, safety, and justice outcomes in NFS cases.