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moral injury

Abby L Braitman, Allison R Battles, Michelle L Kelley, Hannah C Hamrick, Robert J Cramer, Sarah Ehlke, Adrian J Bravo
Moral injury (MI) results from perpetration of or exposure to distressing events, known as morally injurious events (MIEs), that challenge moral beliefs and values. Due to the type of involvement in recent military conflicts, many veterans report MIEs that may cause dissonance and, in turn, MI. Although two existing measures assess MIEs, neither currently assesses the defining characteristics of MI (i.e., guilt, shame, difficulty forgiving self and others, and withdrawal). The present study reports the initial psychometric test of a modified version (Robbins, Kelley, Hamrick, Bravo, & White, 2017) of the Moral Injury Questionnaire - Military version (MIQ-M; Currier, Holland, Drescher, & Foy, 2015) in a sample of 328 military personnel (e...
December 2018: Traumatology
Yeny Concha-Cisternas, Eduardo Guzmán-Muñoz, Pablo Valdés-Badilla, Carlos Lira-Cea, Fanny Petermann, Carlos Celis-Morales
BACKGROUND: University students are considered a vulnerable group due to their adoption of unhealthy diets and lifestyles. AIM: To determine the main risk factors associated with low level of physical activity and excess body weight in university students. MATERIAL AND METHODS: This cross-sectional study included 358 university students from Talca, (53% female). Sociodemographic, academic, health, lifestyle, nutritional status, physical activity and sedentary behavior variables were analyzed by logistic regression...
August 2018: Revista Médica de Chile
Paula Ferrada, Luke Wolfe, Juan Duchesne, Gustavo P Fraga, Elizabeth Benjamin, Agustin Alvarez, Andre Campbell, Christopher Wybourn, Alberto García, Carlos Morales, Julieta Correa, Bruno M Pereira, Marcelo Ribeiro, Martha Quiodettis, Gregory Peck, Juan C Salamea, Vitor F Kruger, Rao Ivatury, Thomas Scalea
INTRODUCTION: The operative management of duodenal trauma remains controversial. Our hypothesis is that a simplified operative approach could lead to better outcomes. METHODS: We conducted an international multicenter study, involving thirteen centers. We performed a retrospective review from January 2007 to December of 2016. Data on demographics, mechanism of trauma, blood loss, operative time, and associated injured organs were collected. Outcomes included post-operative intra-abdominal sepsis, leak, need for unplanned surgery, length of stay, renal failure and mortality...
December 6, 2018: Journal of Trauma and Acute Care Surgery
J Morales-Villanueva, F Tamayo-Pacho, O P Pineda-Castro
BACKGROUND: Fractures of the lateral third of the clavicle represent 18% of all clavicle fractures. Even though non-displaced fractures can be managed conservatively, displaced fractures have a non-union percentage of 30%. Multiple approaches have been proposed to manage the displaced fractures. The objective of this study was to record the prevalence of fractures of the lateral third of the clavicle with involvement of the clavicular-acromial joint, as well as to briefly review the treatment performed in our center and compare it with the current literature...
May 2018: Acta Ortopédica Mexicana
Nancy Vargas-Mendoza, Miguel Vázquez-Velasco, Laura González-Torres, Juana Benedí, Francisco José Sánchez-Muniz, Jose Antonio Morales-González, Osmar Antonio Jaramillo-Morales, Carmen Valadez-Vega, Mirandeli Bautista
Geranium schiedeanum has been used in traditional therapies as an antiseptic, antipyretic, and as analgesic. The present study was designed to evaluate the pretreatment with G. schiedeanum total extract (GS) and its active metabolites on stimulating the endogenous antioxidant defense system (EADS): catalase (Cat), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), and glutathione reduction index (RI GSH/GSSG) in rat liver treated with a sublethal dose (6.6 mmol/Kg) of thioacetamide (TAA) in order to probe the capacity of GS and the active compounds to reduce liver injury...
November 30, 2018: Antioxidants (Basel, Switzerland)
Encarnación Liébana, Cristina Monleón, Raquel Morales, Carlos Pablos, Consuelo Moratal, Esther Blasco
Dancers are subjected to high-intensity workouts when they practice dancesport, and according to the literature, they are prone to injury, primarily of the lower limbs. The purpose of this study was to determine whether differences exist in relative activation amplitudes for dancers involved in dancesport due to muscle, gender, and type of dance. Measurements were carried out using surface electromyography equipment during the choreography of a performance in the following leg muscles: rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius medialis...
December 2018: Medical Problems of Performing Artists
Lorraine A Smith-MacDonald, Jean-Sébastien Morin, Suzette Brémault-Phillips
Moral Injury (MI) describes the profound distress experienced by military personnel as a result of a violation of personal beliefs. Impacting not only psychological, but spiritual, health, and well-being, MI is associated with spiritual/religious (S/R) suffering and a need to find hope, trust, connection, reconciliation, and wholeness. Addressing spiritual wounds can help military personnel overcome fundamental barriers that may impede them from effectively engaging in or benefitting from traditional trauma therapies and having a more complete recovery...
2018: Frontiers in Psychiatry
Sebastián Montoro-Molina, Antonio López-Carmona, Andrés Quesada, Francisco O'Valle, Natividad Martín-Morales, Antonio Osuna, Félix Vargas, Rosemary Wangensteen
The aim of this study was to investigate if urinary glutamyl aminopeptidase (GluAp), alanyl aminopeptidase (AlaAp), Klotho and hydroxyproline can be considered as potential biomarkers of renal injury and fibrosis in an experimental model of obesity. Male Zucker lean (ZL) and obese (ZO) rats were studied from 2 to 8 months old. Kidneys from ZO rats at the end of the study (8 months old) developed mild focal and segmental glomerulosclerosis as well as moderate tubulointerstitial injury. Urinary excretion of Klotho was higher in ZO rats at 2, 5, and 8 months of study, plasma Klotho levels were reduced and protein abundance of Klotho in renal tissue was similar in ZL and ZO rats...
2018: Frontiers in Physiology
Terri Link
Physical stressors that occur with patient and equipment handling in the OR (eg, moving or lifting patients, carrying heavy instrument sets, prolonged standing) can contribute to musculoskeletal disorders for perioperative personnel. In addition to increasing patient safety, safe patient handling and movement (SPHM) programs have been shown to reduce the risk and severity of injuries, workers' compensation costs, and personnel fatigue and to increase health care workers' morale and quality of life. The AORN "Guideline for safe patient handling and movement" provides guidance for implementing an SPHM program...
December 2018: AORN Journal
Daniel Maxwell, Peter Rhee, Mack Drake, Juvonda Hodge, Walter Ingram, Rachael Williams
BACKGROUND: Frailty has demonstrated enhanced prognostic ability for elderly patient morbidity. The aim was to create a burn-specific frailty index for elderly patients and compare it to commonly used scoring systems in burn management. METHODS: From 2013 to 2017, we prospectively surveyed a randomized cohort of patients ≥65-years-old previously admitted to our burn unit. Prognostic comparisons with 6 commonly used indices and multivariate risk analyses were performed...
November 14, 2018: American Journal of Surgery
Sarah B Mulkey, Dorothy I Bulas, Gilbert Vezina, Yamil Fourzali, Armando Morales, Margarita Arroyave-Wessel, Christopher B Swisher, Caitlin Cristante, Stephanie M Russo, Liliana Encinales, Nelly Pacheco, Youssef A Kousa, Robert S Lanciotti, Carlos Cure, Roberta L DeBiasi, Adre J du Plessis
Importance: The evolution of fetal brain injury by Zika virus (ZIKV) infection is not well described. Objectives: To perform longitudinal neuroimaging of fetuses and infants exposed to in utero maternal ZIKV infection using concomitant magnetic resonance imaging (MRI) and ultrasonography (US), as well as to determine the duration of viremia in pregnant women with ZIKV infection and whether the duration of viremia correlated with fetal and/or infant brain abnormalities...
November 26, 2018: JAMA Pediatrics
Sheila B Frankfurt, Bryann B DeBeer, Sandra B Morissette, Nathan A Kimbrel, Heidi La Bash, Eric C Meyer
Objective: Moral injury may result from perpetration-based and betrayal-based acts that violate deeply held norms; however, researchers and clinicians have little guidance about the moral injury syndrome's specific developmental pathways following morally injurious events. The present study's objective was to examine the direct and indirect pathways proposed in a frequently cited model of moral injury (1) in relation to two types of military-related traumas [experiencing military sexual trauma (MST) and combat exposure]...
2018: Frontiers in Psychiatry
Melissa A Smigelsky, Jesse D Malott, Katherine Veazey Morris, Kristoffer S Berlin, Robert A Neimeyer
OBJECTIVES: Theoretical support for the moral injury (MI) construct is mounting, yet empirical support has lagged behind. A conceptual model has been proposed, but studies have not yet explored the constellation of symptoms within treatment-seeking Veterans. METHODS: Veterans (N = 212) seeking trauma recovery services completed measures of potential MI symptoms that functioned as indicators in person-centered Latent Profile Analysis. Differences in exposure to potentially morally injurious experiences (pMIEs) were compared across profiles using logistic regression...
November 15, 2018: Journal of Clinical Psychology
Jun Shigemura, Takeshi Tanigawa, Yuki Kobayashi, Mie Kurosawa, Ai Noda, Aihide Yoshino
Posttraumatic stress disorder (PTSD) is a mental disorder that can develop following exposure to a traumatic event. Historically, it has been debated whether features of this disorder derive from mental or brain organic changes. Recent developments in neuroimaging and biological studies suggest a biological background of PTSD. In contrast, recent literature shows an impact of psychological context in the traumatic experiences, and concepts such as "moral injury" have been developed. Future studies are needed to better understand the mental and organic mechanisms underlying PTSD...
November 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Tomo Ando, Oluwole Adegbala, Pedro A Villablanca, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Theodore Schreiber, Tamim Nazif, Susheel Kodali, Luis Afonso
OBJECTIVES: To assess the in-hospital outcomes of transcatheter aortic valve replacement (TAVR) vs. surgical aortic valve replacement (SAVR) in non-teaching hospitals. BACKGROUND: TAVR has become widely available in the United States. However, the comparative outcomes of TAVR vs. SAVR in non-teaching hospitals are largely under explored. METHODS: We queried the Nationwide Inpatient Sample database from 2011 to September 2015 to identify those who were 50 years or above and underwent either trans-arterial TAVR or SAVR at non-teaching hospital...
November 8, 2018: Catheterization and Cardiovascular Interventions
Natalie Purcell, Brandon J Griffin, Kristine Burkman, Shira Maguen
For military veterans struggling with moral injury, forgiveness can become both an animating concern and a potential path to healing. In this perspective piece, we draw on our clinical work and research findings to examine why forgiveness matters to veterans who feel guilt and shame about their actions in war, what type of forgiveness is attainable and meaningful, and what role clinicians can play in facilitating forgiveness. We conclude by reflecting on the potential, as well as the limits and tensions, of forgiveness work in the context of military moral injury...
2018: Frontiers in Psychiatry
Adolfo Cuendis-Velázquez, Mario Trejo-Ávila, Orlando Bada-Yllán, Eduardo Cárdenas-Lailson, Carlos Morales-Chávez, Luis Fernández-Álvarez, Sujey Romero-Loera, Martin Rojano-Rodríguez, Carlos Valenzuela-Salazar, Mucio Moreno-Portillo
BACKGROUND: Despite scientific evidence of the safety, efficacy, and in some cases superiority of minimally invasive surgery in hepato-pancreato-biliary procedures, there are scarce publications about bile duct repairs. The aim of this study was to compare the outcomes of robotic-assisted surgery versus laparoscopic surgery on bile duct repair in patients with post-cholecystectomy bile duct injury. METHODS: This is a retrospective comparative study of our prospectively collected database of patients with bile duct injury who underwent robotic or laparoscopic hepaticojejunostomy...
November 6, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Ismael Juárez, Julio César Morales-Medina, Julia Flores-Tochihuitl, Gamaliel Santiago Juárez, Gonzalo Flores, Hortencia Chávez Oseki
Orofacial injuries often result in persistent pain and are therefore considered a common health problem worldwide. Considerable evidence suggests that peripheral sensory nerve injury results in diverse plastic changes in the central nervous system (CNS). Tooth pulp is innervated by trigeminal afferents which extend to the trigeminal brainstem sensory nuclear complex and send input to higher level neurons in the CNS, including the ventral posterolateral nucleus of the thalamus (VPL). In the present study, we examined the long term effects of pulpal injury on neuronal arborization in the VPL using morphological analysis via Golgi-Cox staining...
November 2, 2018: Journal of Chemical Neuroanatomy
Jose Maria Morales, Manuel Serrano, Jose Antonio Martinez-Flores, Dolores Perez, Antonio Serrano
Renal allograft thrombosis is the most frequent and devastating complication in the early postrenal transplantation period. Several risk factors to develop graft thrombosis depending on donors and recipients are well known. Antiphospholipid syndrome (APS) is well recognized as an important cause of kidney injury, with specific clinical and histological features that may lead to renal injury caused by thrombosis at any location within the renal vasculature. There are 3 forms of APS, primary (the most common form), associated to other systemic autoimmune diseases (SAD-APS) and catastrophic...
October 30, 2018: Transplantation
Nagy A Youssef, Elizabeth Lee, Donna Ames, Rev John P Oliver, Ellen J Teng, Kerry Haynes, Fred Volk, Harold G Koenig
BACKGROUND: We examined U.S. veterans' interest in spiritually-oriented therapy (SOT) for treating inner conflict/moral injury (ICMI); identified combat-related, demographic, religious, and psychological characteristics of those interested in this treatment modality; and determined which participants would prefer SOT therapy. METHODS: This study was a cross-sectional multi-site study of 464 veterans with posttraumatic stress disorder (PTSD) related to war time experiences...
November 2018: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
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