Fear Of Retribution Research Articles

Time’s Up Healthcare Sets a Wake-Up Call

Time’s Up Healthcare Sets a Wake-Up Call

The health impacts of violence perpetrated by police, military and other public security forces on gay, bisexual and other men who have sex with men in El Salvador

Gay, bisexual and other men who have sex with men face both high levels of violence and a disproportionate burden of poor health outcomes. We explored violence perpetrated against Salvadoran gay, bisexual and other men who have sex with men by public security forces; perceived motivations of violence; and impacts on health. We conducted structured qualitative interviews with 20 participants and used systematic coding and narrative analysis to identify emergent themes. Nearly all participants described the physical, emotional, sexual and/or economic violence by public security forces. Most attributed being targeted to their gender expression and/or perceived sexual orientation. The most common impact was emotional distress, including humiliation, fear and depression; lasting physical injuries were also widely reported. Study participants felt unable to report these incidents for fear of retribution or inaction. Men reported feelings of helplessness and distrust, avoidance of authorities and altering when, where or how often they appeared in public spaces. Programmes and interventions should focus on providing mental health services for LGBTI (lesbian, gay, bisexual, transgender and intersex) victims of violence, educating public security forces on the legal rights of Salvadorans and expanding current LGBTI-inclusive policies to all public security forces.

You Say Seduction and I Say Coercion: The Gray Areas of Consent

#MeToo, although freeing women (and men) to report harassment and abuse, mostly without the fear of retribution, has resulted in significant confusion and disorientation for people entering romantic or sexual relationships. A common thread in many reports of harassment and abuse is that a male “harasser” viewed the encounter as “consensual” and a female “victim” insists she was coerced. If one were to conceptualize a continuum of encounters from rape on the one end to sex that is mutually and joyously engaged in by both parties at the other the focus of this discussion is the “in-between” or gray areas. Gender differences, sexual fantasy, “spectatoring,” and other dissociative experiences in sexual encounters all contribute to the confusion. Consent may ultimately be about people giving themselves the right to “consent”; that is, to think, in the moment about whether a sexual encounter is something they want/desire, and the permission to call it off if they find it is not.

A 100th birthday wish: uphold academic freedom in dark times.

The Haldane principle, born a century ago, has enabled government scientists to speak truth to power without fear of retribution — cherish it, says Ehsan Masood. The Haldane principle, born a century ago, has enabled government scientists to speak truth to power without fear of retribution — cherish it, says Ehsan Masood.

Leading the Dialysis Unit: Role of the Medical Director.

The responsibilities of a dialysis unit medical director are specified in the ESRD Conditions for Coverage and encompass multiple quality, safety, and educational domains. Many of these responsibilities require leadership skills that are neither intuitive nor acquired as part of the medical director's training. An effective medical director is able to shape the culture of the dialysis facility such that patients and staff feel free to communicate their concerns regarding suboptimal processes without fear of retribution, and there is a continuous iterative process of quality improvement and safety, which values input from all stakeholders. This ultimately decreases the use of shortcuts and work-arounds that may compromise patient safety and quality because policies and procedures make it easiest to do the right thing. Fundamental to this leadership by the medical director are communications skills, staff empowerment, allocation of resources, mentoring, team building, and strategic vision. The medical director leads by example and must be present in the dialysis unit for extended periods to send a message of accessibility and commitment. Many dialysis medical directors would benefit from leadership training inside or outside their dialysis corporation.

Initial assessment of the psychometric properties of the Sexual Harassment Reporting Attitudes Scale

Although sexual harassment remains a common problem in the workplace, many victims and witnesses fail to report it to organizational authorities. Fear of retribution as well as perceptions of futil...

Advocacy: Perspectives of Future Nurse Administrators.

Advocacy is a core competency of the nurse, and especially the nurse leader. It is a multidimensional concept that requires knowledge, experience, self-confidence, and above all, courage. This article describes and illustrates the perspectives of nursing administration graduate students, as they depict advocacy in many relationships. These include advocacy for the patient, family, self, community, organization, profession, and society. The themes that emerged from narratives written by these nurse leaders were the development of courage and the finding of their voices. Stories demonstrate participants' courage to speak up despite feeling conflicted due to issues of autonomy, moral distress, or fear of retribution. Implications for nurse administrators to support advocacy at all levels are presented.

Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database.

A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. The extent of blame attribution in safety incident reports, which may reflect the underlying safety culture of health care systems, is unknown. This study set out to explore the nature of blame in family practice safety incident reports. We characterized a random sample of family practice patient safety incident reports from the England and Wales National Reporting and Learning System. Reports were analyzed according to prespecified classification systems to describe the incident type, contributory factors, outcomes, and severity of harm. We developed a taxonomy of blame attribution, and we then used descriptive statistical analyses to identify the proportions of blame types and to explore associations between incident characteristics and one type of blame. Health care professionals making family practice incident reports attributed blame to a person in 45% of cases (n = 975 of 2,148; 95% CI, 43%-47%). In 36% of cases, those who reported the incidents attributed fault to another person, whereas 2% of those reporting acknowledged personal responsibility. Blame was commonly associated with incidents where a complaint was anticipated. The high frequency of blame in these safety, incident reports may reflect a health care culture that leads to blame and retribution, rather than to identifying areas for learning and improvement, and a failure to appreciate the contribution of system factors in others' behavior. Successful improvement in patient safety through the analysis of incident reports is unlikely without achieving a blame-free culture.

The anxious host: Czechoslovakia and Carlos the Jackal 1978–1986

ABSTRACTThe nature of engagement by communist states with international terrorism remains contested. Furthermore, it represents one of the most enigmatic aspects of the Cold War. This article challenges the notion that the Soviet Bloc provided uniform active support to late Cold War terrorists and suggests new categories of host. To demonstrate the complexities and paradoxes of state-terrorist relations we examine Communist Czechoslovakia's relations with Carlos the Jackal – the most notorious terrorist of the period. The historical consensus remains that Carlos was supported by the Eastern Bloc. However, as newly-released Eastern European secret service documents show, attitudes of Moscow's allies varied considerably. Czechoslovakia was, at best, a temporary and ‘anxious host’. The arrival of major terrorists in such ‘anxious’ states were in fact often unannounced, uninvited and undesired – yet the hosts fell short of arresting the terrorists either due to ideological affinity or fear of retribution. From his first visit to Prague, Carlos the Jackal was considered to be a threat and a reputational hazard by the Czechoslovak State Security (StB). Gradually, the StB adopted subtle measures aimed at deterring the return of Carlos and his Group. Finally, in the mid-1980s, they artfully ejected the Jackal and his accomplices from its territory, but without risking formal expulsion.

Using Moral Distress for Organizational Improvement

Moral distress is a major problem for nurses, other clinicians, and the health system itself. But if properly understood and responded to, it is also a promising guide for healthcare improvement. When individuals experience moral distress or burnout, their reports must be seen as crucial data requiring careful attention to the individuals and to the organization. Distress and burnout will often point to important opportunities for system improvements, which may in turn reduce the experience of distress. For this potential virtuous cycle to happen, individuals must be able to articulate their concerns without fear of retribution, and organizational leaders must be able to listen in an undefensive, improvement-oriented manner.

Perceptions of public land governance from two Canadian provinces: How is the social agenda being met through sustainable forest management?

This article presents a comparative assessment of current spaces for public involvement in Crown (public) land management in the Canadian provinces of New Brunswick and Nova Scotia. More specifically, it addresses the barriers to public participation by examining the agency-client relationship – specifically, through the theoretical lens of capture – as an impediment to the inclusion of values that are outside the traditional, technocratic management realm of public forest management. Without public input, the public’s needs, values, and desires are not articulated and the social side of sustainable forest management is likely to be neglected. Low levels of trust in public land management agencies in New Brunswick and Nova Scotia, coupled with minimal space for public involvement, have created the perception of a policy network that is dominated by industry and/or government and provides minimal space for other interests. The primary research method is an online survey informed by forty-two interviews. The survey was administered to 89 key forestry stakeholders in New Brunswick and Nova Scotia. Participation observation and a document analysis are utilized to complement the survey. This research finds that (1) although survey participants come from diverse affiliations and two provinces with different forest policy and unique approaches to public participation, there is essential consensus of the need for an improvement of public involvement processes for public land; (2) trust in the forest industry and the Department of Natural Resources (DNR) is extremely low in both provinces. Even with recent participatory efforts in Nova Scotia, the trust level is lower than in the neighboring province of New Brunswick. Some participants connect this distrust to privileged access for certain interest groups and a closed policy network; (3) barriers to participatory processes differ between provinces, especially a fear of retribution, which is specific to New Brunswick; and (4) key stakeholders identify barriers to engagement that they perceive to be different for themselves and the general public.

Mediatization in Pakistan: Perceptions of media influence on a fragile democracy

A survey of Pakistani journalists, members of the policy community and media academics found that the mediatization of Pakistan is having a mixed effect on the stability of the country’s fragile democracy. Members of the policy community generally have a more positive view of the impact of the media on Pakistani society than those who work in the profession and say they take media reaction into account before making decisions, although all groups said the media are still unable to fulfill its watchdog role without fear of retribution. The results are in line with studies in the developed world that found that the more politicians believe in a stronger media effect, the more susceptible they become to media agenda setting. The findings also bolster the ‘co-evolution’ theory that argues media gain influence as democracy stabilizes in post-autocratic environments.

Factors Related to Rape Reporting Behavior in Brazil: Examining the Role of Spatio-Temporal Factors.

The reporting of rape to police is an important component of this crime to have the criminal justice system involved and, potentially, punish offenders. However, for a number of reasons (fear of retribution, self-blame, etc.), most rapes are not reported to police. Most often, the research investigating this phenomenon considers incident and victim factors with little attention to the spatio-temporal factors of the rape. In this study, we consider incident, victim, and spatio-temporal factors relating to rape reporting in Campinas, Brazil. Our primary research question is whether or not the spatio-temporal factors play a significant role in the reporting of rape, over and above incident and victim factors. The subjects under study are women who were admitted to the Women's Integrated Healthcare Center at the State University of Campinas, Brazil, and surveyed by a psychologist or a social worker. Rape reporting to police was measured using a dichotomous variable. Logistic regression was used to predict the probability of rape reporting based on incident, victim, and spatio-temporal factors. Although we find that incident and victim factors matter for rape reporting, spatio-temporal factors (rape/home location and whether the rape was in a private or public place) play an important role in rape reporting, similar to the literature that considers these factors. This result has significant implications for sexual violence education. Only when we know why women decide not to report a rape may we begin to work on strategies to overcome these hurdles.

Understanding maladaptive responses to rejection: Aggression with an audience

ABSTRACTLogically, responding aggressively to rejection is maladaptive because one is unlikely to seek a relationship with an aggressor. We predict that when concealed, the illogical aggressive response to rejection is more likely, whereas when the rejected individuals’ aggressive responses are perceived as public, the aggressive acts may be reduced. Participants were rejected by others (Experiment 1) or were either accepted or rejected during an online ball-tossing game (Experiment 2) and were then given an opportunity to aggress publicly or privately. Across experiments, when the opportunity to aggress was made public, rejected participants exhibited less aggressive behavior. When concerned about the perception of their public aggressive responses by others, rejected individuals’ aggressive responses diminished compared with those whose actions were private. Crucially, this extended to aggression visible only to neutral others, suggesting that effects cannot solely be due to fear of retribution.

Former Japanese Soldiers Who Joined Communist Guerrillas in Malaya: Reconstructing an Elusive History

At the end of the Pacific War, 200–400 Japanese ex-soldiers stationed in Malaya joined the Malayan Communist Party guerrillas out of fear of retribution by victorious Allied soldiers or to fulfil Japan’s promise to liberate Malaya from colonial rule. However, the MCP led by Lai Teck decided not to wage armed struggle after the Japanese surrender, and Lai Tek ordered the execution of a number of Japanese. Those who remained fought for the liberation of Malaya during the Emergency, but by the late 1950s most of this group had either been killed in action, succumbed to disease, or surrendered. When the MCP ceased armed struggle in December 1989, just two Japanese remained with the group. This article uses Japanese and Malayan documents, including those of the Malayan Communist Party, to identify Japanese who joined the guerrillas as a first step toward allowing historians to evaluate their role.

Assessing the Perceived Level of Institutional Support for the Second Victim After a Patient Safety Event

The objective of this study was to establish a baseline of perceived availability of institutional support services or interventions and experiences following an adverse patient safety event (PSE) in a 650-bed children and adult community teaching hospital. Investigators queried associates about their experiences after a PSE, what institutional support services or interventions they perceived to be available, and how helpful used services were. The investigators used an online modified version of a PSE survey developed by several health related organizations in Boston. One hundred twenty evaluable surveys were analyzed. Sixty-eight percent of respondents were nurses, 99% of whom were female. Only 10% to 30% of respondents reported that various support services or interventions were actively offered, and 30% to 60% indicated that they were not available. Respondents reported having experienced several distressing symptoms after a PSE, most notably, troubling memories (56%) and worry about lawsuits (37%). Less than 32% "agreed" or "strongly agreed" that they could report concerns without fear of retribution or punitive action. More respondents experienced support from clinical colleagues (64%) than from their manager or department chair (38%). These results validate a need by associates for emotional support after a PSE and that associates' perception of available formal institutional support services or interventions is low.

HIV and the Arab Spring

HIV and the Arab Spring

Non-reporting of work injuries and aspects of jobsite safety climate and behavioral-based safety elements among carpenters in Washington State.

Declining work injury rates may reflect safer work conditions as well as under-reporting. Union carpenters were invited to participate in a mailed, cross-sectional survey designed to capture information about injury reporting practices. Prevalence of non-reporting and fear of repercussions for reporting were compared across exposure to behavioral-based safety elements and three domains of the Nordic Safety Climate Questionnaire (NOSACQ-50). The majority (>75%) of the 1,155 participants felt they could report work-related injuries to their supervisor without fear of retribution, and most felt that the majority of injuries on their jobsites got reported. However, nearly half indicated it was best not to report minor injuries, and felt pressures to use their private insurance for work injury care. The prevalence of non-reporting and fear of reporting increased markedly with poorer measures of management safety justice (NOSACQ-50). Formal and informal policies and practices on jobsites likely influence injury reporting.

Effect of face-to-face interview versus computer-assisted self-interview on disclosure of intimate partner violence among African American women in WIC clinics.

African American women in the United States report intimate partner violence (IPV) more often than the general population of women. Overall, women underreport IPV because of shame, embarrassment, fear of retribution, or low expectation of legal support. African American women may be especially unlikely to report IPV because of poverty, low social support, and past experiences of discrimination. The purpose of this article is to determine the context in which low-income African American women disclose IPV. Consenting African American women receiving Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services in WIC clinics were randomized to complete an IPV screening (Revised Conflict Tactics Scales-Short Form) via computer-assisted self-interview (CASI) or face-to-face interview (FTFI). Women (n = 368) reported high rates of lifetime and prior-year verbal (48%, 34%), physical (12%, 7%), sexual (10%, 7%), and any (49%, 36%) IPV, as well as IPV-related injury (13%, 7%). Mode of screening, but not interviewer race, affected disclosure. Women screened via FTFI reported significantly more lifetime and prior-year negotiation (adjusted odds ratio [aOR] = 10.54, 3.97) and more prior-year verbal (aOR = 2.10), sexual (aOR = 4.31), and any (aOR = 2.02) IPV than CASI-screened women. African American women in a WIC setting disclosed IPV more often in face-to-face than computer screening, and race-matching of client and interviewer did not affect disclosure. Findings highlight the potential value of face-to-face screening to identify women at risk of IPV. Programs should weigh the costs and benefits of training staff versus using computer-based technologies to screen for IPV in WIC settings.

When the Outside World Changes: A Group's Attempts to Emerge from Apartheid

This was a plenary presentation at the 18th International Congress of IAGP ‘Between Worlds and Cultures: Social Transformation’ Cartagena de Indias, Colombia in 2012. The demise of the apartheid system in South Africa brought about a change in the external world so profound that all who lived through it sensed its unique, oncein- a-lifetime quality. Yet, alongside the palpable and widespread relief that a hated system had finally passed, there was also considerable anxiety as to possible threats that racism internalised into the mind during the apartheid years, working especially at an unconscious level, might pose for the future. This was not easy to address - it was often said that in the new South Africa one could not find anyone who had ever supported apartheid, which made it difficult to have a proper dialogue, at the personal level, about how that system had become so central to white thinking. It also led to concerns about what was being denied. This paper describes work in a small group setting that tried to investigate that anxiety. Early on, mention of an incident involving hidden racist dynamics led to a deadening paralysis. Paralysis of such intensity usually gives expression to psychotic anxiety but is also characteristic, I have found, of the deployment of internal racist defences. These comprise an organised us-them defensive system, constituted around a split between self and ‘racial’ other, which is a universal feature of the mind that can be mobilised to deal with anxiety - in the group’s case, underlying anxiety about change itself. It was not this anxiety that paralysed the group. Instead, it stemmed from an unconscious belief that the racialised defence was necessary for protection, which generates unbearable guilt and a fear of retribution. The intensity of these emotions and the paralysis they engendered stem from the racialised defence being located at a primitive level of functioning in the mind. Despite the intensity, the theoretical understanding that it occurs within a normal rather than psychotic mind made it possible to address the paralysis in a direct and ordinary way. This approach provided an opportunity to engage directly the defensive system in which the racist object relationship is located. Splitting became the group’s dominant defence, recreating an apartheid mindset in the here-and-now but the facilitator’s capacity to contain, by verbalising accurately what was being projected, enabled the group to work with the projections. I bring forward moving material that shows unconscious recognition of the fact that the group had traversed this apartheid terrain in its own short history, as well as its pain at losing such a containing space, seen as precious in a changing world that generates considerable anxiety and in which the regressive pull to a racialised defence is ever-present. Would its members, as individuals, be able to take forward into the world the learning from the group, or would they succumb to the unconscious pull of the radicalised defence?