Psychological Harm Research Articles

Bacha Bazi: Unraveling Debate between Crime Against Humanity and Regional Tradition

This study analyzes the Bacha Bazi phenomenon in Afghanistan through the lens of international law, exploring its potential classification as a crime against humanity. It examines the physical, psychological, and sexual harm inflicted on underage boys and highlights the Taliban’s involvement. It assesses the harm inflicted on underage boys and the Taliban’s involvement while also reviewing Afghanistan’s revised penal code and its implementation challenges. The study suggests utilizing the Responsibility to Protect framework to address the issue, emphasizing collective action and cooperation between Afghanistan and the international community to combat Bacha Bazi and protect children’s rights.

REGULATING TRANSNATIONAL DISSIDENT CYBER ESPIONAGE

AbstractRemote-access cyber espionage operations against activists, dissidents or human rights defenders abroad are increasingly a feature of digital transnational repression. This arises when State or State-related actors use digital technologies to silence or stifle dissent from human rights defenders, activists and dissidents abroad through the collection of confidential information that is then weaponized against the target or their networks. Examples include the targeting of Ghanem Al-Masarir (a Saudi dissident living in the United Kingdom), Carine Kanimba (a United States–Belgian dual citizen and daughter of Rwandan activist Paul Rusesabagina living in the United States) and Omar Abdulaziz (another Saudi dissident living in Canada) with NSO Group's mercenary spyware. This practice erodes human rights, democracy and the rule of law and has a negative impact on targeted communities, including social isolation, self-censorship, the fragmentation and impairment of transnational political and social advocacy networks, and psychological and social harm. Despite this, international law does little to restrain this practice. Building on momentum around the regulation of mercenary spyware and transnational repression, this article elaborates on how States could consider regulating dissident cyber espionage and streamlines a unified approach among ratifying States addressing issues such as State immunity, burden of proof, export control and international and public–private sector collaboration.

AN ASSESSMENT OF CONFLICT-INDUCED INTERNAL DISPLACEMENT TRENDS AND SITUATIONS OF IDPS IN ETHIOPIA

Internal displacement has emerged as one of the world's greatest human disasters today. IDMC 2023 statistics showedthat, there are approximately 77.1 million internally displaced persons. It causes death and property damage, foodinsecurity and starvation, family disruption, psychological and physical problems on IDPs. Hence, the objective of thisstudy was to examine the prevalence of conflict-induced internal displacement in Ethiopia from 2017 to 2023, andidentify the situations of IDPs housed in IDPs camps of North-western Ethiopia (Amhara region). The data wascollected from 415 surveyed IDPs, 14 interviewee and 8 key informants. The secondary sources i.e. published articlesand IDMC data were taken. Descriptive statistics and textual analysis were used to analyse the data.The result demonstrated that, a total of 670,999; 187,592, and 1,431,682 persons were displaced within the regions andwithin the country due to the escalation of conflict before 2018, during 2018, and in 2019 respectively. This shows thatan enormous tragedy also referred to as a human catastrophe occurred in the Ethiopian historic event in 2019, withabout 1.432 million people fleeing their homes because of inter-communal violence in the country. As a result of conflictand violence, more than 2.9 million people have been internally displaced in the country since 2020. Hence, from 2008to December 2021, the overall number of internal displaced people in Ethiopia was more than 5,142,000, whereas thetotal number of IDPs due to conflict is more than 3,589,000 as of the end of 2021. As of March 2022, an estimated5,582,000 people were internally displaced within Ethiopia as a result of armed conflict and disasters, with 2,848, 0001IDPs in the Amhara, Afar, and Tigray regions. Nearly 3.9 million people living in displacement because of conflict andviolence across Ethiopia at the end of 2022. Based on the findings, a significant number of displaced people housed inIDP camps did not have shelter, shortage of food and nonfood items, rare safe drinking water sources, high sicknessand death, limited sanitation, health and hygiene services. Additionally, IDPs did not have security protection, whichprevent them from physical and psychological harms, and did not receive any protective and resilient support fromgovernment to their survival in the dwelled camp sites. In conclusion, Ethiopia represented the highest proportion ofIDPs in the global displacement numbers. Conflict-induced displaced persons housed in the camps of Amhara regionare living in desperate conditions. Therefore, federal government of Ethiopia should work towards addressing thecauses of conflict and ethnic based violence, human rights protection, and political commitment with regionalgovernments on the issues of IDPs for durable solutions.

FACTORS AFFECTING VIOLENCE AGAINST WOMEN IN CABANATUAN CITY

This study aimed to examine the factors affecting violence against women in Cabanatuan City, Philippines. The research questions focused on identifying common crimes/violence/abuse committed against women and exploring the factors influencing such violence. A descriptive research design was employed, gathering quantifiable information through data analysis. The study was conducted in selected barangays in Cabanatuan City, namely Sumacab Este, Bagong Sikat, and Bakero, which had a high number of reported cases of violence against women. The participants included barangay officials and barangay tanods. The findings revealed numerous forms of violence and abuse against women, such as physical violence, sexual violence, economic abuse, emotional abuse, and psychological abuse. These forms of violence stem from gender-based inequality and power imbalances, resulting in significant physical, emotional, and psychological harm to women. The study also highlighted low levels of womens access to paid employment, indicating gender disparities in the workforce due to discrimination, limited job opportunities, unequal pay, and inadequate support for work-life balance. These inequalities hinder womens economic independence and overall empowerment, contributing to gender-based economic disparities. Additionally, the study identified limited access to education among women, emphasizing an educational gap that restricts personal and professional development, limits socio-economic opportunities, and perpetuates gender inequality. The study accentuates the urgent need for interventions and policies to address violence against women and promote gender equality in Cabanatuan City. Efforts should focus on raising awareness about the various forms of violence, implementing measures to protect women, promoting economic opportunities for women, and ensuring equal access to education. By addressing these factors, the study aims to contribute to the creation of a safer and more equitable society for women in Cabanatuan City and beyond. KEYWORDS: Factors, Violence against women, Cabanatuan City, Abused against Women

Impact of sharing Alzheimer’s disease biomarker results with individuals without dementia: a systematic review and meta‐analysis of empirical data

AbstractBackgroundA biological definition of Alzheimer’s disease (AD) is increasingly used in research, but little is known about the consequences of early biomarker testing from the perspective of professional (healthcare professionals) and personal (citizens, patients, and their families) stakeholders. We aim to provide a systematic literature review and meta‐analysis of empirical evidence on expected and experienced implications of sharing AD biomarker results with individuals without dementia.MethodWe searched PubMed, Embase, APA PsycINFO, and Web of Science Core Collection on 10 November 2021 for literature on sharing AD biomarker results with individuals without dementia. Two reviewers independently screened 8034 titles and abstracts, and 192 full‐text records, for eligibility. Results from included studies were synthesized and quantitative data on psychosocial impact (anxiety, depression, stress, and suicidal ideation) were meta‐analyzed using a random‐effects model.ResultWe included 33 publications (20 quantitative and 13 qualitative data). Of these, eight reported on professional stakeholders’ attitudes and practices, 13 on personal stakeholders’ expectations, and 12 on their actual experiences. Most professional stakeholders valued biomarker testing, believing the benefits outweigh the risks, although attitudes and practices varied considerably. Most personal stakeholders expressed interest in (hypothetical) biomarker assessment, expecting to gain insight, reduce dementia risk and prepare for the future. Studies evaluating actual experiences found that sharing negative biomarker results led to relief and sometimes frustration for not having an explanation for concerns, while positive biomarkers prompted anxiety but also clarity. Those tested positive intended to adapt their lifestyle and plans, yet some worried about stigmatization. The majority did not regret being informed. Meta‐analysis of 5 studies including 2012 participants (elevated amyloid = 1324, asymptomatic = 1855) showed that short‐term psychological impact was not significant when considering all participants (random‐effect estimate = 0.026, SE = 0.018, p = 0.153), nor biomarker‐positive (estimate = 0.012, SE = 0.019, p = 0.538), or biomarker‐negative individuals (estimate = 0.061, SE = 0.043, p = 0.154) separately.ConclusionMost personal stakeholders indicate they wish to know their AD biomarker status. While sharing results could induce mixed emotions, it does not cause short‐term psychological harm and may offer actionability. There is a need for developing and harmonizing guidelines for biomarker testing and sharing results, particularly in view of the imminent advancements in disease‐modifying treatment.

Child Labour in India.

Child labour is the exploitation of children who are denied access to education. In India, one can observe many children below the poverty line engaged in labour to meet their basic needs. Child labour causes social, psychological and physical harm. Access to education is essential for children to improve their standard of living. They must be protected from involvement in hazardous industries such as fireworks and chemical production. The COVID-19 pandemic has become a significant factor contributing to the increase in child labour as the socio-economic condition has worsened. According to a new report by the International Labour Organization (ILO) and UNICEF, the number of children in child labour has risen to 160 million worldwide – an increase of 8.4 million children in the last four years – with millions more at risk due to the impacts of COVID-19. Despite numerous measures taken by the government, the number of children being employed is increasing day by day. This article tends to explain the hardships faced by child labourers, the sectors in which they are employed, legislation to prevent child labour and its effects

Fear in Nursing: The Heroes Perspective

Nurses encounter unique and substantial challenges in professional practice. Nurses remain at the forefront of care but struggle with work-related fears and risk exposure. These challenges have significantly increased during unprecedented social unrest and the global pandemic making nurses less safe than in previous years. Nurses' fears and risks include patient harm, changing healthcare environments, and psychological and physical harm. This study reveals nurses' fears and highlights the significance of fear on the individual nurse and the profession. Healthcare leaders, administrators, educators, and practitioners must work on creating a culture of preparedness, support, and protection for healthcare workers in all areas.

Awareness with paralysis and symptoms of post-traumatic stress disorder among mechanically ventilated emergency department survivors (ED-AWARENESS-2 Trial): study protocol for a pragmatic, multicenter, stepped wedge cluster randomized trial

BackgroundAwareness with paralysis (AWP) is memory recall during neuromuscular blockade (NMB) and can cause significant psychological harm. Decades of effort and rigorous trials have been conducted to prevent AWP in the operating room, where prevalence is 0.1–0.2%. By contrast, AWP in mechanically ventilated emergency department (ED) patients is common, with estimated prevalence of 3.3–7.4% among survivors given NMB. Longer-acting NMB use is a critical risk for AWP, and we have shown an association between ED rocuronium use and increased AWP prevalence. As NMB are given to more than 90% of ED patients during tracheal intubation, this trial provides a platform to test an intervention aimed at reducing AWP. The overall objective is to test the hypothesis that limiting ED rocuronium exposure will significantly reduce the proportion of patients experiencing AWP.MethodsThis is a pragmatic, stepped wedge cluster randomized trial conducted in five academic EDs, and will enroll 3090 patients. Per the design, all sites begin in a control phase, under observational conditions. At 6-month intervals, sites sequentially enter a 2-month transition phase, during which we will implement the multifaceted intervention, which will rely on use of nudges and defaults to change clinician decisions regarding ED NMB use. During the intervention phase, succinylcholine will be the default NMB over rocuronium. The primary outcome is AWP, assessed with the modified Brice questionnaire, adjudicated by three independent, blinded experts. The secondary outcome is the proportion of patients developing clinically significant symptoms of post-traumatic stress disorder at 30 and 180 days after hospital discharge. We will also assess for symptoms of depression and anxiety, and health-related quality of life. A generalized linear model, adjusted for time and cluster interactions, will be used to compare AWP in control versus intervention phases, analyzed by intention-to-treat.DiscussionThe ED-AWARENESS-2 Trial will be the first ED-based trial aimed at preventing AWP, a critical threat to patient safety. Results could shape clinical use of NMB in the ED and prevent more than 10,000 annual cases of AWP related to ED care.Trial registrationClinicalTrials.gov identifier NCT05534243. Registered 06, September 2022.

Not Just Non-Consensual Pelvic Exams

Not Just Non-Consensual Pelvic Exams

Perlindungan Hukum terhadap Korban Perempuan pada Tindak Kekerasan dalam Rumah Tangga

Every human being in general will always be side by side with differences such as differences between background or SARA, physicality, gender and many other things. However, this can also be a problem for each human being, such as between individuals and individuals, between individuals and groups, and also between groups and groups. These differences can cause conflict and trigger acts of violence or crime within society. According to WHO, acts of violence are the use of violence or physical force that is carried out intentionally or contains an element of intent in the form of threats or actions against a person or group of people or society which causes injury, death, psychological harm, and developmental abnormalities or deprivation of rights. This act of violence is also an act that violates human rights because this act does not reflect the norms and values ​​that reflect human rights. One example of an act of violence that does not reflect human rights is domestic violence. Domestic violence or what is commonly known as domestic violence is any act against someone, especially women, which results in physical, sexual, psychological misery or suffering, as well as domestic neglect, including threats to commit acts, coercion or unlawful deprivation of liberty. in the household sphere.

Engaging Mental Health Service Providers to Recognize and Support Conversion Practice Survivors Through Their Journey to Recovery

Conversion practices include a range of efforts that attempt to change or suppress LGBTQA+ individuals’ sexual or gender identity. Formal versions of these practices are occurring less frequently in Western settings, yet informal versions and the ideology underpinning them continue to cause psychological and spiritual harm to people who are subjected to them. As evidence for the harmful nature of conversion practices increases, and some governments and professional bodies are responding with measures that restrict their use, there is a growing need for the mental health sector to be engaged with these issues so that practitioners are appropriately prepared to recognize and support survivors in ways that are effective and affirming of sexual and gender diversity. In this paper, we review the state of the evidence concerning associated harms and their lack of efficacy in changing sexuality or gender identity, and highlight the changing nature of research in this space to focus on the negative impacts of conversion practices on survivors. We then discuss the evidence around mental health practitioners’ knowledge and support capacity for conversion practices survivors. We close by commenting on specific features of therapeutic practices that can guide practitioners as they support survivors through the recovery process.

The Influence of Reasonableness in Determining Delictual or Tort Liability for Psychological or Psychiatric Harm in South African and English Law

Due to a lack of authority in Roman-Dutch law in respect of claims for psychological harm, our courts in South Africa relied on English law for guidance, in particular the tort of negligence where emphasis is placed on reasonable foreseeability of harm. The courts in both jurisdictions generally face challenges with who exactly is entitled to claim, the quantification of the damages that should be awarded and how to limit delictual or tort liability emanating from these types of claims. South African law also followed English law in making the distinction between primary and secondary victims and as will be shown in this contribution, limiting liability in respect of secondary victims is problematic. The courts generally tread with caution in awarding damages for pure psychological or psychiatric harm and several policy considerations are taken into account when deciding to award damages or not. Nevertheless, as will be shown in this contribution, the courts in South Africa and the United Kingdom acknowledge these claims and have been developing the law around the cases that have come before them. What is rather interesting and prevalent though with regard to primary and secondary victim claims for psychological or psychiatric harm in these jurisdictions, is the implicit and explicit influence of "reasonableness" in determining delictual or tort liability for these types of claims. This will be explored further in this contribution.

The Early Benefits and Psychological Effects of Screening for Monoclonal Gammopathy of Undetermined Significance: Results of the Istopmm Study

Introduction: Multiple myeloma (MM) develops over years from the asymptomatic precursors, monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma (SMM). Recent evidence shows that initiating treatment at an asymptomatic stage improves outcomes in MM. However, a vast majority of MM patients are diagnosed at the point of symptomatic malignancy and never have the opportunity to receive early treatment. We aimed to evaluate systematic screening for MGUS as a way to significantly expand the availability of early treatment and improve overall outcomes. Despite the widespread use of cancer screening, the literature on the potential harms of screening, particularly psychological harms, is limited. Studies on the psychological effects of screening are therefore, urgently needed. The Iceland Screens, Treats, or Prevents Multiple Myeloma study (iStopMM) is a population-based screening study and randomized controlled trial (RCT) of follow-up strategies aimed at evaluating the potential benefits and harms of MGUS screening. Methods: All residents of Iceland born in 1975 or earlier were invited to participate of whom 80,759 individuals (54% of the eligible population) provided written informed consent for screening. Serum samples collected between 2016-2020 were screened by serum protein electrophoresis (SPEP) and free light-chain (FLC) assay. Those who had MGUS entered a RCT of follow-up strategies. Arm 1 was not notified; Arm 2 was followed according to guidelines; Arm 3 was followed according to a more intensive strategy. Participants who progressed were offered early treatment. Participants were followed to a diagnosis of MM, SMM, Waldenström's macroglobulinemia (WM), smoldering WM, chronic lymphocytic leukemia (CLL), and non-Hodgkin's lymphoma (NHL) with censoring at death. Progression rates were compared using the log-rank test. At registration, all participants were asked to answer the Patient Health Questionnaire 9 (PHQ-9), General Anxiety Disorder 7 (GAD-7), and the Satisfaction with Life Scale (SWLS), validated questionnaires that assess depression, anxiety, and satisfaction with life. These questionnaires were sent annually to all participants and two weeks after MGUS diagnosis to Arms 2 and 3. Scores for Arm 1 and Arms 2 and 3 combined were compared using a generalized estimating equations linear model to account for multiple and differential numbers of observations before and after MGUS diagnosis. Results: A total of 75,422 participants provided a serum sample for screening and 3,487 had previously unknown MGUS and entered the RCT. Over a median follow-up of 4-4.5 years (depending on the outcome of interest) a total of 33, 136, and 185 were diagnosed with MM, SMM, WM, SWM, CLL, or NHL in Arms 1, 2, and 3 (p<0.001), respectively (Figure). In total, 775 (65%) and 1,838 (72%) participants in Arm 1 and Arms 2 and 3 answered a total of 2,673 and 8,540 questionnaires respectively. PHQ-9 and GAD-7 scores were not higher and SWLS scores were not lower in those who were made aware of their MGUS status (Arms 2 and 3) either at MGUS diagnosis, one year after diagnosis, or at the end of follow-up. Thus, no negative psychological impact was observed. In fact, a small positive psychological impact of MGUS diagnosis was observed as demonstrated by lower scores on PHQ-9 and GAD-7. However, the effect sizes were small (Cohens' d range: 0.02-0.2) indicating no meaningful difference in psychological wellbeing between the groups (Table). Discussion: In this first, large population-based screening study for MGUS and subsequent RCT, we found that screening is feasible and leads to early diagnosis and treatment of MM and related disorders. Importantly, MGUS screening was not associated with any demonstrable psychological harm. This shows, for first time, that providing detailed and balanced information at diagnosis, and plans for follow-up can prevent psychological harm from the diagnosis of this precancerous condition, a finding which is of significance to the field of cancer screening in general. These findings are a major milestone towards establishing the role of MGUS screening. If they translate into the prevention of symptomatic malignancies and improvements in overall survival, screening for MGUS can produce a paradigm shift in the field of plasma cell disorders towards a future of early detection, early treatment, and prevention, and perhaps even a cure.

Clinical Utility of Monoclonal Gammopathy Screening in the Evaluation of Anemia

Background Screening for monoclonal gammopathy (MG) is often performed in the evaluation of anemia. While certain MGs may be associated with anemia, these are rare conditions. Monoclonal gammopathy of undetermined significance (MGUS; prevalence of 8% among age >50 years) is common, but rarely causes anemia in isolation. Therefore, abnormal results from MG screening may be unrelated to patient symptoms and result in both financial and psychological harm. Limited data exist to guide clinicians regarding the utility of MG testing for anemia. Aims This study aims to describe both the clinical utility of MG screening during the evaluation of anemia and the most common etiologies for anemia in patients whose workup included MG screening. Methods We reviewed medical records of patients who received MG screening to evaluate anemia at Mayo Clinic in 2021. Patients with a previously diagnosed MG were excluded. MG testing included serum protein electrophoresis and free light chain assessments. The following data were extracted: hemoglobin, hematocrit, mean corpuscular volume (MCV), calcium, creatinine, eGFR, and the final hematologic diagnosis related to the monoclonal protein. Clinician documentation was evaluated to determine the attributed etiology of anemia. Results Among the 271 patients with anemia who were screened for MG, 33 (12.2%) were found to have a newly diagnosed MG. Only 2 patients screened for MG were ultimately found to have anemia caused by MG. These included a case of multiple myeloma and one patient with cold agglutinin disease and secondary hemolysis. In all patients screened, their anemia was ultimately thought to be due to iron deficiency (31.7%), B12 deficiency (3.0%), anemia of chronic disease (ACD)/inflammatory anemia (14.4%), chronic kidney disease (CKD) (3.7%), hemolysis (1.5%), hypogonadism (1.9%), idiopathic (21.0%), multifactorial: iron deficiency + ACD/inflammatory (3.0%), multifactorial: nutritional; iron deficiency + B12 deficiency (3.0%), multifactorial: ACD + CKD (5.2%), multifactorial: iron deficiency + CKD (1.8%), multifactorial: not otherwise specified (NOS) (6.6%), medications (0.4%), and other (2.6%). Both patients with newly diagnosed MG associated anemia presented with peripheral neuropathy as their primary symptom. Among these 2 patients diagnosed with dysproteinemia associated anemia, only one (0.4%) was placed on therapy for their MG. Summary/Conclusions In the evaluation of anemia, routine MG screening has low clinical utility. Less than 1 in 100 patients were found to have anemia attributable to MG. Furthermore, only 0.4 in 100 patients received MG-directed therapy. Most patients screened with SPEP for undifferentiated anemia were found to have anemia attributable to common causes including iron/nutritional deficiency, inflammatory processes, and CKD. Most patients with undifferentiated anemia would benefit from an anemia evaluation that focuses on the most common causes up front. Given the cost to healthcare and potential psychological harm to the patient of incidental MG diagnosis, further study is warranted to guide clinicians and limit the ordering of MG testing to individuals who are most likely to derive benefit.

Understanding inpatient mortality and 30-day mortality at a comprehensive cancer center.

59 Background: Inpatient mortality quality metric for hospital settings. We sought to review instances of inpatient mortality as part of continuing quality improvement (QI) in our pursuit of the Triple Aim of Health care to improve individual and population health, while reducing unnecessary physical harm, psychological harm, and costs. Methods: An interdisciplinary institutional mortality review committee (MRC) was assembled to review all instances of inpatient mortality or 30-day hospital mortality (hospital mortalities). Individual team members reviewed pertinent clinical information, and appropriate instances were discussed during monthly meetings. The purpose is to review the details of the hospitalization and make determinations if any learning opportunities or process improvements were present. Study data were collected and managed using REDCap electronic data capture tools. Approval from the IRB was obtained to conduct this retrospective analysis. Results: Between January 2022 and April 2023, a total of 430 instances of hospital mortalities were identified and reviewed. Of the 421 patients for which data was available, 294 deaths were classified as “Anticipated” while 127 were classified as “Unanticipated”. Out of the 421 patients, 189 (44.9%) were classified as having an improvement opportunity. There was no association between anticipated vs unanticipated death and opportunity for improvement χ2,(1, n=421) =0, p=.998. However, we noted a significant inverse association with prior goals of care conversation and learning opportunity χ2,(3, n=421) =77.2, p<0.001. During the period of this initiative, we have noted an upward trend in the percentage of patients who had a GOC conversation from 83% to 96%. Improvement opportunities and hospital mortalities related to hospital acquired infections, direct surgical complications, and misdiagnosis were rare. Conclusions: Regarding hospital mortality, opportunities for improvement were largely centered around goals of care conversations and advanced care planning. There is a suggestion that MRC may have contributed to the increase in documented Goals of Care conversations. We believe that an MRC can contribute towards a cultural shift to promote Advanced Care Planning. Initiatives to improve goals of care conservations early in a patient’s disease course may have the potential to reduce inpatient mortality and reduce the physical, psychological, and financial toll of disease.

CHILD SEXUAL ABUSE: what should dental surgeons know?

Child sexual abuse is defined as the involvement of a child in sexual activity that he or she does not fully understand or is unable to give informed consent to. Dental surgeons who work with children must be alert to signs and behaviors that can help diagnose abuse and criminalize the aggressor. Thus, the present study aimed to present a literature review regarding dental management in cases suggestive of child sexual abuse. According to the literature review, it was possible to identify that child sexual abuse is a silently underreported social issue, capable of causing physical and psychological harm to the victim. Suggestive injuries, preferably in the head and neck region, should be evaluated taking note of the causal history reported by the child and their guardian, if necessary, separately. In the assimilation of injuries resulting from sexually transmitted infections, testing and treatment must be included in care. The dental surgeon must be prepared to carry out compulsory notification under the risk of ethical, civil and criminal charges. The creation of public policies and the union of sectors that work directly with the child population must focus on education and children's understanding of the limits of access by third parties to their bodies, as well as support networks for the victim's mental and social restructuring.

Microaggressions Toward Sexual and Gender Minority Emerging Adults: An Updated Systematic Review of Psychological Correlates and Outcomes and the Role of Intersectionality.

Purpose: Quantitative data on the psychological effects of microaggressions toward sexual and gender minority individuals have grown substantially. Sexual orientation-based and transgender and gender-diverse (trans+) identity-based microaggressions have been thematically identified in prior research. In addition, combined lesbian, gay, bisexual, transgender and gender-diverse, queer/questioning, and other non-heterosexual (LGBTQ) microaggressions can be examined intersectionally with other marginalized identities. This systematic review synthesizes research on the relationships among these microaggressions and psychological correlates and outcomes. Methods: Forty-five quantitative studies examining sexual orientation-, trans+ identity-, or intersectional identity-based microaggressions and various psychological outcomes were identified from systematic searches of PsycINFO, PsycARTICLES, MEDLINE, and PubMed databases. Data regarding microaggressions were extracted, synthesized, and grouped by mental health outcome or correlate. Results: Sexual orientation-based microaggressions were risk factors for depression, anxiety, and internalized stigma and were positively associated with psychological distress, traumatic stress symptoms, alcohol use and abuse, cannabis use and problems, suicidal ideation, and suicide attempt. Trans+ identity-based microaggressions were positively associated with depression, suicide attempt, and cannabis use. LGBTQ intersectional identity-based microaggressions concerning race/ethnicity were associated with depression, anxiety, and suicidal ideation. Research on other intersectional identity-based microaggressions is scarce. Conclusion: These findings emphasize the psychological harm inflicted by various microaggressions on LGBTQ late adolescents and early adults. Future work should focus on microaggressions toward individuals with trans+ and intersectional identities and protective factors for these experiences. This review also highlights the distinct need for community-based research on implementing microintervention strategies in family, school, and work environments to mitigate the harmful effects of these microaggressions.

Aspects of restitution in cases of sexual violence against children: a review of criminal law and its impact on victims

This article investigates aspects of restitution in cases of sexual violence against children, focusing on criminal law review and its impact on victims. Sexual violence against children is a severe problem that requires careful legal and judicial attention. One aspect often overlooked is the issue of restitution, which is an effort to compensate for the losses suffered by victims. This research aims to identify issues related to restitution in cases of sexual violence against children and analyze the impact on victims. This study uses a criminal law approach and analyzes various legal provisions relating to restitution in the context of sexual violence against children. We also reviewed previous research on this issue and interviewed legal experts experienced in handling cases of sexual violence against children. The research results show that restitution is often ignored in the judicial process and does not receive the attention it deserves. Victims of sexual violence against children often experience severe physical, emotional, and psychological harm. Therefore, it is essential to consider the role of restitution in helping victims recover and obtain fair compensation for their losses. This study also discusses several challenges in implementing restitution in cases of sexual violence against children and provides recommendations to improve the protection and recovery of victims.

Improving Emotional Safety, Coping, and Resilience Among Women Conducting Research on Sexual and Domestic Violence and Abuse.

Secondary trauma arises through indirect exposure to trauma through engaging with first-hand accounts and narratives of traumatic events. While a significant amount of research has explored secondary trauma experienced by professionals who work with survivors of trauma, such as clinicians and front-line service providers, there is little research exploring the experiences of secondary trauma among violence researchers who routinely engage with traumatic first-hand accounts through their work. This study qualitatively explored violence researcher's professional experiences of secondary trauma and their perceptions of what enables and constrains their own coping and resilience. Participants were recruited using purposive sampling methods. Semi-structured interviews were conducted online with seven female violence researchers from the United Kingdom. Questions explored participant's experiences of secondary trauma symptoms related to their research, perceptions of their own coping and resilience, and experiences of organizational support that have enabled or constrained their resilience. Data were analyzed thematically using a coding framework applied reflexively across interview transcripts. All participants reported experiencing symptoms of secondary trauma from their work including cognitive disturbances; altered beliefs of themselves, others or the world; and challenges connecting with others. Participants' assessment of their own expertise in violence research did not generally impact their perception of their own resilience. Organizational support for violence researchers was rarely provided and participants felt generally unsupported-left to manage any resultant distress alone. Research organizations and universities should implement trauma-informed policies which positively transform workplace culture, provide peer support spaces, and conduct effective training in order to mitigate psychological harm and promote resilience among violence researchers. Support should be tailored to the requirements of violence researchers, and institutions should develop policies that are specifically attentive to the needs of researchers who also have lived experience of violence and abuse.

Exploring the informational needs and use of information by patients undergoing risk-reducing breast surgery: a qualitative study

ABSTRACT Women with a pathogenic variant in a breast cancer susceptibility gene undergoing a risk-reducing mastectomy have poorly understood informational needs. Information contributes to individuals achieving their full health potential and is essential in informed decision-making. Whilst many women are satisfied with their decision to have risk-reducing surgery, some will experience regret. Informed decision-making may be important in reducing any associated psychological harm. This study aimed to explore satisfaction with information accessed by patients regarding their risk-reducing mastectomy and better understand their informational needs for risk-reducing surgery decision-making Semi-structured interviews were conducted pre- and post-operatively with 22 women undergoing risk-reducing mastectomies for BRCA1/2 pathogenic variants with no breast cancer history at the Nottingham Breast Institute. Inductive thematic analysis was conducted. Four themes were constructed: Sources of information, Informational needs, Uses of information and Impacts of information. A broad spectrum of information sources were used with an apparent hierarchy. Information from clinicians and lived experiences were preferred to written and online sources. Some participants felt their informational needs were met, others found the information contradictory, cancer-focused and jargon filled. Participants required information early enough to be useful. Informational needs differed between individuals which affected the desired format. Participants informational needs were distinct from women with breast cancer undergoing a mastectomy. Encouraging active and informed decision-making could be important to reduce regret and the associated psychological harm some women experience following a risk-reducing mastectomy. This research offers insights into the informational needs of this distinct cohort and recommendations will guide patient information development.