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moral injury

Sarah E Steinmetz, Matt J Gray, Joshua D Clapp
Although the topic of moral injury (MI) has been garnering increasing attention in recent years within military populations, research has rarely applied the concept to civilian contexts. Extant literature on distinct acts of perpetration or transgressions suggests similar emotional, cognitive, and behavioral patterns of distress associated with appraisals of wrongdoing. However, the absence of a psychometrically sound measure to detect and quantify pathological levels of distress associated with perpetrating harm against others has hindered additional research from being conducted on the topic...
March 20, 2019: Journal of Traumatic Stress
Joseph Wiinikka-Lydon
Moral injury is a term whose popularity has grown in psychology and psychiatry, as well as philosophy, over the last several years. This presents challenges, because these fields use the term in different ways and draw their understanding from different sources, creating the potential for contradiction. This, however, is also an opportunity. Comparison between behavioral sciences and philosophy can help enrich understandings of harms considered not just psychological but moral. To this end, I provide an overview of the more influential writing of moral injury, mapping them into three broad discourses: clinical, juridical-critical, and structural...
March 16, 2019: Journal of Medicine and Philosophy
Cesar Ortega, Leticia Cañas-Lopez, Rute Irgang, Raúl Fajardo, Matías Poblete-Morales, Benjamin Valladares-Carranza, Diana Tapia-Cammas, Ruben Avendaño-Herrera
Spring viraemia of carp (SVC) is an infectious disease responsible for severe economic losses for various cyprinid species, particularly common carp (Cyprinus carpio carpio). The causative agent is the SVC virus (SVCV), a member of the Sprivivirus genus, Rhabdoviridae family, and a List 1 pathogen notifiable by the World Organization for Animal Health. This study describes the diagnosis of an SVCV pathogen isolated in October 2015 from wild common carp inhabiting a natural lagoon in central Mexico. While neither an epidemic nor fish mortalities were reported, the collected killed specimens exhibited clinical signs of disease (e...
March 15, 2019: Journal of Fish Diseases
Rejane Cristina Leite da Fonseca, Jose Leopoldo Ferreira Antunes, Andreia Morales Cascaes, Rafael Aiello Bomfim
BACKGROUND/AIMS: Traumatic dental injuries (TDIs) stand out as one of the major public health problems worldwide, characterized by a high prevalence in children and adolescents, however, their association with the 15-19 years age group has not been fully described. The aim of this study was to evaluate TDIs in a population of Brazilian adolescents. METHODS: An association study was performed with 5,558 adolescents attending the São Paulo State Oral Health Survey (SBSP-15)...
March 13, 2019: Dental Traumatology: Official Publication of International Association for Dental Traumatology
Joseph M Currier, Joshua D Foster, Steven L Isaak
War-related traumas can lead to emotional, relational, and spiritual suffering. Drawing on two community samples of war zone veterans from diverse military eras (Study 1, N = 616 and Study 2, N = 300), the purpose of this study was to examine patterns of constellations between outcomes related to moral injury (MI) and common ways in which veterans may struggle with religion or spirituality, defined as divine, morality, meaning, interpersonal, and doubt. Results from latent profile analyses revealed three distinct classes across the samples, based on psychometrically validated instruments: (a) no MI-related outcomes or spiritual struggles (nondistressed group; Study 1 = 72...
March 12, 2019: Journal of Traumatic Stress
Shannon R Forkus, Juliana G Breines, Nicole H Weiss
INTRODUCTION: Military veterans are at heightened risk for developing mental and behavioral health problems. Morally injurious combat experiences have recently gained empirical and clinical attention following the increased rates of mental and behavioral health problems observed in this population. OBJECTIVE: Extending extant research, the current investigation assessed the relationship between morally injurious experiences and mental and behavioral health outcomes...
March 11, 2019: Psychological Trauma: Theory, Research, Practice and Policy
Mariana Lizeth Orozco Morales, Nagi M Marsit, Owen D McIntosh, Andrew Hopkinson, Laura E Sidney
BACKGROUND: An in vitro injury model mimicking a corneal surface injury was optimised using human corneal epithelial cells (hCEC). AIM: To investigate whether corneal-stroma derived stem cells (CSSC) seeded on an amniotic membrane (AM) construct manifests an anti-inflammatory, healing response. METHODS: Treatment of hCEC with ethanol and pro-inflammatory cytokines were compared in terms of viability loss, cytotoxicity, and pro-inflammatory cytokine release, in order to generate the in vitro injury...
February 26, 2019: World Journal of Stem Cells
Pedro Rojas-Morales, Juan Carlos León-Contreras, Omar Emiliano Aparicio-Trejo, Jazmin Gabriela Reyes-Ocampo, Omar Noel Medina-Campos, Angélica Saraí Jiménez-Osorio, Susana González-Reyes, Brenda Marquina-Castillo, Rogelio Hernández-Pando, Diana Barrera-Oviedo, Laura Gabriela Sánchez-Lozada, José Pedraza-Chaverri, Edilia Tapia
Food deprivation protects against ischemia-reperfusion (IR) injury through unknown mechanisms. In an experimental rat model of acute IR injury, we found that preoperative fasting for 3 days protects rats from tubular damage and renal functional decline by increasing antioxidant protection independently of the NF-E2-related factor 2 (Nrf2), and by maintaining mitochondrial morphology and function. In addition, further analysis revealed that fasting protects against tubulointerstitial fibrosis. In summary, our results point out to fasting as a robust nutritional intervention to limit oxidative stress and mitochondrial dysfunction in early acute kidney injury and also to promote long-term protection against fibrosis...
February 25, 2019: Free Radical Biology & Medicine
Patricia Huelin, Elsa Solà, Chiara Elia, Cristina Solé, Alessandro Risso, Rebeca Moreira, Marta Carol, Núria Fabrellas, Octavi Bassegoda, Adrià Juanola, Gloria de Prada, Sonia Albertos, Salvatore Piano, Isabel Graupera, Xavier Ariza, Laura Napoleone, Elisa Pose, Xavier Filella, Manuel Morales-Ruiz, José Rios, Javier Fernández, Wladimiro Jiménez, Esteban Poch, Ferran Torres, Pere Ginès
BACKGROUND/AIMS: Kidney biomarkers appear to be useful in differential diagnosis between Acute Tubular Necrosis (ATN) and other types of AKI in cirrhosis, particularly hepatorenal syndrome (HRS-AKI). Distinction is important because treatment is different. However, kidney biomarkers are still not used in clinical practice. Aim of the current study was to investigate the accuracy of several biomarkers in differential diagnosis of AKI and in predicting kidney outcome and patient survival...
February 27, 2019: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Ney Arencibia Pérez, María Luisa Agüera Morales, Rafael Sánchez Sánchez, Rosa María Ortega Salas, Rafael Ángel Fernández de la Puebla, Mario Espinosa Hernández
In kidney biopsies reviews, scleroderma renal crisis (SRC) is characterized by vascular endothelial injuries, C4d deposits on peritubular vessels, and acute and chronic injuries coexisting on the same biopsy. The clinical signs of thrombotic microangiopathy (TMA) are described in systemic sclerosis (SSc), nevertheless, it has not been related to acute injuries described on kidney biopsies. We report a case of SRC in a patient with scleroderma-dermatomyositis overlap syndrome, which also showed clinical and histopathological data of TMA...
February 25, 2019: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Sarkis G Morales-Vidal
PURPOSE OF REVIEW: Fat embolism syndrome (FES) is a rare disorder with potentially devastating neurologic complications. This article reviews the history, pathophysiology, clinical features, diagnosis, and treatment of FES with a focus on its neurologic aspects. RECENT FINDINGS: The neurologic complications of FES are more commonly recognized with current diagnostic testing and increase awareness of the disorder. FES may present initially with neurologic manifestations...
February 20, 2019: Current Neurology and Neuroscience Reports
Christopher J Zimmermann, Nathan D Baggett, Lauren J Taylor, Anne Buffington, Joseph Scalea, Norman Fost, Kenneth D Croes, Joshua D Mezrich, Margaret L Schwarze
Donation before circulatory death for imminently dying patients has been proposed to address organ scarcity and harms of non-donation. To characterize stakeholder attitudes about organ recovery before circulatory death we conducted semi-structured interviews with family members (N=15) who had experienced a loved one's unsuccessful donation after circulatory death and focus groups with professional stakeholders (surgeons, anesthesiologists, critical care specialists, palliative care specialists, organ procurement personnel, and policymakers, N=46)...
February 15, 2019: American Journal of Transplantation
Elisa García, Roxana Rodríguez-Barrera, Vinnitsa Buzoianu-Anguiano, Adrian Flores-Romero, Emanuel Malagón-Axotla, Marco Guerrero-Godinez, Estefanía De la Cruz-Castillo, Laura Castillo-Carvajal, Monserrat Rivas-Gonzalez, Paola Santiago-Tovar, Ivis Morales, Cesar Borlongan, Antonio Ibarra
Spinal cord injury is a very common pathological event that has devastating functional consequences in patients. In recent years, several research groups are trying to find an effective therapy that could be applied in clinical practice. In this study, we analyzed the combination of different strategies as a potential therapy for spinal cord injury. Immunization with neural derived peptides (INDP), inhibition of glial scar formation (dipyridyl: DPY), as well as the use of biocompatible matrix (fibrin glue: FG) impregnated with bone marrow mesenchymal stem cells (MSCs) were combined and then its beneficial effects were evaluated in the induction of neuroprotection and neuroregeneration after acute SCI...
June 2019: Neural Regeneration Research
Gadi Zerach, Yossi Levi-Belz
Exposure to potentially morally injurious events (PMIEs) among combat veterans has been acknowledged as significant stressful combat events that may lead to mental health problems, including self-injurious thoughts and behavior (SITB). However, few studies have examined the risk and protective factors that can explain the conditions in which PMIEs may contribute to the development and maintenance of SITB. In the current study, we aimed to examine the association between PMIEs and SITB among combat veterans and explore the moderating roles of intolerance of uncertainty (IU) in this association...
February 5, 2019: Journal of Traumatic Stress
Joseph M Currier, Ryon C McDermott, Jacob K Farnsworth, Lauren M Borges
War zone veterans who experience posttraumatic stress disorder (PTSD) symptoms might struggle with co-occurring cognitive, emotional, and behavioral expressions of suffering that align with conceptual definitions of moral injury (MI). However, given that PTSD is a multidimensional condition, disentangling the apparent interplay with MI may inform clinical practice and research. This study incorporated a cross-lagged design to explore temporal associations between self- and other-directed outcomes related to MI and severity of DSM-5 PTSD symptom clusters while accounting for depressive symptoms...
February 4, 2019: Journal of Traumatic Stress
Victoria Williamson, Neil Greenberg, Dominic Murphy
Background : Moral injury has been found to adversely affect US veteran mental health, and the mental health difficulties resulting from moral injury can be particularly challenging to treat. Yet little is known about the impact of moral injury on the well-being of UK armed forces (AF) veterans and how moral injury is currently addressed in treatment. Objective : The aim of this study was to examine UK AF veterans' experiences of moral injury, and the perceptions and challenges faced by clinicians in treating moral injury-related mental health difficulties...
2019: European Journal of Psychotraumatology
Anthony M Battaglia, Alina Protopopescu, Jenna E Boyd, Chantelle Lloyd, Rakesh Jetly, Charlene O'Connor, Heather K Hood, Anthony Nazarov, Shawn G Rhind, Ruth A Lanius, Margaret C McKinnon
Background : There is increasing evidence that moral injuries (MIs) may affect the mental health of Canadian Armed Forces (CAF) members and veterans. Despite knowledge suggesting that MIs are related to multiple negative mental health outcomes, including the onset of post-traumatic stress disorder (PTSD), it is unknown whether pre-traumatic variables, including the presence of childhood abuse, are related to MIs. Objective : This study seeks to investigate the potential relationship between adverse childhood experiences and later onset MI in military members...
2019: European Journal of Psychotraumatology
Delin Sun, Rachel D Phillips, Hannah L Mulready, Stephen T Zablonski, Jessica A Turner, Matthew D Turner, Kathryn McClymond, Jason A Nieuwsma, Rajendra A Morey
Moral injury is closely associated with posttraumatic stress disorder (PTSD) and characterized by disturbances in social and moral cognition. Little is known about the neural underpinnings of moral injury, and whether the neural correlates are different between moral injury and PTSD. A sample of 26 U.S. military veterans (two females: 28-55 years old) were investigated to determine how subjective appraisals of morally injurious events measured by Moral Injury Event Scale (MIES) and PTSD symptoms are differentially related to spontaneous fluctuations indexed by amplitude of low frequency fluctuation (ALFF) as well as functional connectivity during resting-state functional magnetic resonance imaging scanning...
January 28, 2019: Depression and Anxiety
Brandon J Griffin, Natalie Purcell, Kristine Burkman, Brett T Litz, Craig J Bryan, Martha Schmitz, Claudia Villierme, Jessica Walsh, Shira Maguen
Individuals who are exposed to traumatic events that violate their moral values may experience severe distress and functional impairments known as "moral injuries." Over the last decade, moral injury has captured the attention of mental health care providers, spiritual and faith communities, media outlets, and the general public. Research about moral injury, especially among military personnel and veterans, has also proliferated. For this article, we reviewed scientific research about moral injury...
January 28, 2019: Journal of Traumatic Stress
Jacob K Farnsworth
Debate exists regarding the most appropriate way to address moral injuries that stem from involvement in war and other military conflicts. In recent years, some researchers have suggested that existing treatments for trauma may be inadequate to address moral injury and have thus proposed novel interventions to help mitigate these concerns. In response, advocates of more traditional approaches have argued that standard trauma interventions are generally sufficient for moral injury, and investment in new interventions may be premature...
January 22, 2019: Journal of Traumatic Stress
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