Search Results (735)

Background/Objectives: The spinal cord is a critical component of the central nervous system that transmits neural signals between the brain and the body’s peripheral regions through its nerve roots. Despite being partially protected by the vertebral column, the spinal cord remains highly vulnerable to trauma, tumors, infections, and degenerative or inflammatory disorders. These conditions can disrupt neural conduction, resulting in severe functional impairments, such as paralysis, motor deficits, and sensory loss. Therefore, accurate and comprehensive spinal cord segmentation is essential for characterizing its structural features and evaluating neural integrity. Methods: In this study, we propose a fully automated method for segmentation of the cervical spinal cord in sagittal magnetic resonance (MR) images. This method facilitates rapid clinical evaluation and supports early diagnosis. Our approach uses a Swin-Unet architecture, which integrates vision transformer blocks into the U-Net framework. This enables the model to capture both local anatomical details and global contextual information. This design improves the delineation of the thin, curved, low-contrast cervical cord, resulting in more precise and robust segmentation. Results: In experimental studies, the proposed Swin-Unet model (SWU1), which uses transformer blocks in the encoder layer, achieved Dice Similarity Coefficient (DSC) and Hausdorff Distance 95 (HD95) scores of 0.9526 and 1.0707 mm, respectively, for cervical spinal cord segmentation. These results confirm that the model can consistently deliver precise, pixel-level delineations that are structurally accurate, which supports its reliability for clinical assessment. Conclusions: The attention-enhanced Swin-Unet architecture demonstrated high accuracy in segmenting thin and complex anatomical structures, such as the cervical spinal cord. Its ability to generalize with limited data highlights its potential for integration into clinical workflows to support diagnosis, monitoring, and treatment planning. Full article

Intimate partner violence (IPV) has far-reaching health and social consequences, particularly for survivors experiencing polyvictimization—multiple forms of IPV such as physical, emotional, and sexual abuse. This study examined help-seeking behaviors and the perceived helpfulness of formal support sources (police, medical professionals, and psychologists) among a nationally representative sample of 2387 IPV survivors drawn from the 2010 National Intimate Partner and Sexual Violence Survey (NISVS) in the United States. Latent class analysis identified three distinct polyvictimization profiles: Coercive Control and Psychological Aggression (CCPA), Psychological and Physical Violence (PPV), and Multiple Violence (MV). Survivors’ patterns of formal help-seeking varied significantly by gender, sexual orientation, socioeconomic status, and type of victimization. Psychologists were the most commonly contacted and perceived as the most helpful overall, though disparities emerged. Female survivors and those with less severe victimization were more likely to rate support as helpful, whereas male and sexual/gender minority (SGM) survivors, particularly those facing severe or multiple forms of violence, were less likely to find formal sources helpful—especially law enforcement. These findings highlight the need for more inclusive, culturally competent, and trauma-informed services tailored to the diverse experiences of IPV survivors. Full article

(1) Background: The COVID-19 pandemic exacerbated existing health inequities for Native American communities, intensifying the challenges faced in accessing addiction and recovery services. As part of a tribal-university collaborative effort in Arizona, our team explored the impacts of the COVID-19 pandemic on mental well-being and resilience among the Indigenous substance use recovery community. (2) Methods: We conducted qualitative analysis of transcribed individual interviews (n = 19) to understand the factors of resilience and mental well-being for providers of Western addiction treatment services and Indigenous community members who were in addiction recovery or engaged in addiction treatment during the pandemic. (3) Results: Four major themes that impacted mental well-being among the Indigenous recovery group during the pandemic were identified: (1) healthcare barriers; (2) culture in recovery; (3) the impact of colonization/historical trauma; and (4) the importance of relationships. (4) Conclusions: This work provides insight into the disproportionate impact of the COVID-19 pandemic on Indigenous communities and vulnerable populations such as the recovery community. Findings from this study highlight the need for Indigenous-grounded and culturally informed recovery interventions. Full article

Black women disproportionately experience sexual health-related trauma, yet their mental health needs are often inadequately addressed due to systemic barriers and stigma. This literature review examines trauma-informed care (TIC) frameworks tailored to Black women, emphasizing culturally responsive practices in addressing sexual health-related trauma. By synthesizing findings from existing research, including the importance of intersectionality, culturally specific interventions, and community-centered approaches, this review highlights effective strategies for mental health providers. The review concludes with implications for enhancing TIC training and implementation in clinical settings which contributes to the advancement of equitable mental health services for Black women. Full article

Background/Objectives: Hybrid Angio-CT suites have emerged in response to the growing demands for innovation and procedural complexity in minimally invasive therapies. It is hypothesized that enhanced image guidance capabilities enabled by multimodality imaging can improve procedural safety, accuracy, and efficacy. However, due to the current lack of sufficient data to support a systematic review, the objective of this article is to present a comprehensive synthesis of the existing literature through a narrative review. Methods: This narrative review is based on purposefully identified research reports, their critical evaluation, and synthesis by a group of experienced users. The analysis covers three key areas: (1) current state of available technologies and functionalities, (2) novel perspectives through ‘Direct Intravascular Contrast media Injection CT’ (DICI-CT), and (3) the role of Angio-CT in established and emerging image-guided procedures. Results: The review presents typical configurations and room layouts for Angio-CT systems and discusses further technological improvement potential. Selected literature is complemented by expert experience to report on the current state of the art and demonstrate its use and efficiency. Based on our expert experience, it is demonstrated how DICI-CT can be used to reduce contrast dose and improve lesion visualization, targeting, and endpoint determination. Furthermore, in this review the advantages, including survival benefit (i.e., in trans-arterial chemoembolization and in blunt trauma) and cost-effectiveness (i.e., in emergency care), are reviewed with reference to oncologic and non-oncologic applications in both elective and emergency medicine. Conclusions: Hybrid Angio-CT suites can provide significant additional imaging information with the potential to improve image-guided procedures. This perspective is increasingly supported by retrospective data in interventional oncology and beyond. Provided that further technological advancements are achieved and prospective clinical data substantiates the anticipated clinical and economical benefits, hybrid Angio-CT suites are anticipated to play a key role in the multimodality interventional suite of the future. Full article

Transitions from care into adulthood are often a shift from dependence to independence. Yet for care-experienced individuals, this process is neither linear nor complete at a predetermined age. Despite progressive Scottish policies—such as The Promise—many still face unequal access to support. This article explores how structural and relational scaffolding can transform outcomes. Drawing on the lived and professional knowledge of three care-experienced authors, it examines how language, relationship-based practice, and support influence definitions of success. Reframing care experience as lifelong challenges systems to provide enduring, person-centered support. While research affirms the importance of responsive scaffolding, few studies center the voices of care-experienced adults in defining what effective support looks like. This article addresses that gap by placing care-experienced authors not as subjects, but as analysts and advocates. The article is based on a collaborative, care-informed reflective process. The authors adapted the Gibbs Reflective Cycle to suit a trauma-aware and relational approach. Their reflections are not anecdotal—they are critically analyzed, thematically structured, and used as evidence to interrogate systems and propose alternatives. Key findings highlight the importance of sustained relational practice, responsive educational support, and recognizing care experience as lifelong. Full article

Psychopathy in women remains understudied, particularly regarding the role of early relational experiences such as attachment. This systematic review aims to synthesize the current evidence on the association between attachment-related factors and psychopathic traits in women. A structured search following PRISMA guidelines across multidisciplinary databases (Scopus-Elsevier^®, ESBCO^®, Pubmed^®, Sage Publishing^®, B-On, and Web of Science-Core Collection^®) yielded 147 articles, of which eight met the inclusion criteria. The majority of the studies met three to four out of the five methodological quality criteria. Findings indicate that insecure attachment styles are differentially associated with psychopathy. Avoidant attachment is positively linked to callous-unemotional traits, whereas the role of anxious attachment appears more heterogeneous. Some studies associate it with higher levels of affective traits and secondary psychopathy, while others identify it as a negative predictor of callous-unemotional features in women. Avoidant attachment was also negatively correlated with empathy and positively related to maladaptive emotion regulation strategies, particularly among women with secondary psychopathic traits. Negative maternal parenting was associated with elevated psychopathic traits, whereas positive parental involvement acted as a protective factor. Additional predictors included early maladaptive schemas and childhood risk factors such as parental criminality and poor supervision. These findings highlight the relevance of early intervention and attachment-informed approaches in forensic risk assessment, trauma-informed care, and prevention programs targeting women with psychopathic traits. Full article

This study reviews the role of Child-Friendly Green Spaces (CFGS) in supporting children’s psychological, physical, and educational recovery following natural disasters. The main research question guiding this review is the following: how do CFGS contribute to holistic child well-being and resilience in disaster-affected contexts, and what barriers and strategies influence their effective integration into recovery frameworks? Employing a rigorous literature review methodology, we synthesized interdisciplinary evidence from environmental psychology, urban planning, public health, and education, encompassing studies published between 2000 and 2024. Findings demonstrate that CFGS significantly reduce trauma-related symptoms such as anxiety, depression, and post-traumatic stress, promotes physical health through active play, and foster educational engagement by improving concentration, attendance, and informal learning opportunities. Furthermore, CFGS contribute directly to multiple Sustainable Development Goals, particularly SDG 3 (Good Health and Well-being), SDG 4 (Quality Education), and SDG 11 (Sustainable Cities and Communities). Despite these advantages, CFGS are often overlooked in formal disaster recovery planning due to prioritization of immediate relief, financial and logistical challenges, and socio-cultural factors. To address these challenges, this study proposes a participatory, culturally sensitive framework for CFGS implementation, which integrates inclusive design, multi-sector collaboration, and ongoing monitoring and evaluation. Grounded in theoretical perspectives such as the Biophilia Hypothesis, Bronfenbrenner’s Ecological Systems Theory, and restorative environments, CFGS are reframed as critical infrastructures for children’s holistic recovery and resilience. The findings underscore the urgent need to embed CFGS within disaster recovery and urban planning policies to promote child-centered, sustainable community development. Full article

Jurors play a critical role in the administration of justice, yet their compulsory exposure to graphic and distressing evidence during criminal trials is often overlooked in discussions of mental health and legal reform. This paper investigates the psychological impact of jury service in trials involving murder, domestic violence, sexual assault, and child abuse, where laypeople are required to view autopsy photographs, listen to emergency calls, and assess disturbing testimonies without any formal training or mandatory psychological support. While vicarious trauma, secondary traumatic stress, and moral injury are recognised in research on law enforcement, social work, and healthcare, there is limited acknowledgement that no professional group consistently receives adequate trauma prevention or recovery support. This gap is particularly concerning for jurors, who are laypeople compelled to participate in the justice process. Drawing on legal case studies, psychiatric research, and international precedent, this paper argues that the justice system imposes an invisible emotional burden on jurors while offering limited, inconsistent, and mostly reactive support. Although applicable to many countries, particular attention is given to Australian jurisdictions, where counselling services are sparse and optional, and where juror confidentiality laws restrict therapeutic disclosures. This research also considers the legal and ethical implications of exposing untrained civilians to traumatic material and explores whether the state could, or should, bear legal liability for post-trial psychological harm. Ultimately, this paper calls for the introduction of clearly defined trauma-informed jury procedures, including pre-trial psychological briefings, structured debriefings, and systemic reform, to acknowledge juror well-being as a necessary component of fair and ethical justice. Full article

Background: Heroin addiction is associated with profound dysregulation of the endogenous opioid and stress response systems, yet current diagnostic frameworks may inadequately capture the traumatising aspects of this condition. This perspective proposes the concept of post-heroin post-traumatic stress spectrum (pH-PTSD/S) as a clinical syndrome emerging from chronic opioid-induced neurobiological and psychosocial dysregulation, even in the absence of Criterion A trauma. Methods: The authors review evidence from neuroendocrinology, behavioural neuroscience, and clinical psychopathology to support a sensitisation-based model of trauma vulnerability in heroin use disorder (HUD). Results: Findings suggest that HUD patients frequently exhibit PTSD-spectrum symptoms, including hyperarousal, avoidance, emotional dysregulation, and altered stress reactivity. Opioid agonist treatment (OAT) may mitigate these symptoms by stabilising HPA axis function and reducing exposure to trauma-related contexts. The pH-PTSD/S construct, measured through a dedicated instrument, identifies patients with subthreshold trauma-related symptoms and greater psychopathological burden. Conclusions: Heroin dependence may constitute a traumatising condition, requiring dimensional diagnostic tools and trauma-informed treatment strategies. Further research is needed to validate the nosological status of pH-PTSD/S, clarify its distinction from protracted withdrawal or complex PTSD, and determine its implications for OAT duration and integrated care pathways. Full article

Background/Objectives: Dental neglect represents a preventable form of child maltreatment that may lead to significant oral and systemic health complications. This study primarily aimed to investigate the main oral manifestations and determinants of dental neglect in a pediatric population from Bihor County, Romania. Additionally, it assessed the association between systemic factors, such as nutritional status and psychological conditions, and the severity of oro-dental lesions, with the goal of informing future preventive strategies and public health interventions. Methods: A retrospective analysis was conducted on 333 pediatric patients diagnosed with dental neglect. Clinical data were collected from two centers between 2020 and 2024. Oral health status, socio-demographic characteristics, and psychological conditions were evaluated. Statistical analyses included Fisher’s Exact Test, Mann–Whitney U Test, and Bonferroni-adjusted Z-tests, with significance set at p ≤ 0.05. Results: Among the 333 participants, 52.9% were male, with a mean age of 8.75 ± 3.29 years. Most children (81.7%) resided in rural areas, and 55.6% were first-born. Carious lesions were identified in 100% of cases, with 54.7% showing complications such as endodontic pathology. Poor oral hygiene was reported in 99.1% of children, while 58.6% presented signs of periodontal disease and 37.2% reported spontaneous gingival bleeding. Acute pain was experienced by 40.2% of participants. Nutritional issues were prevalent, with 24.3% classified as obese and 21.6% as malnourished. Significant associations were found between lesion severity and both psychological disorders (p < 0.001) and malnutrition (p < 0.001). Conclusions: This study identifies untreated carious lesions, poor oral hygiene, acute dental pain, and oro-dental trauma as key clinical indicators of pediatric dental neglect, with rural residency and limited education as significant socio-demographic risk factors. The findings highlight the urgent need for integrated, community-based strategies, including school-based screenings, parental education, and referral pathways, to improve early detection and prevention in Romania. Full article

Background: Pediatric road traffic injuries (RTIs) represent a significant public health concern, particularly in countries like Romania, where road infrastructure and safety remain challenges. Despite recent economic reclassification, Romania continues to report high rates of pediatric traffic-related injuries. Non-fatal RTIs often result in long-term physical and psychological harm. This study aims to assess age- and gender-specific injury patterns and mechanisms of non-fatal RTIs in children and adolescents, using data from “St. Mary’s” Emergency Clinical Hospital for Children in Iași over a ten-year period to inform targeted prevention strategies. Methods: This 10-year retrospective study (2015–2024) was conducted at “St. Mary’s” Emergency Clinical Hospital for Children in Iași, Romania, a regional referral center. Data from 1074 pediatric patients (aged 1 month–17 years, 11 months) with RTIs were analyzed using ICD-10 codes and verified manually. Variables included demographics, injury type, mechanism, and treatment. Patients were stratified into four age groups. Statistical analysis was performed using IBM SPSS Statistics 25, with significance set at p < 0.05. Results: The highest incidence was observed among boys (77.7%) and children aged 10–14 years. Car passengers and cyclists constituted the most frequently affected groups, with only 11% of passengers appropriately restrained and 78% of cyclists not wearing helmets. Common injuries included excoriations, thoracic contusions, and abdominal trauma, with notable variations by age and sex. Thoracic injuries were more frequent among girls, whereas younger children exhibited a higher incidence of abdominal trauma. Conclusions: The findings emphasize critical safety gaps in child restraint and helmet use and highlight the urgent need for targeted, age-specific road safety interventions and improved public health education. Full article

Background/Objectives: Children’s social–emotional difficulties and unhealthy lifestyle behaviors co-occur but are rarely addressed concurrently in parent-based interventions. These problems are exacerbated by family stressors (e.g., parental trauma, mental health, substance misuse, illness, financial strain, racism), which further compound existing health and healthcare inequities for families experiencing marginalization who are more likely to face major stressors. Yet, most parent-based interventions do not sufficiently address parents’ own stress and self-regulation. To inform prevention efforts to address these gaps, this mixed methods formative needs assessment explored strengths, challenges, and intervention preferences of parents dealing with major stressors, informing parent-based prevention to improve child social–emotional and physical health. Method: A sociodemographically diverse sample of parents/caregivers (N = 46) who had a child aged 3–9 years and ≥ two major stressors completed surveys assessing child well-being, parenting, parental stress, self-regulation, and intervention preferences. A subsample (n = 24) completed qualitative interviews further exploring these areas. Results: Parents expressed high interest in programming on emotion regulation, mindfulness, dealing with trauma, and reducing stress while strengthening children’s social–emotional and physical health. Conclusions: Results underscore the need to address caregivers’ own emotion-related skills to promote children’s well-being. Findings inform implementation and evaluation of a preventive program to improve child health, promote positive parenting, and address parental stress through self-regulation and coping. By aligning with community needs and preferences, parenting interventions that simultaneously address parental well-being and stress may be a promising avenue for improving equitable access to and quality of healthcare for families experiencing marginalization and stress. Full article

Background/Objectives: The nasal bone is critical to both the functional integrity and esthetic contour of the facial skeleton. Nasal bone fractures constitute the most prevalent facial fracture presentation in emergency departments. The identification of these fractures and the determination of immediate intervention requirements pose significant challenges for inexperienced residents, potentially leading to oversight. Methods: A retrospective analysis was conducted on facial trauma patients undergoing cranial radiography (Waters’ view) during initial emergency department assessment between March 2008 and July 2022. This study incorporated 2099 radiographic images. Surgical indications comprised the displacement angle, interosseous gap size, soft tissue swelling thickness, and subcutaneous emphysema. A deep learning-based artificial intelligence (AI) algorithm was designed, trained, and validated for fracture detection on radiographic images. Model performance was quantified through accuracy, precision, recall, and F1 score. Hyperparameters included the batch size (20), epochs (70), 50-layer network architecture, Adam optimizer, and initial learning rate (0.001). Results: The deep learning AI model employing segmentation labeling demonstrated 97.68% accuracy, 82.2% precision, 88.9% recall, and an 85.4% F1 score in nasal bone fracture identification. These outcomes informed the development of a predictive algorithm for guiding conservative versus surgical management decisions. Conclusions: The proposed AI-driven algorithm and criteria exhibit high diagnostic accuracy and operational efficiency in both detecting nasal bone fractures and predicting surgical indications, establishing its utility as a clinical decision-support tool in emergency settings. Full article

Background/Objectives: Childhood trauma significantly hinders the developmental and academic outcomes of learners, particularly in under-resourced schools such as those in Limpopo province, South Africa. Teachers in these settings often face challenges in supporting trauma-exposed learners due to a lack of knowledge, training, and appropriate resources. Addressing this gap requires the development of structured, trauma-informed educational support systems. Methods: This study forms the final phase of a multi-phase research project aimed at developing a trauma-informed curriculum for primary school teachers. A multi-phase mixed method design was adopted across four phases: (1) a global scoping review to identify effective trauma-informed interventions; (2) empirical interviews with primary school teachers, trauma center managers, clinical psychologists, and social workers to understand local needs and experiences; (3) development of a conceptual framework grounded in theoretical and empirical findings; and (4) curriculum development guided by El Sawi’s curriculum design model. The curriculum was validated using structured questionnaires with a panel of stakeholders including educators, mental health professionals, and curriculum experts. Results: The study identified critical issues, including teachers’ limited understanding of childhood trauma, lack of standardized training, and inadequate classroom strategies. Key curriculum components were developed to address these gaps, including modules on the nature of trauma, early identification of symptoms, trauma-informed teaching practices, and collaboration with mental health professionals. Validation results indicated strong agreement on the curriculum’s clarity, relevance, and potential impact. Conclusions: The developed trauma-informed curriculum provides primary school teachers in Limpopo with the knowledge, tools, and confidence to support trauma-exposed learners. It emphasizes early identification, responsive classroom strategies, and inter-professional collaboration. This curriculum has the potential to enhance learning environments and promote better educational and psychosocial outcomes for trauma-affected learners. Full article