In lieu of an abstract, here is a brief excerpt of the content:Silent Screams; Lily's StoryEva V. Regel"Trauma is personal. It does not disappear if it is not validated. When it is ignored or invalidated, the silent screams continue internally heard only by the one held captive. When someone enters the pain and hears the scream, healing can begin."—Danielle Bernock, "Emerging Wings; A true story of Lies, Pain and the Love that Heals."Some patients stay with you long after they (...) leave. They appear in your mind when you walk by the hospital room they occupied or when someone mentions their name. There is [End Page 19] something about the narrative of their life and illness that makes you hold on to them. Lily is one such patient for me.Lily was a 45-year-old paraplegic woman who was well known to many providers in the hospital. She had a complex trauma history (childhood physical and sexual abuse, intimate partner violence, domestic violence), homelessness, and multiple psychiatric admissions. In addition, she had a complex medical history, including chronic pain issues and substance use disorder. Many providers considered her to be a "very difficult" or "challenging" patient because she would "dictate" her care, had low distress tolerance and would have explosive angry outbursts requiring frequent visits from Police and Security. To top it off, after months of a challenging stay on a unit, she would eventually leave against medical advice. Everyone involved in her care felt that discharge to a safe setting such as a skilled nursing facility would be her best option. Yet, she was a very "hard" sell to any facility because of her behavioral issues, relatively young age, extensive history of drug use, and medication non-compliance. Even though the unit I worked in was familiar with "difficult" patients like Lily, the floor staff was anxious and concerned about the effect Lily would have on patients, staff, and providers. The combined anticipatory anxiety worsened after we were told that Lily left against medical advice three days before her admission to our unit as a reaction to the staff's attempt to develop a behavioral plan.I remember the day I met Lily. I was working as the clinical social worker on the floor, helping patients with adjustment to coping with hospitalization, addressing mental health issues that usually exacerbate in the acute care setting, and providing support to the staff caring for a psychosocially complex patient population. It was the second day after Lily arrived on the floor, and Police and Security had already come up three times. As I walked out of another patient's room, a bedside nurse stopped me in the hallway. "Can you please talk to her? … Please, just talk to her, or sit with her. I just need a break. I have been in that room since I started my shift. I am exhausted." The nurse had an exasperated and pleading look, and even though I was rushing to a meeting, I decided to meet with Lily instead. When I walked into her room, I saw a thin, small-framed woman with brown hair pulled back into a tight bun. She had freckles peppered all over her round face, neck, and chest. Her features were delicate and small, and her almond-shaped green eyes were her most prominent feature. She was wearing a white tee and jeans. She was sitting in her wheelchair; her makeup bag was lying on the table next to her. I introduced myself and my role on the team, trying not to stumble under a very heavy glare. "Tell them to leave me alone. That nurse is always in my room. Spying. I might not be able to walk, but I can still use my hands. I can call if I need help."And so I did. And when I came back, Lily and I talked a little about her life. And the next day, we talked a little more. And then again. Lily was giving me small glimpses of who she was and the events in her life. Then, one day, in the middle of the conversation about her day and telling me how much she hated to be confined to her hospital room, she looked... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Full Collection of Personal NarrativesZohar Lederman, Ola Ziara, Rachel Coghlan, Oksana Sulaieva, Anna Shcherbakova, Oleksandr Dudin, Vladyslava Kachkovska, Iryna Dudchenko, Anna Kovchun, Lyudmyla Prystupa, Yuliya Nogovitsyna, Ghaiath Hussein, Kathryn Fausch, P. P. Kyaw, Ayesha Ahmad, Richard W Sams II, Handreen Mohammed Saeed, Artem Riga, Ryan C. Maves, Elizabeth Dotsenko, Irina Deyneka, Eva V. Regel, and Vita Voloshchuk• An Unsettling Affair• How We Keep Caring While Walking Through Our (...) Pain• Adjusting Laboratory Practices to the Challenges of Wartime• Why We Stay• A Semi-Personal Story from a Ukrainian NGO Professional (or a Semi-Professional Story from a Ukrainian Person) Living through the War• When Ethics Survives Where People Do Not: A Story From Darfur• Burma’s Healthcare Under Fire: My Experience as an Exiled Medical Professional• When a Conflict Collapses on a Child: An (Aborted) Medical Evacuation of a Hazara Toddler During the Kabul Airport Blast and the Taliban Takeover• The Vagaries and Vicissitudes of War• Providing Care to a Potential Aggressor: An Ethical Dilemma• One Surgeon’s Experience During Armed Conflict in Ukraine• The Limits of Our Obligations• A Liberating Breath• Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under Fire• Stories of Families with Chronically Ill Pediatric Patients during the War in UkraineCopyright © 2023 Johns Hopkins University Press... (shrink)

While a significant literature has appeared discussing theoretical ethical concerns regarding COVID-19, particularly regarding resource prioritization, as well as a number of personal reflections on providing patient care during the early stages of the pandemic, systematic analysis of the actual ethical issues involving patient care during this time is limited. This single-center retrospective cohort mixed methods study of ethics consultations during the first surge of the COVID 19 pandemic in Massachusetts between March 15, 2020 through June 15, 2020 aim to (...) fill this gap. Results indicate that there was no significant difference in the median number of monthly consultation cases during the first COVID-19 surge compared to the same period the year prior and that the characteristics of the ethics consults during the COVID-19 surge and same period the year prior were also similar. Through inductive analysis, we identified four themes related to ethics consults during the first COVID-19 surge including (1) prognostic difficulty for COVID-19 positive patients, (2) challenges related to visitor restrictions, (3) end of life scenarios, and (4) family members who were also positive for COVID-19. Cases were complex and often aligned with multiple themes. These patient case-related sources of ethical issues were managed against the backdrop of intense systemic ethical issues and a near lockdown of daily life. Healthcare ethics consultants can learn from this experience to enhance training to be ready for future disasters. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under FireIrina Deyneka and Eva RegelIrina DeynekaWhen the Russian army attacked my country, I became a volunteer for a hotline offering psychological support to those in crisis; refugees, those who were under the shelling, those who were hiding in bomb shelters, and who were directly in the zone of fighting. People were (...) lost and disoriented by constant bombing, by the fact that their country was under attack. Once, I had a woman who lived in Mariupol on one of these calls. I was living then in another city, Odessa, but was experiencing the same horrors of war that my client was—the shelling, uncertainty, and despair. We were processing my client’s feelings of grief and anxiety when I heard the sirens on her end. I offered to stop our session so she could seek shelter. She told me she would not have time to find shelter and wanted to continue our meeting. And so, we continued... But soon, Odessa’s sirens broke the silence, and it was my turn to decide what to do; should I continue our session or try to find a bomb shelter for myself? I decided to stay because I thought that was the right thing to do morally, professionally, and personally.I eventually left Odessa, but only after a bomb destroyed a house next to mine, and I saw a family, my neighbors, perish in the destruction. I am now a member of one of Slovakia’s Non-Governmental Organizations (NGOs) and work in a mobile brigade providing medical and psychological support to refugees. I can remember every one of my clients. Children, adults... I can remember their stories, their traumas, their memories of the horrors of war and devastation. Sometimes I meet with them only once, and they move on to another refugee center or are on their way to a Western part of Ukraine, trying to escape the war. And frequently, I do not know how many sessions I will be able to have with clients. Sometimes it is only one time, and sometimes we can meet for many months. Initially, I thought, What can I do in one therapy session? Now, I know that I can do a lot. I can provide people who survived the most inhuman conditions and witnessed death and destruction around them with a space and time to talk through and process their experiences. I am their support, and they lean on me as they try to make sense of what has happened to them and their country. I always tell my clients that my goal as a psychotherapist is to help them withstand, survive, and hold on while still being able to continue to function in a country at war. All I can do is treat each of the therapy sessions as our last one and try to provide as many strategies and skills as possible to cope with anxiety and depression, to be able to function, and to live in the present.Every session is about installing hope, moving slowly forward, and away from traumatic events. One of my clients, a 14-year-old boy, was diagnosed with a neurological condition, involuntary facial muscle spasm, or tics. He was barely talking when I first saw him, and I decided to use art therapy as a trauma-processing tool during one of the therapy sessions. He was drawing an explosion, fire, and destruction of his neighbor’s house. He blacked out the horrors of his experience to preserve his strength. Yet, he began slowly remembering his experiences, re-creating the story of his trauma, and making memories. I was fortunate to work with [End Page E4] him for many months, carefully and thoughtfully helping him re-create the sorry of his trauma, helping to become its witness. Ultimately, it was great to see that he could control his memories and his emotional stress; he felt empowered and in control.Eva RegelThis is the story of Irina Deyneka, one of many Ukrainian psychotherapists working in Ukraine, providing mental health support to a nation ravaged by... (shrink)

Предназначено для студентов художественных вузов и факультетов, а также для учащихся профессиональных учебных заведений художественного профиля.

Книга предназначена для исследователей, специалистов, преподавателей, аспирантов, студентов, а также всех тех, кто интересуется вопросами становления постнеклассической науки.

The Aleksanteri Institute of the University of Helsinki organized in 25–26 of September 2009 a special symposium Northern Lights — Facets of Enlightenment Culture with the aim to discuss form of Enlightenment thought in Sweden/Finland and Russia. The symposium, which was opened by Prof. Emeritus Matti Klinge, a renowned historian of 18th- and 19th-century Finland, had four participants from Russia, five from Finland and one from Germany; thus, it was yet a quite small event, but we hope that with it (...) the foundations of a fruitful co-operation, with annual symposia on questions of Enlightenment culture, will be laid. Of the speakers, Prof. Tatiana Artemyeva, Dr. Oili Pulkkinen and Prof. Vesa Oittinen focused on more general problems of study of Enlightenment ideas, while the other contributions dealt with different ―case studies‖ either in Sweden/Finland (Dr. Kimmo Sarje, Dr. Johan Sten), Russia (Prof. Mikhail Mikeshin, Dr. Johannes Remy, Dr. Larisa Agamalian), in France (Dr. Alla Zlatopolskaya) or Germany (Dr. Carola Häntsch). (shrink)

Diez años desde la entrada en vigor de la Ley Orgánica 5/2000, de 12 de enero, de la Responsabilidad Penal de los Menores han servido para mucho. Desde que se optó por legislar los ilícitos penales cometidos por aquellos menores con edades comprendidas entre los 14 y los 18 años, muchas y variadas son las certezas e incertidumbres que, al respecto de un tema tan complejo y tortuoso, han visto la luz en nuestro entramado social.

Cultural norms may dictate how grief is displayed. The present study explores the display behaviours and rules in the bereavement context from a cross-cultural perspective. 86 German-speaking Swiss and 99 Chinese bereaved people who lost their first-degree relative completed the adapted bereavement version of the Display Rules Assessment Inventory. Results indicated that the German-speaking Swiss bereaved displayed more emotions than the Chinese bereaved. The Chinese bereaved, but not the German-speaking Swiss bereaved, thought that bereaved people should display more emotions than (...) they actually did when they were with their close others (but not when they were alone). Bereaved people endorsed more emotional expression “when alone” than “when with close others”, demonstrating a social disconnection tendency, which was more evident in the Chinese sample. Bereaved people endorsed more expression of positive emotions (e.g. affection/love) and less expression of powerful negative emotions (e.g. blame/guilt, anger) across cultures. Compared to their Chinese counterparts, the German-speaking Swiss sample indicated more actual expressions for most emotion types (i.e. joy/happiness, affection/love, sadness, anger, and denial) but thought bereaved people should express more joy/happiness and less blame/guilt. The results suggest that bereaved people’s display behaviours and rules are influenced by culture, situation, and type of emotion. (shrink)

Legal professionals in Malawi rely on a limited number of textbooks, outdated law reports and inadequate library services. Most documents available are in image form, are un-structured, i.e. contain no useful legal meta-data, summaries, keynotes, and do not support a system of citation that is essential to legal research. While advances in document processing and machine learning have benefited many fields, legal research is still only marginally affected. In this interdisciplinary research, the authors build semi-automatic tools for creating a corpus (...) of Malawi criminal law decisions annotated with legal meta-data, case and law citations. We used this corpus to extract legal meta-data, including law and case citations as used in Malawi by employing machine learning tools, spaCy and Gensim LDA. We set the foundation for a new methodology for classifying Malawi criminal case law according to the recently introduced International Classification of Crime for Statistical Purposes (ICCS). (shrink)