Boundaries of civility promotion in education and leadership
Incivility at work includes rudeness, demeaning attitudes, exclusion, and hurtful words, but as Graso (2023) notes in this commentary, while civility should be promoted, ‘[t]he unexamined pursuit of civility, if characterised by inconsistent definitions of harm and inappropriate allegations of uncivil acts, runs the risk of fostering its own toxicity spiral.’
Those accused of incivility may seldom recognise themselves as villains, but could justify their actions on account of, for example, harsh performance management tactics ‘or they might invoke their own pressures and work demands as reasons for their own misbehaviour.’ It is commonplace, argues Graso (2023) that interactions between professionals who are committed to mastering their occupation often contain elements of friction. One outcome might entail a drift from an otherwise robust and healthy exchange of views towards a more aggressive encounter without clear warning signs.
So, while the exercise of civil behaviour is a worthy aim in the workplace, it is almost inevitable that ‘human imperfections and mutual incompatibilities will likely continue hindering efforts to foster civility.’ Despite this, one is dutybound, in the interests of organisational cohesion, ‘to address multiple sources of incivility, including both those originating from people perpetrating mistreatment and those stemming from perceptions.’
Reminiscence therapy relieves anxiety, depression and boosts spiritual well being
Despite the application of optimised treatments for stroke patients, recurrence and cognitive impairment are common, so it is necessary to pay attention to psychological issues of stroke patients and their carers. Reminiscence therapy (RT) is often used to ameliorate psychological disorders, but rarely applied in stroke patients and their carers.
In this randomised controlled study, Zhang et al (2023) randomised 162 couples of stroke patients and their spouse/carers to receive RT or control care four times monthly for six months, with each session lasting for one hour. The aim was to determine whether RT influenced anxiety, depression, and spiritual well-being. RT comprised 12 categories which included introducing closest relatives; recalling unforgettable events experienced with their carers; recalling two interesting things they experienced as a child; and recalling two interesting or important events that they experienced.
The results showed that RT reduced anxiety and depression in stroke patients; RT raised spiritual well-being in stroke patients; and RT reduced anxiety and depression in stroke patients’ spouses/carers while also promoting their spiritual well-being. The authors speculate that recalling memories experienced together might help couples better understand each other, and that ‘[b]y receiving RT in a grouped form, spouse caregivers could become aware that stroke was common at this age and accept this situation by listening to and sharing experiences with other couples.’
The role of the microbiome in erectile dysfunction
Erectile dysfunction (ED) is a common condition, with some studies reporting a prevalence as high as 52% in men aged over 40 years and a strong increase in prevalence approaching 70% by age 70 years. This is cited by Leelani et al (2023) who note that one condition ‘highly correlated with the presence of ED is cardiovascular disease, even to the degree that ED has been accepted as a “sentinel event” for systemic cardiovascular disease.’
In this narrative review, Leelani et al (2023) evaluate a growing body of evidence that explores the microbiome in comorbidities known to cause sexual dysfunction. There are several ways in which the gut microbiome is connected to ED. First, there is evidence linking the gut microbiome to known risk factors for ED like diabetes, hypertension, metabolic syndrome, and obesity. Several of the studies considered in this review document a shift towards a lower ratio of the bacterial groups Bacteroidetes to Firmicutes, especially in obese individuals. There also seems to be a role for the gut microbiome in modulating androgen levels. However, the data indicating a direct mechanistic effect of the microbiome in ED remain limited.
One possible therapeutic option requiring more research is determining the degree to which the microbiomes of those with ED can be altered to mimic the diverse microbiomes of individuals without ED.
The role of acceptance in loneliness in those with serious mental illness
Loneliness is both a modern behavioural epidemic and a public health issue affecting up to one third of people in industrialized countries. The prevalence of loneliness among adults with serious mental illness (SMI) is substantially higher than that of the public. For example, one study found that more than 80% of adults with psychosis reported experiencing loneliness.
In this study, undertaken in greater Philadelphia, United States, McCormick et al (2023) recruited 120 adults (aged 18–65 years) with SMI to identify the role of dispositional loneliness and internalised stigma, together with momentary feelings of acceptance on experiential loneliness. Data were collected using Ecological Momentary Assessment via smart phones, with participants completing online surveys three times a day for 14 consecutive days.
The results showed that the prevalence of loneliness is notably high among adults with SMI, and that the momentary experience of loneliness appears to be a combination of personal dispositions and ongoing experience. In addition, ‘[f]eelings of being accepted in everyday life would appear to be one aspect of experience that could be enhanced through supporting people with SMI to engage in experiences and social connections …’ The authors conclude that offering support to adults with SMI to develop relationships where they are valued, needed, and relied upon would promote relational value and, in theory, reduce loneliness.