Coping Tool Research Articles

Poetic care: the orientations and relations of spoken word performance at three venues in East London

ABSTRACT This paper explores the performance of spoken word poetry at three venues in East London through an attention to the ways in which participants experience and conceptualize these expressive events. Drawing from observation at events and interviews with performers, this paper illuminates the most commonly reported motivations behind the uptake of this genre of performance: achieving emotional healing and providing coping tools to others. By investigating these motivations, this paper considers how spoken word performance can become a personal and collective process of care, where performers overcome individual struggle through shifting bodily orientations and attitudes, while attuning affectively with others through pedagogical caretaking relations.

Prevalence of anxiety and depression in medical students of a public sector medical college in Islamabad and coping mechanisms adopted.

The objectives of this study were to find out the frequency of anxiety and depression in medical students and various coping mechanisms adopted by them to identify the coping trends and to stress the need of equipping these students with positive coping tools to deal with anxiety and depression. A cross-sectional, questionnaire-based observational study was conducted on a population of 500 medical students of Federal Medical and Dental College, Islamabad. The duration of the study was three months. By using the WHO sample size calculator, taking the confidence level 95%, anticipated population proportion 70% and absolute precision required 7%, the sample size was calculated at 165. The samples were collected by non-probability consecutive sampling via a questionnaire. In the study, two instruments were used: 1) Aga Khan University Anxiety and Depression Scale (AKUADS), and 2) Brief Cope Inventory. Self-administered questionnaires were filled by the students and the data collected from these questionnaires was analysed on SPSS version 19. Out of the sample size of 165 (98 female, 67 male) students, excluding 12 students with previous history of mental and physical illness, the prevalence of depressed students found after calculating their scores according to the Aga Khan Anxiety and Depression Scale (AKUADS score ≥19) was 95 (57.57%). The most used positive coping mechanisms by these students were religion (5.55±1.91), acceptance (5.28±1.56), planning (5.27±1.58) and active coping (4.85±1.45). The most used negative coping mechanisms were self-blame (5.52±1.83), self-distraction (5.29±1.56), and venting (4.67±1.49). The high presence of negative coping mechanisms indicates the urgency of the need for proper counselling and guidance of medical students about dealing correctly with anxiety and depression.

Annoyance due to residential road traffic and aircraft noise: Empirical evidence from two European cities

Based on a study in two European cities, Mainz in Germany and Zurich in Switzerland, the article investigates both acoustical and non-acoustical factors affecting indoor annoyance due to residential road traffic and aircraft noise. We specifically focus on three factors: (1) the role of windows as a feature of the building where people live; (2) the role of individual environmental concern as a general attitude; and (3) the role of household income as an indicator of socioeconomic resources. Empirical results show that closed windows in general and closed high-quality windows in particular are an important barrier against outdoor road traffic and aircraft noise, as well as a helpful subjective coping tool against corresponding annoyances. Environmental concern, too, proves to be a significant predictor of noise annoyance. Environmentally highly concerned people articulate feelings of annoyance more often than environmentally less concerned ones. As expected income is negatively related to road traffic noise annoyance. However, we find a positive association of income with annoyance from aircraft noise. Although objective exposure to aircraft noise is lower for high-income households, they feel stronger annoyed by noise from airplanes. Income shows various indirect effects on noise annoyance. A comparative analysis of road traffic and aircraft noise annoyance yields similarities, but also remarkable differences in terms of their influence factors.

Symptoms of Anxiety and Depression among Italian UNiversity academics: the 2020 UN-SAD study

Abstract Background The potential impact of demanding working conditions and career opportunities on the mental health of academic professionals has recently arisen some concerns, possibly resulting in psychological distress. This study aims to assess the prevalence of depression and anxiety within Udine University, comparing academic and administrative staff. Methods A cross-sectional survey involving regular (RP) and short-term academic professionals (STP), and administrative staff (AS) was carried out between June and December 2020 throughout the administration of an online anonymous survey. Prevalence of depressive and anxiety symptoms was assessed using PHQ-9 and GAD-7 tools. Demographic information about age, gender, marital status and seniority was collected. Relationship between mental health outcomes and professional role was analysed using nonparametric tests and ordinal logistic regression. Results All 5 university departments participated for a total of 366 people, being 109 of them STP, 146 RP and 111 AS. 55,7% of them were female, with a mean age of 47,9 years. Compared to administrative and regular staff, short-term professionals have a higher prevalence (95%CI) of both depressive (39,4% (30,8 - 48,8) vs 14,4% (9,6 - 21,0) vs 27,0% (19,6 - 35,9); p < 0,001) and anxiety symptoms (STP: 33,0% (24,9 - 42,3); RP: 15,1% (10,2 - 21,8); AS: 22,5% (15,8 - 31,1); p < 0.005). Multivariate models suggest an increased risk of depression OR 1.61 (0.98-2.64) and anxiety OR 2.08 (1.27-3.41) for female. Conclusions The higher prevalence of depressive and anxiety symptoms among STP could represent the effect on younger academics' mental health of the career uncertainty and challenging arena. The difference between AS and STP in psychological distress could be explained by the different job security status. More support should be given by universities to young academics for their both effective and healthy contribution to the progress of research. Key messages The high level of external pressure, referred as “publish or perish”, can play an important role in determining academics’ mental health. Investment to provide coping tools for young academics could be strategical for researchers’ empowerment.

Impacts of HeartMath techniques on undergraduate college students: A pilot study

While stress is a normal part of a person’s life, it can negatively impact the health and well-being of that person if there is a consistent accumulation of tension. This research pilot study was conducted based on the stress that undergraduate students experience while in a typical semester. An educational intervention was given over a 4-hour period on HeartMath Resilience techniques. Each participant was given a pre- and post-test created based around the Health Belief Model. Results of the research were favorable in relation to HeartMath being a beneficial coping tool for stress as well as participants being confident in using those tools in future situations.

Love in Quarantine: Sexting, Stress, and Coping During the COVID-19 Lockdown

IntroductionThis study investigated the relationships of pandemic-related stress and coping strategies with different kinds of sexting (i.e., experimental, risky, and emotional) during the COVID-19 lockdown in the Italian context.MethodsA sample of 1929 emerging adults (Mage = 24.17, SDage = 2.75; 71.6% girls) completed an online survey about their sexting behaviors during the national lockdown in Italy. Data were gathered in April/May 2020, from 6th to 11th week of home confinement due to COVID-19 pandemic. Hierarchical regression and mediation analyses were performed.ResultsPandemic-related stress directly predicted only risky and emotional sexting. Experimental and emotional sexting were positively predicted by social support, and negatively predicted by turning to religion. Risky and emotional sexting were positively predicted by avoidance, and negatively predicted by problem solving. Adaptive coping (i.e., social support) mediated the relationships from pandemic-related stress to both experimental and emotional sexting. Maladaptive coping (i.e., avoidance and problem solving) mediated the relationships from pandemic related-stress to risky and emotional sexting.ConclusionsSexting was a coping tool during COVID-19 lockdown, showing both adaptive and maladaptive facets.Policy ImplicationsFindings suggest new directions for implementing programs of sexual education and safer Internet use targeted to young people.

Family Adjustment to Pediatric Hematopoietic Stem Cell Transplant During COVID-19.

The COVID-19 pandemic has been difficult for families across the world due to fears about infection risk, increased social isolation, and significant changes in family roles and routines. Families with a child undergoing pediatric hematopoietic stem cell transplant (HCT) may be at even greater risk for poor adjustment during COVID-19 given their child's increased risk for infection. The purpose of the current study was to qualitatively examine the impact of COVID-19 on family adjustment during pediatric HCT to inform clinical care. Twenty-nine caregivers of children (≤12 years) who underwent an HCT within the past 2 years completed semi-structured qualitative interviews and demographic questionnaires in the first 4 months following initial COVID-19 quarantine. Twenty-two themes emerged from the interviews using grounded theory methodology. Although nearly half of caregivers described COVID-19 as a stressor, 69% of caregivers reported adequate adjustment to COVID-19. Caregivers generally attributed their positive adjustment to HCT preparing the family for COVID-19 and more difficult adjustment to increased physical or social isolation and COVID-19 amplifying germ fears. The child's HCT treatment status also had important implications on family adjustment to COVID-19. Results suggest that families undergoing pediatric HCT are uniquely prepared to cope with the impacts of a global pandemic; however, families experiencing certain risk factors (e.g., more recent transplant, impaired access to social support, reduced access to coping tools) may experience poorer adjustment during pandemics such as COVID-19 and may benefit from increased psychosocial support from their healthcare team.

Development and evaluation of employee wellness sessions in response to COVID-19.

The COVID-19 pandemic has led to widespread mental health distress. Few COVID-19 employee wellness initiatives have been evaluated and have primarily focused on frontline health care workers. This study described the feasibility and utilization of, and participant satisfaction for virtual COVID-19 employee wellness sessions at a large university and health system. Thomas Jefferson University behavioral health consultants (BHCs) and behavioral health leaders developed and offered JeffBeWell (JBW) wellness sessions over 17 weeks during March 2020 through July 2020. Sessions were advertised via mass emails and an employee intranet. Multiple live thirty-minute sessions were offered weekly; facilitators provided psychoeducation and offered coping tools. Topics included working remotely, parenting, sleep, nutrition, grief, anxiety, and yoga and relaxation. Attendance was tracked and participants were asked to complete satisfaction surveys; survey data was analyzed using descriptive statistics. A total of 388 sessions were offered with 1,324 participants. Attendance rose in weeks 1-5, followed by a decline and then a second increase in Weeks 15 through 17, 213 participants (16%) responded to the survey. The largest portion of respondents were in academic administrative roles (46%), followed by clinical providers and staff (34%) and faculty and students (9%). Of respondents, 91% of respondents felt that the sessions met their expectations, 92% felt the session helped them, and 92% planned to attend future sessions. JBW sessions were feasible to implement, attended by diverse participants and well received by survey respondents, although attendance has fluctuated during the pandemic. BHCs have refined sessions based on participant feedback and are tailoring more sessions to specific audiences. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Does Talking at the End of Life Matter?: Exploring the Associations between Final Conversations (Fcs) and Coping Strategies

ABSTRACT The purpose of this investigation was to quantitatively examine associations between retrospectively recalled final conversations (FCs) with the outcome of coping strategies. Two-hundred thirty-six individuals participated in an online survey. Correlations revealed significant, positive associations between the FCs factors with coping strategies. Moreover, multiple regressions revealed the following: messages of identity significantly predicted positive reappraisal and cognitive monitoring; difficult relationship talk significantly predicted self and other distancing; and, messages of spirituality significantly predicted the use of faith as a coping tool. Overall, results suggest that retrospectively recalled engagement in FCs are associated with coping strategies after the death of a relational partner. Theoretical and practical implications, limitations, and future directions are discussed.

P-479 Are FET and IUI cycles less emotionally difficult for patients than IVF? Evidence from smartphone app based emotional tracking data

Abstract Study question Is the emotional experience different in FET and stimulated IUI cycles compared to IVF cycles? Summary answer Emotional tracking data demonstrated cautious optimism and lower harm emotions in IUI, but FET cycles are associated with higher harm emotions than fresh IVF. What is known already It is sometimes claimed on clinic websites and by advocates for elective freeze all that FET cycles are inherently less stressful. However, little research evaluates the emotional difference between fresh and frozen cycles and the assumed emotional ease of FET may reflect clinician interpretation/bias rather than patient’s lived experiences. Many undertaking FET will have experienced disappointment in a fresh cycle and with increasing cycles comes increased cost. IUI treatment is perceived as less physically and emotionally intense, but studies have shown increased depression levels after a failed IUI cycle and high drop-out. Study design, size, duration Retrospective single-centre analysis of anonymised emotional tracking data entered by 707 patients using MediEmo app alongside IVF, 104 during stimulated IUI and 65 during medicated FET from May 2017-September 2020. MediEmo includes medication timeline/ notifications, coping tools and emotional tracking. Patients rate 2 questions daily in each emotion domain (challenge, threat, harm, e.g. ‘I am feeling tense’) on a 0-3 scale and indicate coping ability (‘I am unable to cope with the stress I’m experiencing’). Participants/materials, setting, methods Egg donor, recipient and fertility preservation cycles were excluded. Mean and standard deviation of scores in each mood domain entered per cycle day were calculated, centred on luteal day 0/ egg collection, from cycle day +/-14. Between group analysis performed using one-way analysis of variance (ANOVA) is presented here. Time series analysis, graphical presentation of emotions by cycle day and analysis of cycles resulting in live birth or return for further treatment will be presented. Main results and the role of chance Analysis of emotional tracking data demonstrated patients experience higher levels of positive challenge emotions (confident/encouraged/hopeful/positive) during FET and IUI cycles than fresh IVF: mean(s.d) score FET 1.64(1.1), IUI 1.74(0.89), IVF 1.48(1.06) (ANOVA p < 0.00001). The difference between FET and IUI challenge levels was not significant (p = 0.07). Threat emotions (worried/nervous/anxious/tense) are significantly lower in FET compared to IVF and IUI cycles: FET mean 0.67(0.91), IUI 0.97(0.90), IVF 0.87(0.91), (ANOVA p < 0.00001). The difference between IVF and IUI threat levels was not significant (p = 0.06). However, the harm emotions (sad/discouraged/disappointed) experienced by patients are significantly higher in FET, mean 0.62(0.89) compared to IVF 0.50(0.81), which are higher than IUI cycles, 0.36(0.68), (ANOVA p < 0.00001). There were no significant differences in numbers recording intolerable stress between the three groups (FET mean scores 0.24(0.66), IUI 0.21(0.58), IVF 0.21(0.59), (ANOVA p = 0.67). As this is retrospective observational data, there are differences between groups in addition to treatment modality, e.g. mean patient ages in the FET and IUI groups were older than those entering data during IVF; FET 34.2(4.09), IUI 33.9(5.2), IVF 32.6(4.47). However, age was not correlated with levels of challenge emotions, suggesting assumptions that patient emotions, e.g. hopefulness, are closely linked to objective prognosis may be flawed. Limitations, reasons for caution Emotional data was only available for those who chose to use MediEmo, entered emotional tracking data and who gave consent for use of data in research. As such, this analysis may not fully reflect all patients’ experiences. However, these limitations apply to all groups and should not prevent useful comparison. Wider implications of the findings Patients have less contact with clinic staff during FET or IUI than fresh IVF cycles. Fertility staff need to ensure availability of support during all treatment cycles and be empathic, particularly for those embarking on FET, who may still be coming to terms with a failed fresh transfer cycle. Trial registration number Not applicable

P–479 Are FET and IUI cycles less emotionally difficult for patients than IVF? Evidence from smartphone app based emotional tracking data

Abstract Study question Is the emotional experience different in FET and stimulated IUI cycles compared to IVF cycles? Summary answer Emotional tracking data demonstrated cautious optimism and lower harm emotions in IUI, but FET cycles are associated with higher harm emotions than fresh IVF. What is known already It is sometimes claimed on clinic websites and by advocates for elective freeze all that FET cycles are inherently less stressful. However, little research evaluates the emotional difference between fresh and frozen cycles and the assumed emotional ease of FET may reflect clinician interpretation/bias rather than patient’s lived experiences. Many undertaking FET will have experienced disappointment in a fresh cycle and with increasing cycles comes increased cost. IUI treatment is perceived as less physically and emotionally intense, but studies have shown increased depression levels after a failed IUI cycle and high drop-out. Study design, size, duration Retrospective single-centre analysis of anonymised emotional tracking data entered by 707 patients using MediEmo app alongside IVF, 104 during stimulated IUI and 65 during medicated FET from May 2017-September 2020. MediEmo includes medication timeline/ notifications, coping tools and emotional tracking. Patients rate 2 questions daily in each emotion domain (challenge, threat, harm, e.g. ‘I am feeling tense’) on a 0–3 scale and indicate coping ability (‘I am unable to cope with the stress I’m experiencing’). Participants/materials, setting, methods Egg donor, recipient and fertility preservation cycles were excluded. Mean and standard deviation of scores in each mood domain entered per cycle day were calculated, centred on luteal day 0/ egg collection, from cycle day +/–14. Between group analysis performed using one-way analysis of variance (ANOVA) is presented here. Time series analysis, graphical presentation of emotions by cycle day and analysis of cycles resulting in live birth or return for further treatment will be presented. Main results and the role of chance Analysis of emotional tracking data demonstrated patients experience higher levels of positive challenge emotions (confident/encouraged/hopeful/positive) during FET and IUI cycles than fresh IVF: mean(s.d) score FET 1.64(1.1), IUI 1.74(0.89), IVF 1.48(1.06) (ANOVA p < 0.00001). The difference between FET and IUI challenge levels was not significant (p = 0.07). Threat emotions (worried/nervous/anxious/tense) are significantly lower in FET compared to IVF and IUI cycles: FET mean 0.67(0.91), IUI 0.97(0.90), IVF 0.87(0.91), (ANOVA p < 0.00001). The difference between IVF and IUI threat levels was not significant (p = 0.06). However, the harm emotions (sad/discouraged/disappointed) experienced by patients are significantly higher in FET, mean 0.62(0.89) compared to IVF 0.50(0.81), which are higher than IUI cycles, 0.36(0.68), (ANOVA p < 0.00001). There were no significant differences in numbers recording intolerable stress between the three groups (FET mean scores 0.24(0.66), IUI 0.21(0.58), IVF 0.21(0.59), (ANOVA p = 0.67). As this is retrospective observational data, there are differences between groups in addition to treatment modality, e.g. mean patient ages in the FET and IUI groups were older than those entering data during IVF; FET 34.2(4.09), IUI 33.9(5.2), IVF 32.6(4.47). However, age was not correlated with levels of challenge emotions, suggesting assumptions that patient emotions, e.g. hopefulness, are closely linked to objective prognosis may be flawed. Limitations, reasons for caution Emotional data was only available for those who chose to use MediEmo, entered emotional tracking data and who gave consent for use of data in research. As such, this analysis may not fully reflect all patients’ experiences. However, these limitations apply to all groups and should not prevent useful comparison. Wider implications of the findings: Patients have less contact with clinic staff during FET or IUI than fresh IVF cycles. Fertility staff need to ensure availability of support during all treatment cycles and be empathic, particularly for those embarking on FET, who may still be coming to terms with a failed fresh transfer cycle. Trial registration number Not applicable

O-194 Insights from smartphone app based emotional tracking data on the impact of the Covid-19 pandemic on IVF patients

Study questionIs the emotional experience of patients during IVF different since the start of the global Covid-19 pandemic?Summary answerTracking data since re-opening demonstrated patients lower positive challenge emotions but no significant change in harm, threat, or stress.What is known alreadyCovid-19 caused widespread shutdown of fertility centres, including in the UK, when the HFEA mandated closure from March until May 2020. Research shows clinic closure and an uncertain future were a significant psychological burden for patients anticipating treatment. However, emotional experiences before, during and after closure have not yet been compared, which is the aim of the study.Study design, size, durationRetrospective single-centre analysis of anonymised emotional tracking data entered by 707 patients using the MediEmo smartphone app alongside their IVF cycle, from May 2017-September 2020.MediEmo includes medication timeline/ notifications, coping tools and emotional tracking. Patients rate 2 questions daily in each emotion domain (challenge, threat, harm, e.g. ‘I am feeling tense’) on a 0-3 scale and indicate coping ability (‘I am unable to cope with the stress I am experiencing’) on a binary scale.Participants/materials, setting, methodsEgg donor, recipient and fertility preservation cycles were excluded. First, mood scores were analysed by 2020 month of entry to capture the emotional impact of closure. Second, “Pre-Covid” (May 2017-Feb 2020) and “After Re-opening” (May 2020–Sept 2020) emotional experiences were compared, using student t-tests. Mean and standard deviation of scores in each mood domain entered on each cycle day were calculated, centred on luteal day 0/ egg collection, from cycle day -14 to + 14.Main results and the role of chanceGraphical presentation of emotional data by month clearly demonstrates the significant increase in threat, harm and stress emotions and reduced positive emotions experienced immediately prior to and during mandatory clinic closure. Of patients entering emotional data during closure in March/April 2020, 40% (14/35) stated they felt unable to cope with the stress they were currently experiencing.From May 2020 after the clinic reopened, analysis of in-cycle emotional tracking data showed there are no significant differences in harm or threat emotion levels or numbers reporting intolerable stress during IVF, compared to cycles pre-pandemic (May17-Feb 2020). Patients undertaking IVF cycles since closure are logging lower challenge scores (confident, encouraged, positive, hopeful), demonstrating less optimism, particularly in the ‘two-week wait’ phase of the cycle. The mean (s.d) of challenge scores pre-Covid was 1.50 (1.07), compared to 1.38 (1.04) after re-opening, p = 0.00085.The women who had treatment cycles post re-opening from May 2020 onwards were older (33.4(5.2) vs 32.6(4.4)), which may reflect clinical treatment prioritisation decisions. There was no significant differences in number of eggs collected (mean(s.d) Pre-Covid 12.08 (8.0) vs After re-opening 11.83 (9.4), p = 0.84) or live birth/ ongoing pregnancy rates for undelivered pregnancies (p = 0.69) between the groups.Limitations, reasons for cautionEmotional data was only available for those who chose to use MediEmo, entered emotional tracking data and who gave consent for use of their clinical data in research. As such, this analysis may not fully reflect all patients’ experiences. Most of the available data were entered prior to the pandemic.Wider implications of the findingsFor Covid-19 safety reasons, patients currently have less in-person staff contact when undertaking IVF. The findings reassuringly suggest emotional wellbeing was not markedly different in most domains. However, daily ratings did show the emotional fall-out of clinic closures which for most threatened attainability of parenthood goals (e.g., less hope).Trial registration numberNot applicable

Self-Esteem as a Predictor of Psychological Adjustment to Limb Loss: A Case Study of Acquired Limb Amputation


 
 
 
 OBJECTIVES:
 To examine the psychological issues following acquired limb amputation and examine the significance of positive self-esteem in the psychological adjustment of amputation.
 METHODOLOGY:
 This case study was conducted in the surgical and orthopedic units of different government and private hospitals of Peshawar district. The study includes a sample of 100 acquired limb amputees,both adult males and females admitted in different hospitals of Peshawar. Patients with congenital limb loss or with preexisting psychological issues were excluded from the study. Psychological adjustment scale developed by Sabir (1999) and Self-Esteem scale developed by Rifai’s (1999) was used to determine the amputee’s level of psychological adjustment and self-esteem.
 RESULTS:
 Results revealed that amputation leads to number of psychological issues. It was found that males had lowered self-esteem and severe adjustment issues then females while young amputees exhibit greater signs of maladjustment as compared to older amputees. Regression analysis for selfesteem predicting psychological adjustment also displayed pronounced differences in the level of psychological adjustment due changing level of self-esteem. The model suggested a strong positive relation between self-esteem and psychological adjustment (r=0.880, B=0.867, t=18.37, p<.001) and 77.5% of the variance in the dependent variable (psychological adjustment) was caused by predictor variable i.e. self-esteem (R2=0.775, F (98)=337.6, p<.001).
 CONCLUSION:
 Amputation badly disturbs the psychological state of an amputee and an amputee’s self-esteem is an important coping tool and has a direct relation with better psychological adjustment to limb loss.
 
 
 

Debate: Coping and resilience in the time of COVID-19 and structural inequities.

The hardships associated with COVID‐19 have highlighted the importance of coping and resilience, and many mental health providers and organizations have responded by promoting the use of individual and familial coping tools. While individually oriented techniques benefit many, they can also disadvantage populations struggling the most. They exact a cost by placing a higher burden on those with fewer resources and thus risk widening structural inequities. Since community‐level interventions can also enhance resiliency and are cheaper and more sustainable, more effort should be put into developing and deploying them. At a time in which hardship is widespread, parents are overwhelmed by multiple demands, structural inequities are rampant, and demand for services outpaces capacity, the mental health field must prioritize more equitable methods of assisting large numbers of children and families.

Intervention on depression and insomnia symptoms during the COVID-19 pandemic

Objectives: The COVID-19 pandemic has created significant psychological challenges globally. Evidence has been mounting of greater emotional distress and possible worsening of underlying psychiatric disorders, due to repercussions of COVID-19. In addition, the pandemic has created barriers to access for help, due to social distancing and travel restrictions. Thus, creating a major need for effective interventions that can be accessed safely from home and provide coping tools which can be learned and practiced while in isolation. An App based Yoga of Immortals (YOI) program is one such strategy to help cope with stressful situations. The objective of this study was to investigate if the YOI program can provide significant benefit for depressive and insomnia symptoms. Material and Methods: Participants in this study were asked to complete two brief online but well validated mental health screening tools before intervention. This was followed by a 7-week long YOI intervention. Following the intervention, participants were once again asked to complete the online validated questionnaires. The survey questionnaires included baseline demographic data and validated scales for measuring insomnia severity Insomnia severity Index (ISI) and levels of depression symptoms patient health questionnaire-8, (PHQ-8). All statistical analysis was performed using the Statistical Package for the Social Science. Results: SY YOI intervention of 7 weeks significantly improved the ISI scores as well as PHQ-8 scores in the study population (P < 0.0001 in all comparisons). Conclusion: YOI intervention is an effective intervention strategy for decreasing insomnia and depression symptoms, even during the pandemic.

Research as a Coping Mechanism for Racial Trauma: The Story of One Medical Student

Issue: The intersection of being a Black Woman in Medicine is a unique experience that exacerbates racial trauma and can lead to the hypervigilance, withdrawal, and emotional exhaustion that many minority students experience. Yet, there are not enough avenues for medical students like myself to healthily explore and heal from their experiences. I propose that qualitative research mentorship might be one such avenue. Evidence: It was neither my Black identity nor my female identity alone that isolated me: there were a handful of other Black students, and my school had matriculated a class that had equal numbers of men and women. Instead, it was the intersection of being Black and a woman that was unique and specific to me. As the only Black Woman in my cohort of almost 200 people, I took on a research project investigating the experiences of other Black learners. It was not until I sought out and cultivated mentors to guide me through conducting this research that I was positioned as a storyteller and a visionary to encourage future generations of those underrepresented in medicine to heal through sharing their stories and starting a ripple of change. It was empowering specifically because the qualitative research was specific to my experience. These interviews confirmed that my experience was not felt in isolation, and that I was not the only Black student doubting my abilities, qualifications, and right to be in medical school. Implication: Implementing formal qualitative mentorship programs, where medical schools encourage learners to explore some of the difficult and personal parts of their identities that address these intersections and support them, will ultimately make the universities healthier and create belonging for all students. Sharing stories through qualitative research has helped me (a) create positive experiences to achieve personal healing, (b) reveal systemic inequities, explain my individual experiences, and (c) develop agency and power to make change. Research became my most powerful coping tool and it can be just as powerful and healing for other underrepresented in medicine students. The framework I have provided can be used by institutions and faculty who strive to facilitate that healing.

Sustainable Crop Production, the Concurrent Adoption of Contract Farming, and Managing Risks through Income Diversification

This paper is aimed at evaluating the factors affecting the concurrent adoption of two risk coping strategies among hybrid maize farmers, namely income diversification supplemented with off-farm work and contract farming in the wake of changing climatic conditions. Climatic changes and food insecurity at the national level have emerged as key risk elements for hybrid maize production due to varying economic conditions. The present paper addresses these risks by examining various sources of risks faced by hybrid maize farmers and develops ideas to tackle these risks. Bivariate and multinomial probit models were employed to analyze numerous factors that influence farmers’ choice of the simultaneous adoption of income diversification (both on and off the farm) and contract farming at the farm level. The results reveal that hybrid maize farmers’ socioeconomic attributes significantly affect their adoption of risk coping tools. Similarly, the climatic, economic (price-related), biological, and financial risk perceptions and risk preference significantly influence the utilization of risk coping strategies in maize production. These outcomes extend our understanding of farmers’ risk preferences and provide parameters for policymakers to forestall diverse risk sources associated with hybrid maize production.

Predictors and Impact of Arts Engagement During the COVID-19 Pandemic: Analyses of Data From 19,384 Adults in the COVID-19 Social Study.

ObjectivesThe global COVID-19 pandemic in 2020 heavily affected the arts and creative industries due to the instigation of lockdown measures in the United Kingdom and closure of venues. However, it also provided new opportunities for arts and cultural engagement through virtual activities and streamed performances. Yet it remains unclear (i) who was likely to engage with the arts at home during lockdown, (ii) how this engagement differed from patterns of arts engagement prior to COVID-19, and (iii) whether home-based arts engagement was related to people’s ability to cope with their emotions during lockdown. This study was therefore designed to address these questions.MethodsWe used data collected in late May from the United Kingdom COVID-19 Social Study run by University College London. Multivariate regressions were used for the analysis (N = 19,384). Identified factors included demographic factors, socio-economic position, psychosocial wellbeing and health conditions, adverse events/worries, and coping styles.ResultsFour types of home-based arts engagement were identified during the COVID-19 pandemic: digital arts and writing, musical activities, crafts, and reading for pleasure. Our results show that the strongest predictors of the engagement were age, education attainment, social support, and emotion-focused or supportive coping styles. In particular, younger adults (aged 18–29), non-keyworkers, people with greater social support, people who had lost work, those who were worried about catching the virus, and those with an emotion-focused, problem-focused or supportive coping style were more likely to have increased arts engagement during lockdown. Arts activities were used as approach and avoidance strategies to help cope with emotions, as well as to help improve self-development.ConclusionOverall, our study suggests that while some people who engaged in the arts during the COVID-19 pandemic were those who typically engage under normal circumstances, the pandemic has also created new incentives and opportunities for others to engage virtually. Additionally, this study highlights the value of the arts as coping tools during stressful situations.

Pain Self-Management Strategies of Chronic Back Pain Sufferers in Thailand: A Qualitative Study (A Doctoral Project)

Background: Chronic low back pain is among the most common chronic musculoskeletal disorders worldwide. It is prevalent in Thailand, affecting up to 30% of the general population, with much higher rates among manual labourers. Pain self-management, including education, exercise, medication and other components, is an effective strategy for reducing pain intensity and disability rates for chronic low back pain sufferers. Objective: To investigate pain self-management strategies among chronic lower back pain sufferers in Thailand. Methods: The study design was a qualitative interview-based technique. The study setting was an orthopaedic outpatient department at a university hospital in Northern Thailand. Participants (n = 19) were selected based on recruitment criteria, and data was collected using demographic forms and in-depth interviews. Thematic analysis was used for qualitative analysis, with Wilcoxon signed-rank test used to assess changes in pain levels. Results: Participants used a combination of pain self-management modalities, including exercise, modified food consumption, increased rest, herbal treatments, hot and cold compression, Thai massage, and acupressure, along with psychological and spiritual coping tools like meditation and making merit. Ability to use these interventions was dependent on medical support from practitioners as well as social and other support. A small, but significant, mean difference in pain was also observed. Conclusion: Findings point to the possibility that there are significant cultural differences in pain self-management modalities and their effectiveness.

Mental Health Outcomes for Female Inmates without a Mental Disorder: Imprisonment and Post-release Effects of Confinement with Women with a Mental Illness

This study explores the well-being of women offenders without mental disorders during imprisonment and reentry after having been confined with mentally ill female inmates. We found that this joint confinement causes great distress to the mentally stable female inmates, harming both their mental, physical, and emotional condition and their reentry process and rehabilitation. Our findings led us to conclude that women prisoners should be separated from those with mental disorders or be offered a wide range of psychological and emotional coping tools as well as variety of rehabilitative treatment programs.