Core Support Research Articles

Evaluation of the effect of the father's support on the mother's breastfeeding motivation.

One of the factors affecting mothers' breastfeeding success is the father's support and the other is the mother's breastfeeding motivation. This study was conducted to determine the effect of partner breastfeeding support perceived by mothers and reported by fathers on mothers' breastfeeding motivation. The research was conducted using the face-to-face interview method with couples presenting to Family Health Centers in a city in Türkiye. The sample consisted of 114 breastfeeding women in 6 weeks to 6 months postpartum and their partners. Data were collected with a 'Personal Information Form', the 'Breastfeeding Support Scale (BSS)', the 'Breastfeeding Motivation Scale (BMS)', and the 'Partner Breastfeeding Influence Scale (PBIS)'. Participants' mean score was 119.19 ± 23.97 on the PBIS and 11.51 ± 2.94 on the BSS. A moderate-level, significant positive relationship was found between the BSS and PBIS scores of primiparous and multiparous mothers (r = 0.647; r = 0.567). A one-unit increase in fathers' breastfeeding support scores increased integrative regulation motivation scores by 0.548 units in primiparas and 0.458 units in multiparous mothers and by 0.309 units in intrinsic motivation scores and 0.351 units in external regulation-baby health motivation scores in multiparous mothers. It was found that father support affected the autonomous motivation of both primiparous and multiparous mothers at a moderate level. Perceived partner breastfeeding support affected only the autonomous motivation of multiparous mothers at a moderate level, and the types of controlled motivation, namely infant health and social approval, at a weak level.

Association Between Cerebral Microbleeds and Neurological Outcomes in Patients Who Underwent Extracorporeal Membrane Oxygenation.

Cerebral microbleeds (CMBs) are common and varied in patients receiving extracorporeal membrane oxygenation (ECMO). Here, the authors describe CMB findings in patients receiving ECMO and their association with clinical factors. A total of 138 patients receiving ECMO were enrolled and categorized as venovenous and venoarterial. Blood coagulation profiles during ECMO support and Glasgow Coma Scale (GCS) scores within 7 days were recorded. Patients with CMBs exhibited prolonged activated clotting time (P<0.001), decreased fibrinogen levels (P<0.001), reduced platelet counts (P<0.001), and extended prothrombin time (P<0.001). A significant correlation (P<0.05) was observed between the presence of CMBs and most coagulation parameters among all patients. Patients with venoarterial ECMO had significantly higher activated partial thromboplastin time, activated clotting time, and prothrombin time compared with those with venovenous ECMO (all P<0.05). Patients with a less severe CMB burden exhibited higher GCS scores and better neurological injury outcomes at both 7 and 90 days. CMB burden in all patients with ECMO was significantly correlated (P<0.05) with most blood coagulation profiles and neurological injury. CMB burdens after ECMO are common, varied, and associated with a variety of clinical conditions. These findings may guide ECMO management.

Different ECLS Pump Configurations for Temporary Right Ventricular Assist Device in LVAD Patients: A Retrospective Case–Control Study

Background: Acute right ventricular failure is a critical complication after left ventricular assist device (LVAD) implantation, often managed with a temporary paracorporeal right ventricular assist device (RVAD). This study examined three extracorporeal life support (ECLS) systems regarding mortality, bleeding complications, and intensive care unit (ICU) stay duration. Methods: This monocentric, retrospective case–control study included all patients receiving LVAD with paracorporeal RVAD between 2009 and 2020. Three patient groups were formed: CentrimagTM (A), CardiohelpTM (B), and DeltastreamTM (C). Results: A total of 245 patients were included. Preoperative parameters were similar between the CentrimagTM and DeltastreamTM groups, but CardiohelpTM patients had worse Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Scores (A: 1.7 ± 0.8, B: 1.36 ± 0.5, C: 1.9 ± 0.9; p &lt; 0.05). In-hospital death rates were A: 61 (41.8%), B: 15 (32.6%), C: 29 (54.7%); p &lt; 0.05, and reoperation due to bleeding rates were A: 32 (21.9%), B: 8 (17.4%), C: 25 (47.2%); p &lt; 0.05, with the DeltastreamTM group showing the highest rates. This group also had increased thrombocyte consumption and prolonged ICU stays. Conclusions: Temporary RVADs lead to bleeding complications, affecting patient outcomes. The DeltastreamTM group had significantly higher bleeding complications, likely due to high pump revolution rates and thrombocyte decline. Due to the study’s retrospective nature and complex patient profiles, these interesting findings should be validated in future studies.

The effectiveness of secondary-school based interventions on the future physical activity of adolescents in Aotearoa New Zealand: a modelling study.

Secondary schools are important settings for promoting varied physical activity (PA) opportunities for adolescents to promote PA throughout life. However, research on the effect of secondary school-based interventions on future PA is limited. This study examined the potential impact of secondary school-based interventions on the determinants of future PA participation of Aotearoa New Zealand (NZ) adolescents using simulated modelling. We used data from a nationally representative sample of secondary school students (n = 5035) aged 12-17 between 2017 and 2020 in NZ. We modelled four secondary school-based interventions and their projected impact on five determinants of future PA. Modelled interventions were the technological augmentation of physical education (TAPE), a peer-led PA mentoring programme (PL), physically active learning (PAL) and the inclusion of a natural environment play area (NE). Total weekly PA increased the most from the NE intervention (+ 0.2h/week), followed by TAPE (+ 0.08h/week), PAL (+ 0.05h/week) and PL (-0.06h/week). Current number of PA settings increased the most in NE (+ 1.75 settings/week), followed by TAPE (+ 1.29 settings/week), PAL (+ 1.21 settings/week) and PL (+ 0.73 settings/week). Current number of PA types increased the most in NE (+ 1.57 types/week), followed by PL (+ 1.05 types/week), TAPE (+ 0.34 types/week) and PAL (+ 0.15 types/week). Physical literacy scores increased the most from PL (+ 3.6%), followed by PAL (+ 3.3%), TAPE (+ 0.43%) and NE (+ 0.12%). Social support scores increased the most from PAL (+ 5%), followed by PL (+ 1.9%), TAPE (+ 1.46%) and NE (+ 0.57%). On average, all interventions benefitted determinants of future PA participation to a small degree. Results show differing magnitudes of the intervention effect by determinant, indicating the complexities surrounding the promotion of PA adherence. Future interventions could be improved through detailed consultation alongside, and involving, adolescents and stakeholders within schools. Researchers should also prioritise the collection of longitudinal PA data and explore its connection with sociodemographic differences between adolescents.

Real-world study on the application of enhanced recovery after surgery protocol in video-assisted thoracoscopic day surgery for pulmonary nodule resection

ObjectiveThis study aims to evaluate the real-world effectiveness of applying different levels of Enhanced Recovery After Surgery (ERAS) guidelines to video-assisted thoracic day surgery (VATS). The goal is to determine the optimal degree of ERAS protocols and management requirements to improve postoperative recovery outcomes.MethodsIt was designed as a single-centre, prospective pragmatic randomized controlled trial (PRCT), including patients who underwent VATS at the Day Surgery Center of West China Hospital, between January 2021 and November 2022. Patients were divided into Group A and Group B through convenience sampling to implement different levels of ERAS management protocols. Data collection included the baseline characteristics (gender, age, marital status, education level, BMI, PONV risk score, ASA classification), surgery-related indicators (type of surgery, pathological results, hospitalization costs, duration of surgery, intraoperative blood loss, intraoperative rehydration volume), postoperative recovery indicators (postoperative chest tube duration time, time to first postoperative ambulation and urination, postoperative complications, follow-up condition), pain-related indicators (pain threshold score, pain score at 6 h postoperatively, bedtime, and predischarge), psychological state indicators (anxiety level), Athens Insomnia Scale (AIS) scores, and social support scores. Propensity score matching (PSM) was utilized and statistical analyses were conducted using R version 4.4.1. Comparisons of categorical variables were performed using the χ² test, while comparisons of continuous variables were conducted using ANOVA or the Kruskal-Wallis rank-sum test. A significance level of α = 0.05 was set for statistical tests.ResultA total of 340 patients were included, with 187 in Group A and 153 in Group B. After propensity score matching (PSM), there were 142 patients in Group A and 105 in Group B, with no significant baseline differences. Group A had a significantly higher proportion of chest tube removals within 24 h postoperatively (P < 0.001) and earlier mobilization (P < 0.001). Despite a higher pain threshold in Group A (P = 0.016), their postoperative pain scores were not higher than those in Group B. Additionally, Group A had a lower incidence of postoperative complications.ConclusionThe more comprehensive ERAS protocol significantly improved postoperative recovery, confirming its value in day-case VATS and supporting its clinical adoption. However, the study has limitations; future research should focus on standardizing ERAS protocols and expanding their application to a broader patient population to validate these findings further.Trail RegistrationThis study underwent review by the Ethics Committee of West China Hospital of Sichuan University under No. 2020 (1001). It has been officially registered with the China Clinical Trial Registry, TRN: ChiCTR2100051372 and registration date is Sept. 22, 2021.

A Mixed Method Study on Supportive Supervision of Community Health Workers From Central India

Abstract Background: Supportive supervision of the Community health workers (CHWs) is critical for their efficient functioning in various health programmes. CHWs in India are supervised by facilitators known as ASHA Sahyogini. Our study aimed to investigate the linkage between the knowledge and skills of CHW facilitators and their CHWs. To understand the problems encountered by the CHW facilitators while assisting their CHWs. Also, to determine the perceptions of CHWs on the nature of supportive supervision of their facilitators. Materials and Methods: A mixed-method explanatory study using purposive sampling was conducted in a rural block of Madhya Pradesh (Central India). The CHWs were categorized into relatively high performing (RHP) and relatively low performing (RLP) groups based on their performance-based incentives received during (2017-2018). The quantitative component comprised of self-administered questionnaire and skill assessment while the qualitative component comprised of three focused group discussions with RHP, RLP CHWs and their facilitators. Results: The mean (SD) supportive supervision score given by CHW facilitators were found to be significantly associated with CHW’s performance. Problems faced by CHW facilitators while assisting their CHWs resulted from inadequate education of CHWs, insufficient incentives, transport problems and repetitive surveys. While some CHWs perceived to have received good assistance from their facilitators, there were a few who were not dependent on their facilitators and executed duties by themselves. Conclusion: CHW’s performance cannot be ascribed completely to the CHW facilitator’s performance. The challenges perceived by CHW facilitators were unmodifiable and required them to strongly motivate and support their CHWs to improve their functionality.

Psychosocial Determinants for Self-Reported Health Status in Hemodialysis Patients: A Cohort Analysis of the CONVINCE Randomized Trial.

We investigated whether psychosocial determinants self-efficacy and social support are associated with Health-Related Quality of Life in hemodialysis patients enrolled in the CONVINCE trial. We used baseline data from the cohort of patients involved in the CONVINCE randomized trial of hemodiafiltration versus hemodialysis. Measures included age, gender, relationship status, children, housing, education, employment, comorbidities, dialysis schedules, time of first dialysis, residual kidney function, general self-efficacy and social support scores, and PROMIS measurements for health-related quality of life. Associations were analyzed using hierarchical regression. One thousand three hundred and sixty patients from CONVINCE were the cohort of interest. Mean age was 62±13.5 years (range 20-92), and 66.9% were men. Self-efficacy was a significant predictor for all health-related quality of life domains: depression (β = -0.36, p < 0.001), anxiety (β = -0.35, p < 0.001), social participation (β = 0.32, p < 0.001), cognition (β = 0.29, p < 0.001), fatigue (β = -0.29, p < 0.001), physical function (β = 0.27, p < 0.001), sleep disturbance (β = -0.23, p < 0.001), pain interference (β = 0.21, p < 0.001), pain intensity (β = -0.17, p < 0.001), interdialytic symptoms (β = -0.14, p = 0.002) and intradialytic symptoms (β = -0.14, p = 0.002). Social support was a significant predictor for cognition (β = 0.21, p < 0.001), sleep disturbance (β = -0.11, p = 0.017) and intradialytic symptoms (β =- 0.11, p = 0.02). Higher general self-efficacy scale scores are associated with improvements in cognition, depression, anxiety, social participation, fatigue, physical function, sleep disturbance, pain interference, interdialytic symptoms, pain intensity and intradialytic symptoms. Associations for self-efficacy are larger than those for social support and stronger than previously reported. It is plausible that targeted psychosocial interventions may improve health outcomes in people on hemodialysis.

Prevalence of the Unmet Needs and its Predictors among Working Mothers of Children with Epilepsy Attending Specialist Hospitals in Kelantan

INTRODUCTION: Unmet needs arise when everyday assistance is lacking. Epilepsy's unpredictability creates significant work-family conflict for working women, potentially leading to increased unmet needs. This study aimed to determine the prevalence and the factors related with the unmet needs of working mothers with children with epilepsy (CWE) in Kelantan. MATERIALS AND METHODS: A crosssectional study using the validated Malay version of the Family Needs Survey questionnaire was conducted among 204 working mothers aged 18 to 60 of CWE attending specialist hospitals in Kelantan. Data were analysed using descriptive statistics and multiple linear regression. RESULTS: The highest unmet need was for community services (81.6%), followed by information (71.9%), social support (53.1%), financial (43.2%), explaining to others (28.9%), and family functioning (28.4%). Having follow-ups at tertiary hospitals reduced the unmet need score for information (B=-0.669, 95%CI=-1.276,0.081, p=0.021) and social support (B=-1.454, 95%CI=-2.225, -0.683, p=&lt;0.001). Living in nuclear types of family reduced the unmet need score for community services (B=-0.669, 95%CI=-1.276,0.081, p=0.021) and information (B=-1.216, 95%CI=-1.965,-0.466, p=0.002). Working in the government sector increased the unmet need score for social support (B=0.437, 95% CI=0.062, 1.454, p=0.033). Full-time employment (B=-0.761, 95%CI=-1.244,-0.279, p=0.002) reduced the unmet need score for family functioning. Contract employment status (B=0.566, 95%CI=0.074,1.058, p=0.024) increased the unmet need score for family functioning. CONCLUSION: Mothers of CWE working in the government sector, under contract employment, and seeking follow-up care in secondary hospitals were related to higher unmet needs. The study findings may assist policymakers in introducing a child-friendly employment policy and flexible working arrangements among working parents of children with chronic illnesses such as epilepsy.

Investigating the effect of peer-led educational intervention on behaviors related to pubertal health and its determinants in high school girls of Genaveh, Iran: Application of social cognitive theory

Background Empowering adolescents in the field of puberty health is one of the important goals of public health programs. The present study was carried out with the aim of determining the effect of peer-led training on puberty-related behavior and its determinants using social cognitive theory. Methods: A total of 245 teenage girls were randomly divided into two groups: the intervention group and the comparison group. The questionnaire measuring puberty-related behavior and its determinants was self-administered and completed before and 2 months after training in the two groups. One session for parents, four sessions for peer educators, and four sessions for participants were conducted for 1 month. Results: In the intervention group, unlike the comparison group, the mean scores of knowledge, outcome expectations, self-efficacy, self-control, social support, and behavior increased significantly after training (p <0.05). Based on regression analysis, outcome expectations and social support were the main determinants of puberty-related behavior (adjusted R2 = 0.464). Conclusion: The findings of this study support the effectiveness of the peer-led educational intervention based on social cognitive theory in the improvement of puberty-related behavior and its determinants, which can be used in the design of puberty-related health promotion programs. Further research to assess the longer-term outcomes and to examine other theories of behavior change are suggested.

Mediating effect of health literacy on social support and self-care ability in older patients undergoing percutaneous coronary stent implantation.

Health literacy refers to individual skills to access, process, understand, and use health information to stay healthy. Social support is a multi-faceted construct including of perceived, enacted, and structural support dimensions and negative social reactions. This study explored the mediating effect of health literacy on social support and self-care ability in older patients undergoing percutaneous coronary stent implantation (PCI). Between December 2021 and March 2022, a total of 249 older patients who underwent PCI in our hospital were included in this cross-sectional study using the convenience sampling method. The demographic and health history of patients was collected by questionnaire. Exercise of self-care agency scale (ESCA), chronic disease health literacy management scale (HeLMS) and social support rating scale (SSRS) were also analyzed and their correlations were evaluated. This study indicated that the total scores of health literacy, self-care ability and social support after PCI were 85.96±20.03, 82.82±27.65 and 25.3±4.93, respectively. Correlation analysis showed that health literacy, social support and self-care ability were positively correlated. Both social support (P=0.003) and health literacy (P=0.03) could positively predict self-care ability. Health literacy played a partial mediating role between social support and self-care ability, and the mediating effect was 0.015, accounting for 7.32% of the total effect. The health literacy and social support are at the high levels, and the self-care ability of PCI patients is at a medium level. The health literacy of older patients after PCI is the ability of social support and self-care ability. Medical staff can enhance the health literacy of patients by improving their level of social support, and then promote their self-care ability.

Racial Discrimination, Social Support, and Psychological Distress Among Black Pregnant Women.

Black pregnant women who experience racial discrimination are at an increased risk of psychological distress. Studies have not adequately addressed if social support may moderate the association between experiences of racial discrimination and psychological distress among Black pregnant women. We sought to examine the moderating effect of social support on the association between experiences of racial discrimination and psychological distress among Black pregnant women. We report findings based on cross-sectional data collected from 599 Black pregnant women enrolled in a prospective cohort study prior to the COVID-19 pandemic. Women completed questionnaires about experiences of racial discrimination (Experiences of Discrimination), social support (MOS Social Support Survey), and psychological distress (Psychological General Wellbeing Index). Women had an average age of 26 ± 5 years and gestational age at data collection of 17 ± 6 weeks. Approximately 53% of women reported ever experiencing racial discrimination in at least one situation, and 54% reported psychological distress. After adjustment for covariates, racial discrimination was associated with a 2.2-fold increase in psychological distress (odds ratio [OR] = 2.24; 95% confidence interval [CI] 1.35-3.70; P = .002). Low social support (scores below the median) was associated with a 3.8-fold higher likelihood of psychological distress (OR = 3.84, 95% CI 2.27-6.48, P < .001). Social support did not moderate the association of lifetime experiences of racial discrimination with psychological distress. Findings of the study contribute to evidence that lifetime experiences of racial discrimination and low levels of social support relate to psychological distress among Black pregnant women.

Virtual addressing reality: Development of a virtual social work program to address health-related social needs.

405 Background: Assessment of Health-Related Social Needs (HRSNs) has become an integral part of understanding barriers to care and improving patients’ lives and experiences as they receive cancer care. Increased assessment, however, can result in a raised awareness of unmet needs in oncology patient populations. This tends to highlight gaps in services and necessitate additional staff to attend to these needs. Addressing HRSNs can be facilitated with lay navigators (non-licensed staff), licensed staff, clinical staff, and other members of a multi-disciplinary team. Actions can include, but are not limited to, identification of practical concerns, referrals to community-based organizations (CBOs), referral to the clinical team, or further escalation to a licensed clinical social worker (LCSW). Methods: The National Comprehensive Cancer Network (NCCN) Distress Thermometer screening tool was implemented in July 2023 where patients are screened every 3 months in a community oncology setting. A workflow was established where a clinic staff would administer the screening tool and enter the details of the screening into the EHR system. Based on established criteria, the patient would be referred to the social work team via electronic referral. Due to an increase in screening and subsequent referrals, a virtual team of (5) social workers called Patient Resource Coordinators (PRCs) was established in December 2023 to address the practical concerns and facilitate the coordination of resources based on identified needs. After the team was established, non-urgent referrals were then assigned to a PRC. The PRC could refer to an on-site LMSW/LCSW for higher level of acuity assessment, like crisis support or positive PHQ-9 scores. Results: See Table. Conclusions: The virtual PRC team is able to manage ~55% of referrals made to a social worker based on results from an HRSN screening tool. This has allowed the onsite LMSWs/LCSWs to work at the top of their license and enabled patients to receive support with care coordination and connection to resources. Over time, the referrals managed by the virtual team has increased and their connections to patients have grown. In the future, the PRC team aims to add additional LCSW services to assist patients with higher acuity needs. This will broaden the scope of services available to the patients to address their health-related social needs in a timely manner. PRC Activity Dec ’23 Jan ‘24 Feb ‘24 Mar ’24 Apr ‘24 May ’24 (*May to date at time of submission) # of Referrals Received via EHR 110 542 610 586 1216 570 # of Referrals Assigned to PRC 45 245 299 315 660 312 % of Referrals Assigned to PRC 41% 45% 49% 54% 54% 55% *Secondary Referral to SW 8 9 20 4 # of calls attempted 102 479 536 577 959 448 # of patients reached 38 180 217 270 413 277 % of patients reached 37% 38% 40% 47% 43% 62% # of practical concerns identified 31 131 426 430 742 349 Total Visit Duration (in hrs.) 36hrs 181hrs 348hrs 450hrs 836hrs 485hrs

Good Friends and Good Neighbors: Social Capital and Food Insecurity in Families with Newborns

To examine the association between social capital and household food insecurity among US families with newborns. This cross-sectional analysis used enrollment data from 881 newborn-caregiver dyads at six geographically-diverse US academic sites enrolled in the Greenlight Plus Trial, a comparative effectiveness trial to prevent childhood obesity. Ordinal proportional-odds models were used to characterize the associations of two self-reported measures of social capital: 1) caregiver social support and 2) neighborhood social cohesion, with household food insecurity after controlling for sociodemographic characteristics. Among 881 newborn-caregiver dyads (49% Hispanic, 23% non-Hispanic white, 17% non-Hispanic Black; 49% with annual household income <$50,000), food security was high for 75%, marginal for 9%, low for 11% and very low for 4%. In covariate-adjusted analyses, caregivers with a low social support score of 18 had five times the odds (aOR=5.03 95%CI=3.28-7.74) of greater food insecurity compared with caregivers with a high social support score of 30. Caregivers with a low neighborhood social cohesion score of 10 had nearly three times the odds (aOR=2.87 95%CI 1.61-5.11) of greater food insecurity compared with caregivers with a high neighborhood social cohesion score of 20. These associations remained robust when both social capital measures were included in one model. Caregiver social support and neighborhood social cohesion each appear to be inversely associated with food insecurity among US families with newborns. Longitudinal research is needed to determine the directionality of these relationships and whether improving social capital for families with young children reduces household food insecurity.

Social Support and Psychological Capital Mediate the Effect of Personalities on the Mental Health of Professional Staff in China During COVID-19 Pandemic.

COVID-19-related lockdown can lead to mental health problem, which displays heterogeneous between individuals. The aim of this study was to explore the association between mental health, social support and psychological capital state of professional staff with different personalities during the COVID-19 pandemic in China. A cross-section study was conducted via online survey using the questionnaires of General Health Questionnaire (GHQ-12), Multidimensional Scale of Perceived Social Support (MSPSS), Psychological Capital Questionnaire (PCQ), Eysenck Personality Questionnaire-Revision Short Scale of China (EPQ-RSC). A total of 626 employees were included. Multiple regression analysis was performed to investigate the association of psychological capital, perceived social support, EPQ-N and EPQ-E and their interactions in general mental health. About 2.7% of professionals had mental health. The married had a higher mental health score than the single (P<0.05). The regular exercising workers had the lowest mental health score (P<0.05), and higher psychological capital and social support scores than the non-exercising ones (P<0.01). Multivariate analysis showed that the interaction between social support, psychological capital and neuroticism was statistically significant (β=-0.161, P<0.001) in general mental health with neuroticism ranking the top (β=0.352, P<0.001). Mediation analysis showed that social support modified the effect of psychological capital on mental health, accounting for 25.5% of the total effect, and that both social support and psychological capital mediated the effect of neuroticism or extroversion differentially on mental health. Neuroticism is an influencing factor on mental health of professional staff. Social support and psychological capital played a partial mediating role in the effect of neuroticism or extroversion differentially on mental health in China. The findings suggest that during the COVID-19 pandemic, more social support and psychological capital are needed for the professional individuals with neuroticism to alleviate their stress and improve mental health.

Effect of Severity of Depression and Perceived Social Support on Suicidal Ideation among Patients Hospitalized with Substance Use Disorder

Objective: The aim of this study was to investigate the effects of perceived social support and depression on suicidal ideation in inpatients receiving substance abuse disorder treatment.&#x0D; Method: A total of 110 inpatients in an Alcohol and Drug Treatment Center were included in the study. A sociodemographic and clinical information form, Beck Depression Inventory, Suicidal Ideation Scale, and Multidimensional Perceived Social Support Scale were administered to all patients.&#x0D; Results: No significant correlation was identified between total social support score and suicidal ideation, whereas a weak negative but statistically significant correlation was found between social support from family and suicidal ideation scores (r=-0.231; p=0.016). The mean value of suicidal ideation was 2.22 in the non-depressed groupand 10.13 in the severely depressed group. We also found thatpatients whowere exempted from military service and those who had attempted suicide before had statistically significantly higher scores on the suicidal ideation scale.&#x0D; Conclusion: In patients diagnosed with substance use disorder, various factors may increase the risk of suicidal behavior. In particular, patients with insufficient social support, depressive symptoms, unable to carry out their military service and those who have attempted suicide before should be closely followed for suicidal ideation.

Post-Traumatic Stress Disorder, Depression, and Perceived Social Support Among Iraqi and Syrian Immigrant and Refugee Adolescents in Türkiye

This study determined the levels of Post-Traumatic Stress Disorder (PTSD), depression, and perceived social support among 109 Iraqi and 136 Syrian immigrant secondary school students residing in Bolu, Türkiye. The participants, who had previously experienced trauma, were compared with 143 Turkish adolescents. The refugee children had significantly higher scores for both PTSD and depression, and lower scores for social support. While there were no significant gender differences for the three variables, older students had higher PTSD scores. Immigrant students who had lived in Türkiye for four years or longer had lower depression, higher social support, and social support from a special person. Degree of problems with Turkish language had no effect, while those with Turkish friends had significantly higher scores for perceived social support and family social support than those who did not. Surprisingly, students whose families had immigrated for educational reasons had higher PTSD scores and lower family social support scores than those that immigrated due to conflicts. A regression analysis, conducted to predict depression via PTSD and social support, showed that the two variables accounted for 25% of the variance in depression scores.

Predictors of a positive birth experience in childbirth: A cross-sectional study

BackgroundRecognizing predictors of positive birth experience is viewed as essential for minimizing negative experiences during childbirth that are related to current obstetric care, especially when those could be attributed to intrapartum interventions. The CEQ-E is a suitable instrument for investigating maternal birth experience within the Spanish population, highlighting the necessity to identify predictors for all its domains. This study aimed to identify predictors of positive birth experience based on socio-demographic and clinical variables, and obstetric interventions. MethodsCross-sectional study conducted with consecutive sampling (N = 301). Quantitative data were collected by the Childbirth Experience Questionnaire (CEQ-E) and an Ad hoc questionnaire. Clinical data was obtained from participants' medical records. Descriptive, bivariant and multivariant analysis were performed. ResultsThe CEQ overall mean score was 3.18(SD:0.42), showing the highest score for the professional support (3.79; SD: 0.43) and the lowest for the own capacity (2.8; SD:0.57). All domains and overall score showed negative correlations with the number of intrapartum interventions (p ≤ .001). Inductions of labour, instrumental deliveries, and caesarean sections were inversely related to; overall birth experience score (p ≤ .001), perceived safety (p ≤ .001), and own capacity (p ≤ .001). Epidural analgesia was linked to worse values of birth experience (p ≤ .001). Predictors of positive birth experience were identified as having a midwife as birth attendant (p ≤ .001) and neonatal higher Apgar scores at birth (p ≤ .001), whereas higher maternal education grade (p = .04), inductions of labour (p ≤ .001) and caesarean births (p ≤ .001) had worse values on birth experience. ConclusionWomen reported a positive birth experience, and professional support was highly valued. Key predictors of lower scores in birth experience included higher maternal education, caesarean and instrumental deliveries, and neonatal intensive care unit (NICU) admission. Spontaneous labour onset predicted better capacity and safety. Epidural use decreased participation. Midwife-attended births reported better scores on birth experience, highlighting their importance in maternal care.

Exploring the Influence of Perceived Social Support on Medication Adherence Among Patients With Chronic Hypertension in 2024: A Cross-Sectional Study From Jeddah, Kingdom of Saudi Arabia.

Background There is no doubt that hypertension is one of the most widespread global health problems, and it is essential to comply with prescribed medications for optimal control. A lack of studies on the effects of perceived social support (PSS) on medication adherence among hypertension patients, especially in Jeddah, Saudi Arabia, made us conduct this study. Methods This was a cross-sectional study that targeted hypertension patients who were visiting primary healthcare centers under the Ministry of Health in Jeddah, Saudi Arabia. The Morisky Green and Levine (MGL) adherence scale and the Multidimensional Scale of Perceived Social Support (MSPSS) were used to assess adherence and perceived social support, respectively. Results The study included 377 hypertensive patients with a mean age of 57 years (SD = 10). The majority were male (n=226, 59.9%) and married (n=261, 69.2%). Educational levels varied, with 148 (39.3%) completing high school and 79 (21%) holding a bachelor's degree or higher. Income distribution showed 166 (44%) earning less than 5,000 SAR and 47 (12.5%) earning over 15,000 SAR. Medication adherence, assessed using the MGL scale, revealed that 121 (32.1%) had low adherence, 206 (54.6%) had moderate adherence, and 50 (13.3%) had high adherence. Perceived social support, measured using the MSPSS scale, indicated that 219 (58.1%) reported high levels of support. A significant association between medication adherence and perceived social support was found (F = 10.293, p < 0.01), with moderate adherers having higher social support scores. Socio-demographic factors influencing adherence included marital status, education level, income, and occupation, with significant associations for each (p < 0.01). Married participants and those with higher education and income levels had greater adherence. Government employees showed the highest moderate adherence while the unemployed and homemakers had lower adherence. No significant associations were found between gender or age and adherence. Conclusion Higher levels of perceived social support,in addition to the influence of socio-demographic factors, are associated with better medication adherence. Targeted interventions addressing these factors could enhance medication adherence and improve health outcomes in this population.

High-sensitivity nanostructure-based sensor using Fano resonance for noninvasive EEG monitoring

Noninvasive electroencephalogram signal detection with high sensitivity and a high signal-to-noise ratio has attracted much attention. To achieve high-sensitivity electroencephalogram (EEG) sensing, a photonic crystal side-coupled microcavity nanoscale sensor based on Fano resonance is proposed with nano electro-optic sensing technology as the core support. This configuration comprises a nanobeam resonant cavity, a waveguide, and an electrical slab. The substantial overlap between the optical and electric fields within the resonant cavity is analyzed, and the sensor’s electric field sensing performance is assessed. Due to the optically coupled nanoscale sensing structure that is adopted in the sensor, the device has an ultrahigh voltage sensing sensitivity of up to 142.64 nm/V and a compact footprint as small as 4.29 mm2, enabling real-time sensing of EEG signals of 10 μV and below. These improvements overcome the technical challenges of low precision and large size as are associated with existing optical devices used for medical monitoring.

Voting and Violence in Competitive Autocracies: The Case of the 2008 Runoff Election in Zimbabwe

ABSTRACT How, when and where violence is deployed during periods of extreme regime crisis is determined by regime support expectations. Regimes use political geography to direct violence and ensure political compliance. Areas have ‘core’ high regime loyalty, ‘swing’ loyalty where government and opposition have supporters, or ‘costly’ and loyalty opposition support. During elections, regimes accommodate, suppress or force voters in each area. In runoffs, regimes use new information to increase vote share in core support areas, and use violence against suspected defecting voters. In Zimbabwe during 2008, violence patterns maximised the regime’s favourable political geography, placing typically safe communities in danger.