Family Management Research Articles

Development of Microsatellite Markers from Transcriptome of Eriocheir sinensis and Their Application in Multiplex PCR Panels

Background: The development of genetic markers is crucial for aquaculture and population genetics. Polyallelic microsatellite markers are widely used for breeding and family management of Eriocheir sinensis (E. sinensis), contributing to the sustainable development of the industry. Methods: Through transcriptome analysis, 100 highly polymorphic SSR markers were identified and developed. From these, four multiplex PCR panels, each containing 16 markers, were constructed and applied to parentage assignment in six E. sinensis families. Results: The number of alleles (Na) ranged from 7 to 21, the observed heterozygosity (Ho) varied from 0.356 to 0.951, and the expected heterozygosity (He) varied from 0.656 to 0.909. The polymorphism information content (PIC) ranged from 0.633 to 0.900. The CERVUS analysis showed that using only the two most informative multiplex PCR panels, assignment success rates exceeded 90.34%, with 100% accuracy in assigning offspring to parents when three or four panels were used. Conclusions: This method significantly enhances the efficiency of microsatellite marker analysis, which provides a convenient and cost-effective method for breeding programs and family management of E. sinensis.

Effects of Family Caregiver-Nurse Communication on Family Management and Family Caregiver Uncertainty Regarding the Care of Children With Long-Term Ventilator Dependence.

Nurses caring for hospitalized children with long-term ventilator dependence (LTVD) assess family management capability and teach new skills through communication with family caregivers. This theoretically-based quantitative, descriptive study aimed to determine the communication behaviors associated with family caregiver uncertainty and management of the child with LTVD's care after discharge. One hundred families and 48 nurses enrolled. Family caregiver-nurse conversations were recorded and transcripts coded for communication behaviors. Family management and uncertainty data were gathered during hospitalization and after discharge. Data analysis included correlations and linear mixed models. Family caregivers and nurses used advocating and negotiating roles communication behaviors least frequently; however, these communication behaviors were associated with the most aspects in terms of uncertainty about the child's condition and ease of management of the child's care after discharge to home. Nurses should assess family caregiver ease in managing care, provide support, and engage in collaborative problem-solving through respectful communication.

Chinese Ethnic Coffee Shop Adaptation in Riau through Inclusivity in Malay Society

This article focused on non-Muslim Chinese ethnic coffee shop entrepreneurs, aiming to discover and analyse forms of adaptation that have led to the survival of these coffee shops and their acceptance by the Malay-Muslim community. This qualitative research, utilising an ethnographic approach, is situated in Pekanbaru. Data was collected through observation and interviews with 11 predetermined informants, including entrepreneurs from second and third-generation Chinese families, Malay Riau cultural figures, historians, tourism advocates, coffee enthusiasts and customer informants. Documentary data in the form of autobiographies/biographies of the early founders of coffee shops. This study identified forms of adaptation, including the coffee shop managers’ identification with the community, continuity of family management adhering to halal and hygienic standards, prioritising honesty to gain community trust, forming partnerships and employing Muslim-background workers, and fostering communication, organisation, social engagement, and philanthropy. The adaptation of coffee shop entrepreneurs was expedited by the openness and acceptance of Muslim traders in Pekanbaru since the early 20th century. The presence of these coffee shops, deeply rooted in the social and cultural life of the Malay-Muslim community, manifests inclusivity. This encompasses accepting the halal aspect of the coffee shops’ offerings, managed by non-Muslim Chinese ethnic groups.

Clinical reality and challenges with familial hypercholesterolemia patients management. 2024 results from the Regional Center for Rare Diseases (RCRD) Registry in Poland

Abstract Background HeFH is one of the most prevalent genetic diseases significantly increasing the risk of CVD events and mortality. Despite new achievements with earlier diagnosis and new effective drugs, most of heFH patients do not achieve LDL-C goal and are still on residual CVD risk. Purpose We aimed to present the most recent data from the regional FH registry in Poland to show the challenges and reality of everyday clinical management with FH patients. Methods The registry is conducted at the RCRD in the 2nd largest, supraregional hospital in Poland. The main inclusion criteria were being phenotypically or genetically diagnosed with FH. Nonadherence was investigated based on detailed interview, monitoring the treatment’s effects and purchasing prescribed medications. For this analysis we investigated only adult FH patients from the registry. Due to small number of cases (n=5), patients treated with inclisiran were not included in this analysis. Results We included 142 consecutive heFH patients at mean age 45,8±14,9 years (min/max 18-75 years; 60% women). Mean BMI was 29.6±5.52 kg/m2, mean baseline TC was 282.9±80 mg/dl (the highest observed was 600 mg/dl), LDL-C 204.2±72.5 mg/dL (the highest observed -762 mg/dl), TG - 151.1±123.4 mg/dl, Lp(a) 37.6±41.5 mg/dl and HDL-C - 52.3±14.2 mg/dl. Most patients were diagnosed with LDLR (72%) or APOB (24%) mutations. High intensity statin therapy was used in 74.3% of patents, ezetimibe (mostly as a part of combination LLT) in 47.2%, and PCSK9 inhibitors in all those that met the reimbursement criteria – 25.6% of FH patients. Non-adherence to statin therapy and ezetimibe in the follow up of 2 years was 27%. In patients treated with statin therapy and ezetimibe mean achieved LDL-C was 153.6±82.82 mg/dl and on triple therapy - 64.5±43.73 mg/dl. Mean achieved LDL-C in the investigated population was 87.9±55.5 mg/dl. LDL-C goal was achieved in 39% of patients – in those treated with triple therapy with PCSK9 inhibitors it was 57.14%, and in those on statins and ezetimibe only 27.1%. Combination therapy of statins and ezetimibe did not significantly change baseline Lp(a) level (p=0.109), but when PCSK9 inhibitors were introduced the mean Lp(a) reduction by 34.2% (p=0.049) was observed. Based on the multivariable regression analysis, the following factors played the most important role for FH patients to be on LDL-C target: DLCN total score (OR 1.21, 95%CI: 1.04-1.40; p=0.013), DLCN category (10.39, 1.43-75.29; p=0.021), ezetimibe use (4.78, 1.15-19.92; p=0.031), and PCSK9 inhibitors use (4.56; 1.40-14.86; p=0.012). Conclusions FH patients in Poland are diagnosed definitely too late (45 years) and most of them are still not on LDL-C goal. Double and especially triple therapy significantly, even 5 times, increase the chance of achieving LDL-C goal, therefore PCSK9 inhibitors should be available for all FH patients, without the limitations existing currently e.g., within B101 drug program in Poland.

Navigating Communication in Nursing Homes During COVID-19: Perspectives From Families, Healthcare Professionals, and Managers in Southern Switzerland-A Qualitative Study.

This study aims to understand the effectiveness and challenges of communication strategies implemented to maintain contact between nursing home (NH) residents and their families during the COVID-19 pandemic, by considering the perspectives of families, healthcare professionals, and NH managers. Using a qualitative research design, the study analyzed in-depth semi-structured interviews with key stakeholders (N = 34), including family members, NH staff, and managers. The study found that communication strategies like video calls, telephone calls, and window visits were generally appreciated and facilitated contact between residents and their families. However, challenges emerged around technical and organizational issues. Both internal and external stakeholders concurred that an increase in technological and human resources was necessary to alleviate these challenges. The study underscores the importance of innovative and flexible communication strategies to sustain connections between NH residents and their families in crises such as the COVID-19 pandemic. Future readiness calls for increased investment in human and technical resources, and a commitment to understanding and addressing the diverse communication needs of NH residents.

Clinical reality and challenges with familial hypercholesterolemia patients' management. 2024 results from the Regional Center for Rare Diseases (RCRD) Registry in Poland

BackgroundDespite advancements in early diagnosis and effective medications in last decade, most heterozygous familial hypercholesterolemia (heFH) patients still fail to achieve their low-density lipoprotein cholesterol (LDL-C) goals and remain at residual cardiovascular disease risk. We present recent data from the regional FH registry in Poland, highlighting the challenges and real-life clinical management of FH patients. MethodsThe registry is held at the Regional Centre for Rare Diseases, founded in 2016, at the 2nd largest, supraregional hospital in Poland, where >80 different rare diseases in patients from all over Poland are diagnosed and treated, including phenotypically or genetically diagnosed FH patients. Our analysis focused on both children and adult FH patients, excluding those treated with inclisiran due to a small sample size (n = 5). ResultsWe studied 173 consecutive heFH patients, median age for adult population was 40 years (range: 27–57), of whom 56.14 % were women. Among the population, 82.1 % were adults (n = 142), and 31 were children (17.92 %; median age 9 (8–13), females 58.16 %). Children exhibited lower total cholesterol and triglyceride levels compared to adults, with no significant differences in LDL-C and high-density lipoprotein cholesterol (HDL-C) levels. Molecular diagnosis in the whole population revealed that 76.6 % had an LDL receptor (LDLR) mutation, while 23.4 % had an apolipoprotein B (APOB) mutation. Risk assessment categorized patients into high (70.7 %), very high (22.1 %), and extremely high (7.1 %) risk groups. Triple therapy achieved treatment goals in 61.76 % of adults and 70.97 % of children. At baseline, 36.62 % of adult patients were not using statins. High-intensity statin therapy combined with ezetimibe was initiated for the remaining patients. Only 3.33 % of patients avoided statins due to complete intolerance. Ezetimibe was used in 57.27 % of patients (mostly in combination therapy), and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were prescribed for 28.17 % FH patients. In adults receiving statin and ezetimibe therapy, median achieved LDL-C was 141 mg/dl (107–184). For triple therapy, median achieved LDL-C was 52.5 mg/dL (32–86.5). Overall median achieved LDL-C in the study population was 99.5 mg/dl (57.5–145.4). PCSK9 inhibitors reduced LDL-C by 165.6 mg/dl. Combination therapy did not significantly alter baseline lipoprotein(a) (Lp(a)) levels (p = 0.134), and PCSK9 inhibitors led to a mean Lp(a) reduction of 18.66 mg/dl (45 % reduction; p = 0.013). Multivariable regression analysis identified key factors for achieving LDL-C targets in FH patients: DLCN total score, DLCN category, ezetimibe use, and PCSK9 inhibitors. ConclusionsIn Poland, FH patients are often diagnosed too late (usually over 40 years of age), and many still do not reach their LDL-C goals. Combination LLT double or triple therapy significantly increases the likelihood of achieving LDL-C targets – even up to fivefold. Therefore, unrestricted access to PCSK9 inhibitors for all FH patients is crucial, without the current limitations imposed by drug reimbursement programs like B101.

Feasibility and Acceptability of a Self-Guided Digital Family Skills Management Intervention for Children Newly Diagnosed With Type 1 Diabetes: Pilot Randomized Controlled Trial.

Family dynamics play an important role in determining the glycemic outcomes of type 1 diabetes (T1D) in children. The time interval immediately following T1D diagnosis is particularly stressful for families, and interventions to support families in adjusting their family practices to support adjustment to and management of T1D in the months following diagnosis may improve glycemic outcomes. Self-guided digital interventions offer a sustainable model for interventions to support caregivers in learning evidence-based family management skills for adjustment to and management of T1D. We hypothesized that a self-guided, web-based, family skills management program (addressing caregiver social support as well as family problem-solving, communication, and supportive behavior change strategies) initiated at the time of T1D diagnosis would improve glycemic outcomes in children with T1D. In this study, we report on the feasibility and acceptability of this program. We prospectively evaluated a sample of 37 children newly diagnosed with T1D recruited from a pediatric endocrinology clinic. Parent participants were asked to complete web-based modules addressing social support, family problem-solving, communication, and supportive behavior change strategies. Module completion was analyzed for percentage completion, patterns of completion, and differences in completion rates by coparenting status. Qualitative open-ended feedback was collected at the completion of each module. A total of 31 (84%) of the 37 participants initiated the web-based program. Of those 31 participants, 25 (81%) completed some content and 15 (48%) completed all 5 modules. Completion rates were higher when coparenting partners engaged in the intervention together (P=.04). Of the 18 participants given a choice about the spacing of content delivery, 15 (83%) chose to have all sessions delivered at once and 3 (17%) chose to space sessions out at 2-week intervals. Qualitative feedback supported the acceptability of the program for delivery soon after T1D diagnosis. Families reported on positive benefits, including requesting future access to the program and describing helpful changes in personal or family processes for managing T1D. In this study, we found that a self-guided digital family support intervention initiated at the time of a child's T1D diagnosis was largely feasible and acceptable. Overall, rates of participation and module completion were similar to or higher than other self-guided digital prevention interventions for mental and physical health outcomes. Self-guided digital programs addressing family management skills may help prevent challenges common with T1D management and can decrease cost, increase access, and add flexibility compared to traditional interventions. ClinicalTrials.gov NCT03720912; https://clinicaltrials.gov/study/NCT03720912.

HOW TO ADOPT MANAGEMENT CONCEPT TO ORGANIZE FAMILY BEHAVIOR: ISLAMIC MANAGEMENT CONCEPT

How do we deal with developing family life dynamics in the modern era through transforming Islamic management concepts? The cult that organizes family life through traditional theories and practices has experienced a culmination phase. This condition challenges modern society to carry out developments that are juxtaposed with management theory. This is an alternative to face the flow of modernity, which, on the one hand, is a challenge for Muslim society. The outdated concept of the traditional family is an obstacle to the development of modern society. Marriage is a noble business that has a lifelong contract. Therefore, the author hypothesizes that families who understand excellent and structured management will find it easier to face problems and find solutions. To answer these problems, the author uses a qualitative approach with the bibliometric analysis method. This framework aims to find research gaps related to the scientific discourse on family management in Islam and society. Management theory is a framework to analyze the research question trough bibliometric analysis. This study found that three main management concepts, business management, risk, and conflict, are an alternative to facing the challenges of dynamics and building relationships and social strata in modern families. Three of management type can use to face all challenges in modern era. Modern family easily use these ways to build the robustness family and to organize all instrument among them. Keywords: Family Management, Islamic Management Concept, Modern Civilization

Qualitative acceptability testing of a paper-based care planner in patients with metastatic non-small cell lung cancer (mNSCLC).

259 Background: Patients with cancer and their caregivers often describe the fragmented, multi-modal and multi-provider cancer care experience as undertaking a difficult expedition without a map. Based on her experience in 2020 and using self and family management theories (doi: 10.1016/j.outlook.2008.10.004.), Daswani developed a pan-cancer patient planner, which helps patients and families prepare for appointments, track symptoms, and manage their care. It has been available since 2021 through hospitals, advocacy organizations and online retail channels. We adapted and customized the pan-cancer planner for patients with mNSCLC. We tested acceptability through a series of structured patient interviews, and a brief, in-person survey tool. Methods: A lung cancer survivor recruited members of the lung cancer community to participate in a 30-minute structured virtual interview. After reviewing the planner, interviewees were asked: 1) about their diagnosis and treatment experience and 2) to provide semi-structured feedback. We conducted interviews until thematic saturation was reached. We modified the planner based on interview results, distributed planners to patients and care-partners at a major lung cancer patient summit and immediately collected a brief survey to assess patient knowledge of their diagnosis and motivation for planner access. Results: The table shows high level thematic groups of interview responses. Interviewed patients concluded that the planner would have improved their experience because they would have: Stayed organized, facilitated note-taking during appointments, better tracked and managed symptoms & meds, been more confident in decision-making and been able to journal, stay grounded and more mindful. Of 94 planners distributed at the summit, 49 patients knew their diagnosis, 31 knew their stage, 28 knew their cancer mutation status. Of the four domains of self-management, positive responses were: 1. Increase confidence 44 (47%) 2. Gain peace of mind 40 (43%) 3. Stay organized 58 (62%) 4. Manage meds & symptoms 42 (45%). Conclusions: A paper based mNSCLC specific planner is acceptable to patients and they anticipate it would help with all four domains of self management (confidence, peace of mind, organization, med and symptom management) and enhance a difficult experience. We plan further usability testing as we did with the breast cancer planner (JCO Oncol Pract 19, 2023 (suppl 11; abstr 552)). Interviews of 8 (7 female, 1 male) patients (3 with English as a second language) were held in December 2023. Diagnosis Biomarker Testing Treatment Living with lung cancer Medical terms difficult to understand “Mutation” term caused anxiety Understanding options important Need for community Diagnosis often delayed Loss of agency Gratitude for care team Digital tools desired Cumulative trauma Additional languages Young adult survivorship desired

Financial Management Analysis in Early Marriage Families in Galis District, Pamekasan

Early marriage is a marriage that occurs at the age of under 19 years for both men and women. Financial management is one of the skills that must be possessed to manage the economy, especially the family economy. This study aims to describe and explain financial management in early marriage families in Galis Pamekasan District. The method used in this study is a descriptive qualitative method. The data used in this study uses primary data, namely direct observation and interviews with informants, as well as secondary data, namely from previous articles, and other literature sources. The results of this study obtained that financial management in early marriage families is more centered on the wife, meaning that the wife has more rights to manage finances more deeply than the husband. This is because the management of income, expenses, future planning, and debt management is more managed by the wife. Keywords : Early Marriage, Family, Financial Management

Family Management of Hypertension in Brazil: A Cross-Sectional Study.

In Brazil, research indicates that primary family members are the main source of support for individuals with chronic conditions such as hypertension (HTN). The burden of caregiving not only hinders effective HTN management but can also cause stress and anxiety, potentially leading to HTN in caregivers. Despite this, few studies have explored the impact of caregiving on these family members. Aims of the study were to: (1) Describe the prevalence of blood pressure (BP) control in family members of individuals with HTN; (2) identify family member perspectives on facilitators and barriers to HTN management; and (3) identify influences that help or interfere with family member functioning (levels of stress, quality of life [QOL], and caregiver burden). This descriptive, cross-sectional study included 213 family members randomly selected from 3 Family Health Strategy units. Family members were largely female (n = 143; 67.1%); the mean age was 60.1 years (SD ± 17.02) and 42.6% (n = 96) had less than a high school education. The three most important facilitators and barriers were related to medication, medical visits, healthy eating, physical activity, and stress. The mean systolic BP was 132.7 (SD ± 21.9) mmHg and a diastolic BP of 85.9 (SD ± 18.1) mmHg with 120 (56.3%) of family members classified as having normal BP. In regard to family member contributions to the self-care of the individual with HTN, family members displayed low levels of self-care maintenance (n = 148; 69.4%) and management (n = 47; 71.2%) support, while a slight majority (n = 114; 53.5%) had adequate levels of self-care confidence in supporting the individual with HTN. Family members (n = 189; 88.8%) showed moderate-to-high levels of perceived stress, but good physical (n = 189; 88.7%) and mental QOL (n = 196; 92%) and low levels of caregiver burden (n = 113; 53.1%). A variety of contextual sociocultural influences were associated with the outcomes under study. Family-based interventions are urgently needed to address the inadequate management of HTN.

Implementing the Risk Stratification and Clinical Management of Breast Cancer Families Using Polygenic Risk Score Evaluation: A Pilot Study.

The identification of women at high risk of breast cancer (BC) is crucial for personalized screening strategies. Pathogenic and likely pathogenic variants (PVs/LPVs) in susceptibility risk genes explain part of the individual risk. Moreover, a polygenic background, summarized as a polygenic risk score (PRS), contributes to the risk of BC and may modify the individual risk in carrier and non-carrier members of BC families. We performed a retrospective pilot study evaluating PRS in women from a subset of high- (BRCA1 and BRCA2) and moderate-risk (PALB2 and ATM) BC families. We included PVs/LPVs carriers and non-carriers and evaluated a PRS based on 577,113 BC-associated variants. Using BOADICEA, we calculated the adjusted lifetime BC risk. Our data showed that in BRCA1/BRCA2 carriers, PVs have a major role in stratifying the lifetime risk, while PRS improves risk estimation in non-carriers of these families. A different scenario may be observed in PALB2 and ATM families where PRS combined with PV/LPV carrier status gives a more informative lifetime risk. This study showed that in BC families, the PRS might help to quantify the weight of the genetic familial background, improving the individual risk stratification and contributing to personalized clinical management for carrier and non-carrier women.

Family firms’ equity entry modes: Bridging family business and international business

Abstract In the global economy, the international strategies of family firms, influenced by family ownership and management, remain underexplored. Bridging the family business and international business fields, we use the socioemotional wealth lens to examine 1,236 international expansions from 2007 to 2013. Categorizing firms into pure family, nearly pure family, borderline family, and non-family typologies, we assess the influence of internal (experience, knowledge) and external (country risk) factors on their entry modes. Results indicate that higher family involvement in ownership/management increases the preference for greenfield investments over acquisitions or equity alliances, a relationship further moderated by international experience and country risk. This study provides nuanced insights into the international behaviors of family firms.

Child Abuse, Marital Satisfaction and Premarital Counseling: How do They Relate One Another?

One of the reasons for the increase in child abuse in recent years is the actions of those closest to the child, including one or both of their parents. Parents who commit such violence are triggered by several factors, including lack of insight into married life and not getting satisfaction in their marriage. This study aims to describe how premarital counseling can promote marriage satisfaction and anticipating potential child abuse. This study uses literature research with a descriptive approach. This research concerns with systematic and scientific collection of library sources which include books, scientific journals, and related research findings, then analyzed descriptively so as to achieve the research objectives. The results of the discussion show that in premarital counseling, the materials are provided comprehensively which includes the Law on Domestic Violence. Child Protection Law, Munakahat Law, Implementation of Family Functions in Child Protection, Caring for Love in the Family and Conflict Management in the Family as recommended by the Director General of Islamic Community Guidance Regulation Number 542 of 2013. By understanding comprehensively and applying such recommended points, prospective partner can achieve their marriage satisfaction and minimize potential child abuse.

Pain disparities attributed to linguistic minoritization in health care settings

There is a paucity of understanding about how language influences pain communication and outcomes for families who speak languages other than English in the United States. This is of great importance because 21.6% (68 million) of the population speak a language other than English, with 8% (25 million) of the population speaking English “less than very well.” Thus, the aim of this manuscript is to present a narrative review that describes how spoken language influences pediatric pain assessment and outcomes for children who speak languages other than English and discuss hypothesized factors that contribute to pain disparities in hospital settings. Results from the narrative review reveal that children and families who speak languages other than English have disparate pain outcomes compared to children from English-speaking families. It is hypothesized that individual (e.g., clinician bias), interpersonal (e.g., miscommunication of pain concepts), cultural (e.g., misunderstanding of cultural concepts of pain) and systemic (e.g., lack of access to interpretation services) factors influence disparate pain outcomes for linguistically minoritized children. Empirical research, including randomized control trials, regarding hypothesized factors that contribute to pediatric pain disparities for language other than English speaking children is severely lacking. Thus, improved understanding of pain concepts and pain communication processes that center individual, interpersonal, cultural, and systemic factors will enable future research to design interventions that enhance culturally relevant pain assessment and management for families who speak languages other than English. PerspectiveThis article summarizes factors that contribute to pain disparities for children who speak languages other than English. Hypothesized factors that contribute to pain disparities for LOE-speaking children and families include clinician bias, misunderstanding of pain concepts, and lack of access to interpretation services.

Using machine learning to identify and measure the family influence on companies

Many studies have focused on family firms. Yet, grasping the nature of these organizations remains challenging because firms’ familiness can take many forms, which are hard to trace with traditional data. We use ChatGPT – an application of machine learning – to try to unravel the complex and intangible influence of families on firms in large datasets. Whereas it often classifies family firms consistently with equity criteria, ChatGPT appears able to gauge families’ legacy and values. Hence, it detects more family firms in countries where families have a strong influence on firms even without large equity stakes. Also, ChatGPT often treats lone-founder firms as non-family firms, whereas it assigns a higher family score to firms that are eponymous, heir-led, and with multiple family directors. Finally, classifying family firms using ChatGPT provides financially relevant information to investors.

The experiences of individuals in maintaining a long-distance relationship through social media

This qualitative study explores the dynamics of long-distance romantic relationships (LDRRs) in the digital age. Long-distance relationships (LDRs) have emerged as a testament to the enduring strength of human affection in the face of spatial constraints. However, the dynamics of LDRs in the digital era present a diverse array of emotions, obstacles, and coping mechanisms. The purpose of this study is to understand the distinctive experiences of how social media has had a positive influence on the communication and relationship satisfaction between partners who have experienced long distance. The research, conducted through qualitative methods, involved 8 college students, predominantly females, offering insights into their experiences in current LDRs. Through semi-structured interviews with eight participants aged 18 to 24 in LDRRs, themes emerged regarding social media usage, coping strategies for emotional challenges, insecurities and communication, and the influence of family environments. The theme underscores how digital tools serve as essential resources for maintaining emotional intimacy and strengthening the relationship despite the challenges of distance. It also highlights the importance of familial support, privacy management, and individual resilience in sustaining intimate connections across geographical distances. The findings reveal that social media platforms such as WhatsApp and Instagram are integral to communication in LDRRs, with participants emphasising the importance of voice and video calls for maintaining intimacy. Coping with emotional challenges, including insecurities and feelings of disconnection, involves active communication, transparency, reassurance, and planning activities together. Family environments play a significant role in shaping communication dynamics, with participants navigating constraints on privacy and openness based on familial support or constraints. Overall, this study underscores the vital role of social media in sustaining emotional intimacy and connection in LDRRs. Understanding how individuals utilise social media and cope with challenges can inform interventions to support healthy, fulfilling relationships in the digital age.

Multicomponent family support intervention in intensive care units: statistical analysis plan for the cluster-randomized controlled FICUS trial

The FICUS trial is a cluster-randomized superiority trial to determine the effectiveness of a nurse-led, interprofessional family support intervention (FSI) on the quality of care, family management and individual mental health of family members of critically ill patients, compared to usual care. This paper describes the statistical analysis plan of the FICUS trial. The primary outcome is quality of family care, assessed by the Family Satisfaction in ICU Questionnaire (FS-ICU-24R) at patient discharge from the ICU. Several secondary outcomes are additionally assessed 3, 6, and 12 months thereafter. Sixteen clusters (ICUs) were randomly assigned 1:1 to FSI or usual care using minimization (8 per treatment). The target sample size is 56 patients per cluster (896 in total). Recruitment has been completed in January 2024. The follow-up of the last participant will be completed in early 2025. The primary and secondary outcomes will be analyzed by linear mixed-effects models (LMM). The main model for the primary outcome will include a random intercept per cluster with treatment (FSI vs. usual care) as the only explanatory variable due to the relatively small number of clusters. In addition, covariate-adjusted analyses will be conducted, including two cluster-level characteristics used in the minimization as well as participant-level characteristics. Moreover, a number of subgroup analyses by cluster- and participant-level characteristics are pre-specified.Trial registration ClinicalTrials.gov NCT05280691. Registered on February 20, 2022.

Pediatric Cancer Screening in Hereditary Gastrointestinal Cancer Risk Syndromes: An Update from the AACR Childhood Cancer Predisposition Working Group.

Gastrointestinal (GI) polyposis and cancer in pediatric patients is frequently due to an underlying hereditary cancer risk syndrome requiring ongoing cancer screening. Identification of at-risk patients through family history, clinical features of a syndrome, or symptom onset ensures appropriate cancer risk assessment and management in childhood and beyond. In this 2024 perspective, we outline updates to the hereditary GI cancer screening guidelines first published by the American Association of Cancer Research Pediatric Cancer Predisposition Workshop in 2017. These guidelines consider existing recommendations by pediatric and adult gastroenterology consortia to ensure alignment with gastroenterology practices in managing polyposis conditions. We specifically address the recommendations for pediatric screening in familial adenomatous polyposis, Peutz-Jeghers syndrome, and juvenile polyposis syndrome. Further, we emphasize the importance of multidisciplinary care and partnership with gastroenterology, as it is crucial in management of children and families with these conditions.

Screening for common mental disorders in people with epilepsy in Goma, in the Democratic Republic of the Congo: A cross-sectional study

Objectives: Epilepsy is a chronic neurological disease that is highly susceptible to a variety of mental health problems due to its enormous biological, social, and psychological burdens. The purpose of this study was to determine the prevalence and identify risk factors for common mental disorders (CMDs) in people with epilepsy (PWEs) in Goma, in the Democratic Republic of the Congo (DRC). Material and Methods: This is an analytical cross-sectional study conducted at the Neuropsychiatric Hospital Center in Goma (DRC) from March to April 2022, involving 302 PWEs. A questionnaire was administered to collect socio-demographic data, personal and family history, clinical features, and management of epilepsy. CMDs were assessed using the self-report questionnaire-20. Bivariate analysis was performed, followed by multivariate analysis, and variables with P < 0.05 in the final model were considered as risk factors associated with CMDs. Results: The study included 302 PWEs, of which 56.9% were men, and the mean age was 28.4 ± 11.0 years. CMDs were present in 39.1% of the participants. The presence of CMDs was significantly associated with having five or more seizures in the month preceding the survey (adjusted odds ratio [aOR] = 3.8; 95% confidence interval [CI]: 1.7–8.3) and having medical co-morbidities (aOR = 3.1; 95% CI: 1.5–6.4). Conclusion: The prevalence of CMDs in PWEs was high (39.1%), suggesting that this is a public health issue. Therefore, early detection and recognition of CMD symptoms should be a routine activity when managing PWEs.