Individual Context Research Articles

Predictors for psychosocial consequences of screening for liver diseases in Germany: a LASSO approach

Abstract Background Medical screening is extensively used across various disciplines for early disease detection and prevention of severe progression aiming to reduce disease-specific burden, improve quality of life and promote health. However, screening is debated due to unclear evidence of its overall benefits from a public health perspective. Screening is associated with improved health behavior and cost-effectiveness. However, studies identified adverse effects of screening like psychosocial burden. Most results originate from cancer screening and it is unclear whether they are transferable to other contexts. Within a research program, a systematic screening procedure to detect patients with liver cirrhosis at early stage in an asymptomatic general population was evaluated. In this study, we aimed to identify patient characteristics that predict and explain variance in psychosocial outcomes of screened patients. Methods This study analyzed data from 523 participants who underwent a systematic liver disease screening in Germany from Jan 2018 to Feb 2021. We used bootstrapped LASSO regression with 10-fold validation to evaluate the influence of various predictors on the outcomes measured by the Psychological Consequences of Screening Questionnaire (PCQ). The constructs measured by the PCQ are social, physical and emotional dysfunction associated with screening. Results We identified lower severity of comorbidities, higher subjective social status, stronger social support, older age, better critical health communication skills and higher health literacy as relevant predictors of lower psychosocial dysfunction, indicating their protective role in preventing psychosocial burden of screening. Conclusions From a public health perspective, medical screening offers should take into account patients’ individual context regarding their subjective social status, health impairments, personal social networks and health literacy skills to reduce post-screening psychosocial burden. Key messages • Social support, age, health literacy and higher subjective social status were positively associated with lower psychosocial consequences of liver screening. • The findings indicate that liver screening should be carried out, taking into account the individual’s situation and resources available.

Advancing Public Health Equity through Expanded Vaccination Services in prison: case studies from Italy and France

Abstract In Montpellier prison in France and San Vittore remand house in Italy, the provision of expanded, age-appropriate, coercion-free, and tailored vaccination services to PLP has emerged as a cornerstone in improving health outcomes within prison settings. The implementation of life course vaccination programs required the full integration of prison health into public health systems building on existing vaccination services covering HBV, flu and COVID-19. In San Vittore, a vaccination clinic aimed at people living in prison was set-up. Universal vaccination status assessment and vaccination catch-up was introduced targeting people admitted into prison. The vaccination clinic-related activities included information and awareness sessions on vaccination and health literacy offered regularly to PLP: increased vaccination knowledge is effective to enhance uptake. The vaccination clinic team consisted of infectious diseases physicians and a health assistant with an anthropological background, who ran the information and awareness sessions combining and adapting core content on vaccination with individual and community social and cultural contexts. Besides seasonal flu vaccination and anti-SARS-CoV-2 immunisation campaigns, vaccinations against pneumococcal pneumonia and herpes zoster were also offered to older and fragile individuals as per national immunization plan. One of the priority objectives of the vaccination clinic was the increase in vaccination coverage against HBV and HPV, not only as a tool for the prevention of infectious diseases, but as an innovative and effective tool of cancer prevention. As part of a more ambitious program to protect sexual health in prison and related to updated screening tools for the early diagnosis of lesions due to HPV infection, vaccination against HPV was also offered as part of a health empowerment project tailored to women in detention, with the aim of building self-awareness of their own health needs.

The cohort trends of social connectedness in secondary school students in Finland between 2017 and 2021.

The aim was to investigate the cohort trends of the experienced social connectedness in secondary school students between 2017 and 2021 and whether these trends vary by gender, school level and sociodemographic background. We used nationally representative Finnish data of 450,864 students in lower and upper secondary education. Social connectedness was measured by number of close friends, feelings of loneliness and sense of belonging at school. Adjusted regression analyses included year, gender, school level and sociodemographic factors (parental education, immigrant status of the student and urban-rural area of the school). The results showed that social connectedness declined from 2017 to 2021: 11% decline in having 3+ close friends, 15% increase in loneliness and 8% decline in belonging at school. The decline was especially large in girls and upper secondary school. Although some socio-demographically disadvantaged groups showed lower levels of social connectedness, there were differences by gender, school level and year. Many differences diminished because the more advantaged groups declined faster, i.e. moved towards the less advantaged groups. Declining social connectedness in young people is a worrying trend that requires a public health focus on the whole cohort while accommodating the variation by the individual and environmental context.

The influence of health literacy on health outcomes and behaviors in fourth-graders in Germany

Abstract Background For the adult population, evidence suggests that a high level of subjective health literacy is associated with a number of favorable health outcomes and behaviors. However, for younger populations, particularly children, little evidence is available. This study investigates the relationship between subjective health literacy, health outcomes, and health behaviors in children. Methods We conducted a representative survey of 4th-grade students (age 8-11) in North Rhine-Westphalia, Germany, between Oct. 2022 and Feb. 2023. Subjective health literacy was measured with the HLS-Child-Q15 questionnaire. For mental and physical well-being, the KINDL-R was used. For health behaviors, we asked about the frequency of (1) brushing teeth, (2) eating fruit and (3) vegetables, (4) exercising, (5) consuming sweetened drinks, and (6) wearing a helmet when riding the bike. Regression analysis was used to determine the impact of health literacy on outcomes, controlling for a number of sociodemographic indicators (birthplace, home language, sex, age), as well as the tendency to give socially desirable responses. Health behaviors were rated on a Likert scale and where dichotomized for ordinal regression. Results n = 1085 students are included with a mean age of 9.5 years (SD=.6). 50.3% are female. While controlling for a number of variables, health literacy was a significant predictor (p<.05) for every indicator except the frequency of (1) brushing teeth, (4) exercising, and (5) consumption of sweetened drinks. For mental well-being, health literacy was the strongest predictor. Conclusions Our findings highlight the potentially enabling role of subjective health literacy regarding favorable health outcomes and health behaviors. However, because this is a study among younger children, further research is needed on the interplay of individual subjective health literacy, social contexts (e.g., parental health literacy and health behaviors), and children’s health outcomes and behaviors.

Bridges between evidence on vaccination intervention and Ukrainian migrant community needs in Poland

Abstract Background Vaccination coverage in Ukrainian migrants’ (UM) children is lower compared to their Polish counterparts. We aimed to identify and adapt effective evidence-based interventions which would address health system barriers to HPV/MMR vaccination in this community. Methods With the help of the Participatory Action Research (PAR) approach, 4 researchers, 6 experts, 6 UM, 7 Ukrainian GPs and 3 teachers identified and discussed transferability of promising HPV/MMR vaccination interventions and their adaptation from the Polish and contextual perspective. The Population-Intervention-Environment-Transfer Model of Transferability (PIET-T) model was used to accompany the steps for determining transferability. Results Three intervention elements were considered as capable for increasing HPV/MMR vaccination uptake: a health promoter, group educational sessions and an online provider training. Adaptations were needed to make them consistent with the contextual needs. The intervention was adapted to involve Ukrainian GPs delivering culturally sensitive education and a Ukrainian coordinator offering navigation support; barriers (lack of information/language barrier) were addressed. The education sessions for parents were taken into account as having potential to increase knowledge and facilitate making informed decisions regarding vaccination. The online education course was assessed as a strategy to possibly enhance GPs knowledge to let them make strong HPV/MMR vaccine recommendations to UMs. Conclusions Both, community-based PAR approach, and the PIET-T model, facilitated the assessment of intervention transferability and adaptation in terms of covering the individual context, pattern and needs of UMs community in Poland, to finally increase HPV/MMR vaccination uptake.

A realist change model for community-based perinatal mental health peer support from peer volunteers

ABSTRACT Aims To investigate what it is about community-based perinatal mental health peer support from trained volunteers that works, for whom, in what circumstances, in what respects, and why; and build a change model that includes positive and negative mechanisms and outcomes. Methods Realist evaluation methods based on semi-structured interviews were used to create a change model for a third sector programme in England. Results Mothers who received peer support (n = 20), peer support volunteers (n = 27), and programme staff (n = 9) were interviewed. Positive impact on mothers was primarily based on feeling understood and accepted, social comparison (including normalisation, hope, and gaining perspective) and sharing non-directive information from experiential knowledge. Negative impact on mothers was based on negative social comparison, or absence of key peer support mechanisms. Mothers were affected in different ways, depending on individual contexts: their backgrounds, personalities, social situations, resources, experiences, beliefs, and needs. Some different mechanisms were present in one-to-one and group situations. All participants considered the benefits of peer support to greatly outweigh the risks. Conclusion Individual contextual factors affect the multiple mechanisms through which mental health peer support can improve mothers’ emotional wellbeing and social participation. Peer support has potential risks as well as benefits, which can be mitigated. Programmes could use this understanding of how contexts and mechanisms interact to produce peer support outcomes to improve training for peer support volunteers and to design future evaluations that take into account diversity of peer support experience.

Reflections on Inclusion. An Essay on Ideological Contradiction, Expectations and a Search for Meaning

Is it widely known what inclusion is? Is there a difference between inclusion and integration? There are many opinions and answers that reveal a low level of understanding. The certain elusiveness of inclusion is both an advantage and a pitfall. The ambiguity of interpretation allows for greater reflection and exploration. However, it also hinders society-wide understanding since meaning is only given to inclusion by individuals through a unique understanding tied to individual experience and context of meaning. We present here our take on the issue, deliberately raising questions without requiring strict answers, as an inspiration for welcome discussion and reflection.

Dyadic cannabis use, alcohol use and relationship satisfaction: A daily diary study

ObjectiveIntimate relationships are important contexts for understanding individuals’ substance use patterns and trajectories. Using a dyadic daily diary design reporting over 14 consecutive days, the present study examined the association between cannabis use, alcohol use, and momentary relationship satisfaction among adult couples MethodEligible individuals on Prolific were invited to participate. We identified 33 couples where both partners participated. Participants completed a baseline survey and a 14-day daily diary study assessing their daily cannabis use, alcohol use, and relationship satisfaction. Multilevel modeling was used, within an Actor-Partner Interdependence Model (APIM), to evaluate the individual and interactive effects of one’s own use and their partner’s use on relationship satisfaction ResultsSignificant actor and partner effects of alcohol and cannabis use were found using both baseline and daily report data. For individuals who use cannabis more heavily among sampled couples, cannabis and alcohol co-use was associated with reduction in their own next-day relationship satisfaction while alcohol-only use was significantly associated with increased next-day satisfaction. There were no significant effects of one’s own or their partner’s effects for individuals who use cannabis more lightly. ConclusionsFindings replicate and extend prior research by demonstrating the dynamic nature of dyadic substance use and highlighting the unique impact of alcohol and cannabis co-use on daily relationship functioning.

Landscape of regulatory quantitative systems pharmacology submissions to the U.S. Food and Drug Administration: An update report.

The number of quantitative systems pharmacology (QSP) submissions to the U.S. Food and Drug Administration has continued to increase over the past decade. This report summarizes the landscape of QSP submissions as of December 2023. QSP was used to inform drug development across various therapeutic areas and throughout the drug development process of small molecular drugs and biologics and has facilitated dose finding, dose ranging, and dose optimization studies. Though the majority of QSP submissions (>66%) focused on drug effectiveness, QSP was also utilized to simulate drug safety including liver toxicity, risk of cytokine release syndrome (CRS), bone density, and others. This report also includes individual contexts of use from a handful of new drug applications (NDAs) and biologics license applications where QSP modeling was used to demonstrate the utility of QSP modeling in regulatory drug development. According to the models submitted in QSP submissions, an anonymous case was utilized to illustrate how QSP informed development of a bispecific monoclonal antibody with respect to CRS risk. QSP submissions for informing pediatric drug development were summarized along with highlights of a case in inborn errors of metabolism. Furthermore, simulations of response variability with QSP were described. In summary, QSP continues to play a role in informing drug development.

Successful strategies for preventing and controlling violence against people with intellectual disabilities: a scoping review

BackgroundViolence against people with intellectual disabilities is unfortunately a reality all over the world, as they are one of the populations most vulnerable to various forms of aggression. Assertive prevention and control measures are crucial to tackle and reduce this problem. The aim of this study was to map and summarize the main measures for preventing and controlling domestic violence against people with intellectual disabilities. MethodsThis was a scoping review conducted in accordance with the JBI guidelines. The databases consulted were: National Library of Medicine (PubMed); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science; Excerpta Medica DataBASE (EMBASE); Latin American and Caribbean Health Sciences Literature (LILACS) and SCOPUS. Studies included in this review reported on strategies to address domestic violence against people with intellectual disabilities, published in the last ten years, in Portuguese, Spanish or English.ResultsA total of 11 studies were included in this review. Six studies had high methodological quality and five had moderate. Cognitive-behavioral intervention programs, educational technologies and/or auxiliary tools, along with the full participation of people with intellectual disabilities in domestic violence prevention measures are appropriate strategies for dealing with this issue.ConclusionDomestic violence against people with intellectual disabilities is relatively unexplored in the health-field scientific literature. Prevention and control measures should be developed with the active involvement of people with intellectual disabilities, generating engagement and knowledge. Preventive measures should be adapted to the personal context and conditions of individuals with special needs, such as those with persistent or chronic mental disorders.

Unveiling Patience: The Intersection of the Qur'an and Hadith in Buya Hamka’s Thought

This article examines the concept of patience in the thought of Buya Hamka, focusing on the integration between the Qur’an and hadith in Tafsir Al-Azhar. As a central theme in Islam, patience is not only understood as a passive reaction to adversity but as an active attitude reflecting spiritual strength and depth of faith. This article identifies how Buya Hamka interprets patience through the bi al-ma’thūr method, using hadith as an explanatory tool to deepen the meaning of patience-related verses. With a qualitative analysis that emphasizes textual study, this article presents evidence that Buya Hamka relates patience to social and individual contexts and creates practical guidance for Muslims in facing the challenges of daily life. Through this approach, the author shows how patience can serve as a tool to achieve emotional balance and mental resilience. The contribution of this study lies in the emphasis on the relevance of Hamka’s tafsir in the modern context, as well as the functionalization of hadith in expressing the profound values of patience. By filling an existing academic gap, this research offers new insights into the relationship between historical Islamic texts and contemporary spiritual practices, making Tafsir Al-Azhar an essential resource in guiding Muslims to understand and apply patience in their lives.

Pick your battles: Elite ski-jumpers’ motives affect world cup performance depending on competition type

According to motive disposition theory, athletes high in affiliation motivation should find team contexts more rewarding than individual contexts, and hence perform better in a team than in individual competitions. The opposite is predicted for athletes high in power motivation. To the best of our knowledge, this is the first study to test these hypotheses in an elite sample (here: ski jumping athletes) based on archived worldcup competition data from both individual and team competitions on the one hand, and self-reported and projectively assessed motives on the other hand. Results confirmed that even at the highest levels of professional sports, individual differences in motives show systematic relationships to competition performance. First, the negative impact of athletes' projectively assessed affiliation motive in individual competitions was significantly attenuated in team competitions, indicating that these represent more favourable conditions for athletes high in affiliation. Second, the projectively assessed power motive exhibited an overall negative relationship to performance. In contrast, self-reported achievement and affiliation motives showed a positive relationhip to performance. These findings attest to the role of personality differences in predicting motor performance variability in elite sports.

How Effective Are Work-Life Balance Policies? The Importance of Inclusion

In this manuscript we review research on the effectiveness of work-life balance (WLB) policies in improving employee and organizational outcomes. We find that while WLB policies are often implemented with good intentions, their effects are generally small or inconsistent. We identify eight barriers to policy inclusivity that we theorize are linked to reduced effectiveness—a narrow definition of family, focusing on work-family rather than work-nonwork balance, low policy awareness, the practical constraints of access, overlooking vulnerable workers, the nature of the job, supervisor attitudes and behaviors, and unsupportive organizational cultures—and make recommendations for addressing these barriers. We also highlight the importance of considering individual differences and cultural contexts when implementing WLB policies. We conclude by proposing future research directions, such as examining coworker support and the impact of national culture on policy effectiveness.

A Different Case Of Suicide By Hanging - Case Study Of The Event

A thorough analysis of circumstances and examination of the death scene is crucial before determining the manner of death in cases of hanging. While there are numerous reports of suicide and homicide by hanging in India, instances where the deceased is found with hands and/or feet bound and with feet touching a chair, the ground, or a bed, are considerably uncommon, as illustrated in this particular case (figure no.1). Hanging is indeed one of the methods used in suicides due to its accessibility and the perception that it may lead to a quick death. However, it's important to note that the choice of method can vary greatly depending on individual circumstances and cultural context. It is very easy to locate the place (indoor/outdoor) as well as commonly available hanging materials like rope, long napkin, belt, saree, dupatta, and long cloth (dhoti). Partial hanging suicide with hand-tied rope/dupatta cases are very less in number. Data on suicides, such as those reported by the National Crime Records Bureau, provide important insights into patterns and risk factors for suicide, essential information for public health interventions, and policy-making aimed at preventing such deaths. A total of 1,70,924 suicides were reported in the country during 20229. Sometimes suicidal tendency of the victim is so high that he/she can tie his/her hands with ligature material so that he/she cannot escape from the suicidal situation. We can also learn about partial hanging and postmortem blisters from this case study.

Collective and individual practices in popular music: Differences between semi-professionals and professionals in Austria and Germany

Collective and individual practices are essential for popular music bands and their members when preparing for public performances. This study addresses the interplay of collective and individual practices in a sample of 82 members of semi-professional and professional popular music bands in Austria and Germany. Utilizing a structured questionnaire, practices were assessed within collective and individual practice contexts, and attributes and experiences pertinent to the current band and individual members were examined in terms of their reciprocal interplay, differences between semi-professionals and professionals, and relationships with the experience variables of groups and individuals. The results showed that collective and individual deliberate practices and the use of practice strategies were related in both practice contexts. Members of professional popular music bands invested significantly less time in collective practice for fun and significantly more time in individual deliberate practice. The results provide deeper insights into the interplay of collective and individual practices in music bands, the differences between semi-professional and professional practice designs, and the relevance of practice and professional experience for accomplishing professional music performance in general.

Factors associated with caregiver strain among mothers and fathers of children with advanced cancer.

To characterize caregiver experiences in the context of advanced pediatric cancer by identifying individual (i.e., demographic factors, stress) and family context factors (i.e., family roles, social support) associated with caregiver strain. Families of children (ages 5-25) with advanced cancer (i.e., physician-estimated prognosis < 60%, relapsed/refractory disease) were recruited from a large children's hospital. Mothers (n = 55; 87% White) and fathers (n = 30; 83% White) reported on their caregiver strain, cancer-specific stress, general stress, social support, division of 7 family roles (e.g., medical care of ill child, household chores), and their satisfaction with each role. Parents reported moderate caregiver strain, cancer-specific stress, and general stress, and high social support and satisfaction with family roles. Fathers reported family roles were shared equally, whereas mothers reported either sharing roles or completing them independently. When accounting for income and partnership status, greater caregiver strain for mothers was associated with greater general stress, greater satisfaction with family roles, and lower social support. For fathers, greater caregiver strain was associated only with greater cancer-specific stress. In the context of advanced pediatric cancer, fathers may experience caregiver strain as cancer-specific stress increases, whereas mothers' strain may depend on broader family and social factors. Psychosocial providers should address general and cancer-specific stress within families, and provide resources for enhancing mothers' social support. Additional research is needed with larger, more diverse samples to inform future intervention approaches.

Rational Individual and Managerial Decision Model: A Critical Review of the Standard Rationality Hypothesis

Classical economic analysis is based on the hypothesis of perfect rationality attributed to economic agents. Their behavior is considered, according to this analysis, in a narrow sense represented by Homo-oeconomicus. The latter is a calculating agent in the true meaning of the term, who calculates to optimize his choice and maximize a utility function. However, in a decision-making process, the economic agent finds himself interacting with a complex and uncertain environment. To decide, he adapts his choice behavior to an end, considering the constraints of this environment. He does not always seek the optimal solution, but he can be satisfied with the solution that he considers satisfactory. This solution highlights the role of deliberation, which considers the norms and customs of society, as well as environmental constraints. This work revisits rationality by examining the assumptions underlying decision-making behaviors. This analysis considers the real motivations of the decision-maker and their implications in his decision-making process, both in the individual context and in that of the organization. It studies the sources of the limitation of rationality and seeks to know why the decision-maker abandons optimization and is interested in satisfactory solutions in his choice. The results of this analysis recommend that bounded rational behavior can still be considered when motivations are considered. They advocate that their understanding is fundamental to refound the economic behavior of choice on hypotheses, which correspond well to the social and economic context of the decision.

Handling Follow-Ups Professionally: Strategies for Getting Replies When Facing Silence

This article discusses effective strategies for following up with contacts who have not responded to initial requests or messages. It begins by reviewing psychological research on factors that can influence response times, such as personality traits, cultural norms, and procrastination. It then provides guidelines for optimal timing of follow-ups based on priority level and contact type. Specific suggestions are offered for composing follow-up communications, including restating the original request, expressing the need for a response politely, acknowledging time constraints, and problem-solving rather than blaming. The article stresses the need for flexibility based on individual relationships and contexts. It offers examples of appropriately customizing follow-ups for scenarios like status updates, project kickoffs, and external partnerships. By understanding reasons for delays, timing follow-ups appropriately, and adapting language sensitively, leaders can productively follow through to obtain needed information and cooperation while preserving goodwill.

The Individual, Organizational and Social Contexts of Teleworking and Technostress during Covid-19 Pandemic: A Holistic Analysis based on JD-R Model

The purpose of this study is to reveal the researches that deal with teleworking and technostress together with their individual, organizational and social dimensions in a holistic way within the framework of the Job Demands-Resources (JD-R) Model. In this study, a review was carried out on the Web of Science (WoS) and the Scopus databases with the assistance of bibliometric analysis techniques and the PRISMA method. The thematic content analysis method was used to reveal on which dimensions of technostress associated with teleworking and on which methods the focuses were. It can be stated that the results of the relationship analysis based on keyword frequency, performance analysis and thematic content analysis carried out within the scope of the research are consistent with each other. At this point, the findings of the research have revealed that technostress poses a dark side to teleworking as an organizational behavior challenge stemming from the COVID-19 pandemic. The current study found that teleworking-related technostress significantly affects employee well-being, with important impacts on the ISO 45003:2021 standard, and the Sustainable Development Goal 3. On the basis of being such a comprehensive and comparative research on the subject, it contributes to the relevant literature and practice.

The focus on life-prolonging anticancer treatment hampers shared decision-making in people with advanced cancer: A qualitative embedded multiple-case study.

Implementing shared decision-making in oncology practice is often limited, particularly integrating the patient's context into decision-making. To improve this, we conducted a quality improvement project, CONtext. CONtext attempts to accomplish this by: (1) Integrating the patient's context into shared decision-making during consultation with the medical oncologist; (2) Actively involving the GP and case manager (a specialized oncology nurse), who often have knowledge about the patient's context, and; (3) Giving the person with advanced cancer a time-out period of up to 2 weeks to consider and discuss treatment options with others, including close family and friends. To explore how persons with advanced cancer and their involved professionals experienced shared decision-making after the introduction of CONtext. A qualitative embedded multiple-case study using in-depth interviews analysed with inductive content analysis. A purposive sample of 14 cases, each case consisting of a patient with advanced cancer and ideally their medical oncologist, case manager, and GP. Four themes were identified: shared decision-making is a dynamic and continuous process (1), in which the medical oncologist's treatment recommendation is central (2), fuelled by the patients' experience of not having a choice (3), and integrating the patient's context into shared decision-making was considered important but hampered (4), for example, by the association with the terminal phase. The prevailing tendency among medical oncologists and persons with advanced cancer to prioritize life-prolonging anticancer treatments restricts the potential for shared decision-making. This undermines integrating individual context into decision-making, a critical aspect of the palliative care continuum.