Lower Satisfaction Research Articles

A retrospective study on patient satisfaction and Oral Health-Related Quality of Life with fixed 4- or 6-implant supported prostheses over 3-7 years.

To compare patients' satisfaction and oral health-related quality of life (OHRQoL) in edentulous patients treated by All-on-4 and All-on-6 implant-supported fixed prostheses rehabilitation over 3-7 years. All patients (n = 125) were divided into short-term (3-5 years, n = 71) and long-term (5-7 years, n = 54) follow-up groups. Patients' satisfaction was examined in a cross-sectional survey. OHRQoL and psychological impact were evaluated using the Oral Health Impact Profile (OHIP). Comparison of All-on-4 and All-on-6, including OHIP values, satisfaction scores, treatment duration and complications, were analyzed using the Chi-square test and the Mann-Whitney U test. Potential influence of patient-related factors on patient-reported outcome measures (PROMs) were analyzed via the Mann-Whitney U test, the Kruskal-Wallis test and multiple regression analyses. Power calculation was conducted in R Studio. Both All-on-4 and All-on-6 follow-up groups showed high scores in total satisfaction and PROMs, including chewing comfort, aesthetics, cleanability, and stability, with no significant difference (p > 0.05). Meanwhile, no significant differences were observed in the OHIP scores between two groups in both follow-up durations (p > 0.05). However, in patients with 3-5 years follow-up, All-on-4 group had significantly lower phonetic satisfaction scores than All-on-6 group (p < 0.05). Additionally, during both follow-up periods, All-on-4 patients exhibited notably superior psychological effect in contrast to All-on-6 patients (p < 0.05). Edentulous patients treated by four or six implant-supported fixed prostheses showed same high satisfaction in oral health-related quality of life in both 3-5 years and 5-7 years follow-ups.

Clinical inertia in onychomycosis treatment: results from the Illuminating Dialogues and Insights in Onychomycosis Management (IDIOM) survey.

Onychomycosis is a fungal infection of the nail that can serve as a reservoir for tinea infections in other parts of the body and can be transmitted to other individuals. As the disease progresses, it can lead to functional impairment, such as difficulties in walking, and negatively impact the psychosocial aspects of quality of life. Onychomycosis treatment, especially topical, is long-term, and adequate follow-up is essential for cure. However, the realities and issues of patient-physician communication after treatment initiation, including patients' perception of efficacy, treatment satisfaction, and reconsideration of the treatment approach, remain unclear. Therefore, this study aimed to examine the realities and issues associated with onychomycosis treatment, focusing on topical therapies, through a web-based survey of patients with onychomycosis and dermatologists. The duration of topical treatment was prolonged, with 30.5% of patients undergoing topical therapy for more than 2 years. Of these, 54.5% had not perceived clear efficacy. In addition, 93.7% of all patients with onychomycosis expressed a desire to change their treatment if it was ineffective. However, only 29.9% of patients receiving topical treatment discussed changing their treatment with their physicians, and only 7.3% ultimately changed their treatment. These findings indicate that the review of treatment strategies was insufficient. Furthermore, the satisfaction rate among patients treated with oral medications was higher than that of patients treated with topical medication. Despite dermatologists' awareness of low patient satisfaction with topical treatments, approximately 40% recommended alternative topical therapies when the initial topical treatment was ineffective. These results suggest clinical inertia in the treatment of onychomycosis stemming from a lack of appropriate intensification of treatment. In managing onychomycosis, the patient and dermatologist must share a common understanding of the importance of regular evaluation and the optimization of treatment regimens during treatment and must work side by side toward a cure.

Psychosocial work aspects, work ability, mental health and SARS-CoV-2 infection rates of on-site and remote Brazilian workers during the COVID-19 pandemic – a longitudinal study

BackgroundAt the beginning of the COVID-19 pandemic, some workers had the opportunity to work from home, while others remained in on-site work. The aim of the present study was to compare the psychosocial work aspects, work ability, mental health conditions and SARS-CoV-2 infection rates of Brazilian workers in remote and on-site work through a longitudinal study with quarterly follow-up assessments over a 12-month period.MethodA convenience sample of 1,211 workers from different economic sectors participated in the study, 897 of whom (74.1%) worked from home and 314 (25.9%) remained in on-site work. Psychosocial work aspects were assessed using the Copenhagen Psychosocial Questionnaire (COPSOQ). Work ability was assessed using the Work Ability Index (WAI) and the Work Ability Score (WAS). Mental health conditions and SARS-CoV-2 infection rate were recorded based on self-reported medical diagnoses. Online questionnaires were answered from June 2020 to September 2021, involving two waves of the COVID-19 pandemic. The groups were compared using chi-square tests, t-tests, and two-way ANOVA.ResultsIn the first wave of the pandemic, remote workers reported more quantitative demands and work-family conflicts, whereas on-site workers reported more emotional demands, low development of new skills, low commitment, low predictability, low recognition, and low satisfaction. They also reported greater occurrences of unwanted sexual attention, threats of violence, and physical violence. In the second wave, the remote group continued to report high work-family conflicts, whereas the on-site group reported – in addition to the results of the 1st wave – low influence at work, low quality of leadership, and burnout. No significant difference was found between groups with regards to the WAI in either wave. A significant difference was found for the WAS between the 3rd and 12th months (P < 0.01) in both groups. No significant differences were found between groups for the prevalence of anxiety, depression, burnout/stress, insomnia, panic syndrome, and eating disorders, except for the prevalence of insomnia at the 12-month follow-up, with higher rates in the remote group (P = 0.03). SARS-CoV-2 infection was significantly lower in the remote group (11.3%) compared to the on- site (16.9%) group (P < 0.01).ConclusionsPsychosocial work aspects differed between remote and on-site workers. Work ability and mental health conditions were similar between groups. Remote work might have played a role in limiting the spread of the virus in Brazil had it been more widely available.

The relationship between perceived school stress and satisfaction with life among Norwegian school-based adolescents and the moderating role of perceived teacher care: a cross-sectional study

BackgroundPerceived stress from schoolwork and perceived teacher care are shown to influence adolescents’ life satisfaction. However, there is a need to further explore how levels of perceived school stress affect life satisfaction of Norwegian adolescents across gender and school levels using nationwide data, and whether this association is moderated by perceived teacher care. Hence, this paper sought to: (1) describe perceived school stress, perceived teacher care and satisfaction with life in Norwegian adolescents stratified by gender and school level, (2) examine the association between perceived school stress and satisfaction with life by testing perceived teacher care as a possible moderator and (3) explore the association between perceived teacher care and adolescents’ satisfaction with life.MethodsWe utilized cross-sectional data from the Norwegian Ungdata Survey from 2021, encompassing adolescents from lower and upper secondary school. Two-thirds of all Norwegian adolescents participated in the Ungdata Survey from 2021. All data is anonymous. The study variables are presented according to lower and upper secondary school as well as gender. Linear regressions were conducted and adjusted for socioeconomic status (SES) by using SPSS.ResultsIn total, 139,841 adolescents were included. Girls exhibited higher perceived school stress, lower perceived teacher care, and lower life satisfaction than boys in both lower and secondary school (all p < 0.01). Strong inverse associations on satisfaction with life were found in both genders in lower and upper secondary school among those who reported very frequent perceived school stress, with perceived teacher care moderating the relationship (B= -0.67; 95% CI [-0.70 to -0.65], P < 0.01]). Moreover, robust associations were unveiled between high and low levels of perceived teacher care and life satisfaction across gender and school level.ConclusionsHigher perceived school stress was strongly inversely associated with life satisfaction in Norwegian adolescents, in both girls and boys, and in both lower and secondary school. Teacher care was identified as a moderator and seems to play a crucial part in the everyday life of Norwegian adolescents. These implications extend to teacher education, practice, and policy, which should be aware of the pivotal role of perceived teacher care on Norwegian school-based adolescents‘ life satisfaction.

It depends: Platform dependence, schedule control, and satisfaction among gig workers on Amazon's Mechanical Turk platform

AbstractUnderstanding the risks and rewards of gig work requires examining how gig workers themselves feel about their work and how work satisfaction may vary even among workers on the same gig platform. Platform dependence theory posits that financially disadvantaged workers who depend on gig work for essential income will be less satisfied, in part, because they are less able to work their preferred schedules. These predictions, however, have not been tested quantitatively. Using survey data from workers who do gig microtasks on Amazon's Mechanical Turk platform (MTurk), we examine how platform dependence, schedule mismatches (between preferred and actual work schedules), and work stress are related to work satisfaction. We find that all three factors are associated with lower satisfaction. Furthermore, we find support for a hypothesized mediating mechanism: platform dependence lowers satisfaction, in part, because it is associated with more mismatches between workers' preferred and actual schedules. We conclude by discussing reforms that could improve satisfaction for all microtask workers.

Under Pressure: Employee Work Stress, Supervisory Mentoring Support, and Employee Career Success

ABSTRACTDespite consistent findings that stressed employees benefit from social support, these employees do not always have access to such support. We propose and test a conceptual model suggesting employee work stress will negatively affect supervisory career and psychosocial mentoring support. Drawing from social exchange theory, we predict this will indirectly affect employee career success (lower career satisfaction and promotability ratings, fewer promotions), and that the relationship between employee work stress and lower supervisory mentoring support can be explained by lower levels of work engagement experienced by, and attributed to, stressed employees. We tested our model across three studies. In Study 1, we collected four waves of multisource field data (254 employees, 127 managers, and company records) at a large postal organization in the United Kingdom (UK). Employee work stress was negatively related to supervisor career and psychosocial mentoring support, and indirectly affected career satisfaction and manager promotability ratings of employees via supervisor career mentoring support. Cross‐lagged panel analyses in a supplemental study additionally supported the proposed directionality of relationships. Study 2 included data across three waves from employees in Hong Kong (n = 137) and showed that employee work stress had indirect effects on supervisor career and psychosocial mentoring via lower employee engagement. In Study 3, using data from supervisors in the UK (n = 240) we showed that supervisor perceived employee stress had indirect effects on their provision of supervisor career and psychosocial mentoring support via lower perceived employee engagement.

Decoding job satisfaction in the Nepalese public sector: patterns and predictors

ABSTRACT In this study, we investigate job satisfaction within the Nepalese civil service, utilizing data from a survey of 858 Nepalese civil servants. Our findings reveal a moderate level of job satisfaction, with several factors influencing its variability. Particularly, relationships with colleagues, the physical environment, and remuneration emerge as significant determinants, where higher values correspond to increased job satisfaction. These findings are consistent with the theoretical expectations of social exchange theory. Beyond these conventional variables, innovation, higher authoritarian cultural orientation (ACO), and the nature of civil service groups (Administrative service vs. Others) significantly shape job satisfaction levels. Furthermore, factors such as transfer scopes, promotion policy, and human resource development programs are identified as areas of low satisfaction among civil servants. While these factors do not demonstrate statistically significant associations with the degree of variation in job satisfaction, their dissatisfaction likely contributes to an overall decrease in job satisfaction.

Characteristics and Experiences of Employees who Gamble at Work

Given that little is currently known about gambling in the workplace, we conducted a mixed-methods study to describe the characteristics and experiences of people who gamble at work. We administered a Canada-wide online survey (n = 2,000) of adults who 1) gamble, 2) are currently employed full-time, and 3) have internet access at work. A descriptive analysis of quantitative survey data showed that individuals who gamble at work had lower job satisfaction and higher rates of problem gambling compared to those who do not. Among those who gamble at work, we quantitatively described the types of gambling, the consequences experienced, and the motivations for gambling. Qualitative interviews were conducted with 18 individuals who met the criteria for problem gambling and who gamble at work. Data were integrated to provide a richer description of the experiences of those who gamble at work, including their motivations, the role of work–life satisfaction, and the dynamic influence of work as a social context. Motivations for workplace gambling included excitement, social connection, avoidance, and coping with stress or emotions. The results highlight the importance of understanding the varied motivations of individuals who gamble at work, and the role of work experiences in shaping meaning regarding gambling behaviours.

Determinants of low satisfaction with life among wheelchair users with spinal cord injury in Egypt: a cross-sectional study

BackgroundSpinal cord injury (SCI) is one of the most catastrophic injuries that might lead to permanent use of a wheelchair and severely affects the quality of life, hence SCI patients report lower satisfaction with life (SWL) than the general population. Therefore, it is important to identify factors that determine SWL among wheelchair users with SCI. Our study aimed to assess the prevalence of low SWL and to identify its determinants among wheelchair users with SCI in Egypt.MethodsA cross-sectional study included 105 wheelchair users with SCI from the Al Hassan Foundation for wheelchair users in Egypt. The main outcome measure was low SWL, while the independent variables included sociodemographic characteristics, injury-related characteristics, anxiety, depression, neuropathic pain, functional independence, and environmental barriers.ResultsThe prevalence of low SWL among study participants was 57.1%. We found significant associations between SWL and age, area of living, and age at injury. Additionally, SWL correlated negatively with anxiety, depression, neuropathic pain, and environmental barriers, and positively with functional independence. Finally, the binary multiple logistic regression revealed that living in Upper Egypt (p = 0.017, OR = 13.7), depression (p = 0.034, OR = 6.08), older age (p = 0.002, OR = 1.21), and work and school environmental barriers (p = 0.022, OR = 0.46) were the predictors of low SWL.ConclusionTo improve the SWL for wheelchair users with SCI we need to effectively manage neuropathic pain, depression, and anxiety, and promote functional independence. There is an urgent need to reinforce legislation to improve the living conditions for wheelchair users with SCI in Egypt, especially in Upper Egypt.

Microaggressions among staff in higher education: Examining differences by social identities, and the association with job satisfaction

Microaggressions are everyday slights or insults directed toward members of marginalized groups; microaggressions are harmful, even if unintentional, and they occur in various contexts including the workplace. However, there is limited research on microaggressions among staff in higher education. The first aim of this study was to obtain systematic reports of experiences of microaggressions and other forms of discrimination among staff at a large public university. The second aim was to test for differences in these experiences as a function of staff members’ race/ethnicity, gender identity, sexual orientation, and disability status. A third aim was to examine whether microaggression and discrimination predicted job satisfaction. Web-based survey data were collected from a diverse sample of 680 university staff members. The survey included adapted versions of two scales on microaggressions and standard measures of everyday and workplace discrimination. Results indicated that experiences of microaggressions and discrimination were common among staff, and differed by race/ethnicity, gender identity, sexual orientation, and disability status, with those of marginalized identities reporting significantly more negative experiences. Finally, more frequent experiences of microaggressions and workplace discrimination predicted lower job satisfaction. These findings indicate a need for education on microaggressions pertaining to campus climate improvement in institutions of higher education.

Burnout and Work Engagement Concerning Dental Malpractice among Saudi Dentists: A Cross-Sectional Study

Plain Language SummaryDental malpractice is becoming a growing concern in health care. Dentistry is a high-stress job, and ignoring stress and burnout can negatively affect patients, dentists, and the quality of their work. This study examined the prevalence of dental malpractice, burnout, and work engagement among dentists, explored the association between dental malpractice and burnout, and identified other possible risk factors. From May 2023 to May 2024, a study was conducted of 259 Saudi dentists working in public clinics in Jeddah. The dentists completed an anonymous online survey that included questions about their backgrounds, job characteristics, burnout levels, work engagement levels, and dental malpractice experiences. Stata 18 software was used to analyze the data. Of the 259 dentists, 27% were concerned about malpractice, and 20.8% had faced malpractice claims. The analysis showed that dentists who felt detached from their work and who had low community engagement were more likely to worry about malpractice. Dentists working in primary health care centers, those feeling emotionally exhausted, and those with low job satisfaction were more likely to have malpractice claims. This study provided detailed information about the work conditions and burnout levels of Saudi dentists and how these relate to malpractice. It also found that Saudi dentists often experience high levels of emotional exhaustion and lack of personal achievement. Various workplace factors have been linked to dental malpractice.

Job satisfaction of multidisciplinary staff working in intensive care units: a cross-sectional study in Qatar

Background/Aims Job satisfaction is an important contributor to the efficacy and success of organisations. An intensive care unit is a highly skilled area of healthcare that can be a physically and mentally challenging environment for staff, potentially impacting job satisfaction. This study aimed to assess job satisfaction levels among multidisciplinary staff members working in the intensive care units of a hospital in Qatar and evaluate how this is affected by sociodemographic and employment factors. Methods This was a cross-sectional, quantitative study that used a survey method. A total of 142 intensive care unit nurses, physicians and allied health professionals were recruited via random sampling from a tertiary hospital in Qatar. The Minnesota Satisfaction Questionnaire (short form) was used to collect data on respondents' intrinsic, extrinsic and overall job satisfaction levels, using statements scored with 5-point Likert scales. The survey also collected data on respondents' gender, age, job category and years of experience working in intensive care. Data were analysed using Shapiro-Wilk tests, Mann-Whitney U tests, Kruskal–Wallis tests and analysis of variance. Mean overall job satisfaction scores were classified as low (&lt;3.00), moderate (3.00–3.99) or high (&gt;4.00). A P value of &lt;0.05 indicated statistical significance. Results The mean overall job satisfaction score was 3.82 out of 5.00, indicating moderate satisfaction. There were strong correlations between job satisfaction and both intrinsic (0.940) and extrinsic (0.894) satisfaction. There was a significant difference in job satisfaction levels depending on respondents' years of experience working in intensive care units (P=0.0477), with those who had less than 10 years of experience having the highest job satisfaction levels and those with 20–24 years' experience having the lowest job satisfaction levels. There were no significant differences between the job satisfaction levels of participants in different gender, age and job categories. Conclusions This study suggests that intensive care unit staff with more years of experience may have lower job satisfaction than those with fewer years of experience. Healthcare organisations should consider implementing targeted interventions to enhance job satisfaction, such as opportunities for professional development, recognition programmes, mentorship programmes, stress management workshops and efforts to improve work-life balance.

Heterogeneity in happiness: A latent profile analysis of single emerging adults.

Whether attending college, entering the workforce, or finding a romantic partner, single emerging adults navigate a pivotal stage of their lives. The present cross-sectional study sought to examine the heterogeneity in happiness of single emerging adults (N = 1,073) with a person-centered, group-differential approach. Using five predictors of life satisfaction (friendship satisfaction, family satisfaction, self-esteem, neuroticism, and extraversion) as indicators in latent profile analysis (LPA), we identified five distinct profiles (or groups) of young singles. The profiles, ordered from favorable to unfavorable indicator patterns, presented diverse shape and level differences that corresponded to varying happiness levels. Singles in Profile 1 with the most favorable indicator patterns (e.g., high friendship satisfaction, low neuroticism) were the happiest, while those in Profile 5 with the least favorable indicator patterns (e.g., low friendship satisfaction, high neuroticism) were the unhappiest. In the middle profiles, singles often offset disadvantages in one area (e.g., high neuroticism) with advantages in others (e.g., high friendship satisfaction) to achieve average to somewhat high levels of happiness. Importantly, friendship satisfaction emerged as a vital indicator, often distinguishing which singles were happy or not. Covariate analyses further validated the profiles and revealed additional profile differences (e.g., gender, anxiety, depression). Overall, our findings underscore the essential role of satisfying friendships in promoting the well-being of single emerging adults.

Discrepancies in perceptions of PTSD symptoms among veteran couples: Links to poorer relationship and individual functioning.

Veteran and intimate partner perceptions of posttraumatic stress disorder (PTSD) may differ, and little is known about how agreement or disagreement on symptom severity is related to relationship satisfaction. Veterans and their partners (N = 199 couples) completed a baseline assessment for a clinical trial evaluating two couple-based PTSD interventions. Veterans completed the PTSD Checklist for DSM-5 (PCL-5). Partners completed the collateral PCL-5 (PCL-5-C), which asked them to rate the severity of the veteran's PTSD symptoms. Both partner and veteran completed the Couples Satisfaction Index (CSI-32). Intraclass correlations (ICC) assessed agreement between PCL-5 and PCL-5-C total and subscale scores, which was low for total PCL and for all subscales (ICC = 0.15-0.46). Actor-Partner Interdependence Models (APIMs; actor-only pattern) tested associations between relationship satisfaction and PTSD symptom severity (total PCL and subscales), and the magnitude and direction of difference between PCL-5 and PCL-5-C (total and subscales). For veterans, more severetotal PTSD and negative cognition/mood scores were associated with lower relationship satisfaction, and the direction of discrepancy for negative cognition/mood (i.e., higher veteran-rated PTSD symptoms relative to partner's collateral report) was also associated with lower satisfaction. For partners, more severe collateral-reported symptoms for total PTSD and all four subscales were associated with lower relationship satisfaction; further, a larger discrepancy between veterans' and partners' reports of total PTSD, negative cognition/mood, and hyperarousal were associated with lower satisfaction. These results suggest that partners may have different perceptions of PTSD symptoms, and support the potential of fostering a shared understanding of PTSD symptom severity in couples.

Exploring Trade-Offs for Online Mental Health Matching: Agent-Based Modeling Study.

Online mental health communities (OMHCs) are an effective and accessible channel to give and receive social support for individuals with mental and emotional issues. However, a key challenge on these platforms is finding suitable partners to interact with given that mechanisms to match users are currently underdeveloped or highly naive. In this study, we collaborated with one of the world's largest OMHCs; our contribution is to show the application of agent-based modeling for the design of online community matching algorithms. We developed an agent-based simulation framework and showcased how it can uncover trade-offs in different matching algorithms between people seeking support and volunteer counselors. We used a comprehensive data set spanning January 2020 to April 2022 to create a simulation framework based on agent-based modeling that replicates the current matching mechanisms of our research site. After validating the accuracy of this simulated replication, we used this simulation framework as a "sandbox" to test different matching algorithms based on the deferred acceptance algorithm. We compared trade-offs among these different matching algorithms based on various metrics of interest, such as chat ratings and matching success rates. Our study suggests that various tensions emerge through different algorithmic choices for these communities. For example, our simulation uncovered that increased waiting time for support seekers was an inherent consequence on these sites when intelligent matching was used to find more suitable matches. Our simulation also verified some intuitive effects, such as that the greatest number of support seeker-counselor matches occurred using a "first come, first served" protocol, whereas relatively fewer matches occurred using a "last come, first served" protocol. We also discuss practical findings regarding matching for vulnerable versus overall populations. Results by demographic group revealed disparities-underaged and gender minority groups had lower average chat ratings and higher blocking rates on the site when compared to their majority counterparts, indicating the potential benefits of algorithmically matching them. We found that some protocols, such as a "filter"-based approach that matched vulnerable support seekers only with a counselor of their same demographic, led to improvements for these groups but resulted in lower satisfaction (-12%) among the overall population. However, this trade-off between minority and majority groups was not observed when using "topic" as a matching criterion. Topic-based matching actually outperformed the filter-based protocol among underaged people and led to significant improvements over the status quo among all minority and majority groups-specifically, a 6% average chat rating improvement and a decrease in blocking incidents from 5.86% to 4.26%. Agent-based modeling can reveal significant design considerations in the OMHC context, including trade-offs in various outcome metrics and the potential benefits of algorithmic matching for marginalized communities.

“They are not even called by name.”: Security guards in a South African Psychiatric Hospital.

BackgroundSecurity guards (SGs) play a significant role in health care and are an integral part of many psychiatric institutions. While their main duty is to ensure service users’ (SUs) and staff's safety and protect the premises, they are also called upon for other tasks, often ones for which they are not adequately trained. This study aimed to explore the roles, formal and informal tasks performed, working conditions and well-being of SGs working in psychiatric services. MethodsGuided interviews were conducted with n = 12 SGs and n = 18 mental healthcare providers (MHCPs) at a psychiatric hospital in the Western Cape of South Africa. All interviews were audio recorded, transcribed verbatim and analyzed using a thematic analysis approach. ResultsIn addition to ensuring safety, SGs take on numerous informal tasks, often for which they are not adequately trained and which formally fall under the purview of other MHCPs, mostly nurses, including talking with SUs about their mental health issues, dressing, showering, feeding, and administering medication. SGs also serve informally as interpreters, raising ethical concerns regarding accuracy and confidentiality. SGs lack formal training for working in psychiatric services and handling aggressive SUs, which may lead to increased violence instead of de-escalation and, in the worst case, injuries. SGs work under precarious working conditions (i.e. low salary, outsourced employment, absence of labour rights and job insecurity) and lack professional recognition, potentially leading to lower job satisfaction and increased emotional distress. ConclusionAddressing the challenges outlined in the study requires collaborative efforts between government, psychiatric institutions, private security companies, SGs and MHCPs. The establishment of clear roles, implementation of comprehensive formal training, psychosocial support and improved working conditions, particularly in-house employment, higher pay, increased employee rights and job security, are needed.

The role of bicultural stress and shame on the well-being of South Asian college students in the United States.

South Asian U.S. college students experience socialization from South Asian cultures they grew up with and White culture outside the South Asian community. The present study considers that the ways of navigating two conflicting cultures and experiences of shame are associated with anxiety and life satisfaction among South Asian U.S. college students. An anonymous survey, distributed to 271 South Asian students (mean age = 22, 38.2% male, 59.2% female, 2.3% nonbinary), quantitively assessed how bicultural stress and shame are related to anxiety and life satisfaction. Open-ended questions asked students to describe experiences of bicultural identity stressors and shame. Survey results indicated bicultural stress and shame as predictors of anxiety and lower life satisfaction. Thematic analysis of open-ended question responses revealed experienced stressors related to academics, finances, family expectations, and fitting in. Shame experiences were tied to bicultural stress and family and self-imposed expectations of participants. There is a need to further investigate the relationships found in the present study and explore ways to support South Asian students experiencing bicultural stress and shame. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Why are City Residents Less Happy than the Rest of the Population in Developed Countries? Studying the Urban-Rural Happiness Gap in Denmark Using Blinder-Oaxaca Decomposition

AbstractIn Denmark, and in developed countries in general, urban residents tend to report lower subjective well-being than rural residents. This difference has been referred to as a happiness paradox as cities historically have pulled in residents from the countryside in what has become known as the rural exodus. This paper explores the urban-rural happiness gap in Denmark. Using the Danish Rural-Urban Survey administered in 2011/2012 (n = 2000), the paper compares the respondents who live in the five largest cities in Denmark (Copenhagen, Aarhus, Odense, Aalborg, and Esbjerg) to the respondents who live in other parts of the country. The residents in the five largest cities report significantly lower life satisfaction than residents in the rest of the country. In contrast to evidence from other developed countries, this urban-rural happiness gap is found to be consistent across groups in the Danish society, e.g., across age, education, and employment groups. Further, the results show that the urban-rural happiness gap loses its statistical significance - and the two groups display similar satisfaction levels - when adjusting for several important factors. Decomposition analyses reveal that differences in urban-rural characteristics explain up to 94% of the urban-rural happiness gap. Of these urban-rural characteristics, lower access to nature amenities, lower bonding social capital, lower rates of retired people, and higher rates of non-native residents in the five largest cities in Denmark were found to account for up to 37%, 22%, 14%, and 9% of the urban-rural happiness gap, respectively.

Caregiving, caring intensity, and allostatic load: A comparison of caring to others inside and outside the home

ObjectiveCaregiving to a sick or disabled relative is a key chronic stress model in health psychology. However, caregiving is not uniformly stressful, and this study tested whether caregiving effects on life satisfaction and allostatic load varies by caring intensity, i.e., caring within the home, outside the own home, or both (e.g. Dual caring). MethodUsing data from the UK Understanding Society Wave 2, a sample of non-caregivers (N = 3149) and caregivers (N = 562) met inclusion criteria and completed measures of life satisfaction and provided blood samples for capturing endocrine, cardiovascular and immune parameters for assessment of allostatic load. ResultsDual caregivers had lower life satisfaction compared to non-carers, and other caregiver groups. Further, dual caregivers had higher levels of allostatic load compared to non-carers and those caring within the home and those caring outside the home. These group differences withstood adjustment for several co-variates including gender, education, income and lifestyle factors. ConclusionsThese results confirm that caregiving is not uniformly stressful with dual caring, an index of caring intensity being more damaging for health. The findings are also discussed in relation to the caregiver-control model of chronic stress.

Cohen versus Pfannenstiel Cesarean Skin Incision for BMI =35 kg/m2: a Randomized Controlled Trial

Background: Maternal obesity is recognized as a significant risk factor for adverse pregnancy outcomes, including increased cesarean delivery rates and heightened surgical complications. It is unclear if the Cohen or Pfannenstiel skin incisions at cesarean delivery are associated with different outcomes. Objective: To evaluate the impact of either Cohen or Pfannenstiel cesarean skin incision type on maternal morbidity. Study Design: Pregnant individuals with a BMI of ≥35 kg/m2, carrying either singleton or multiple gestations, were consented prenatally and in labor. Eligible participants who underwent a cesarean delivery between 24 and 41 weeks of gestation were randomized to either Pfannenstiel or Cohen skin incisions at Thomas Jefferson University Hospital from October 2016 to March 2020. The study aimed to recruit 284 participants based on a sample size calculation assuming a 50% reduction in wound complications with Cohen versus Pfannenstiel incisions (80% power, α=0.05), but recruitment was terminated early after 72 participants were randomized. The primary outcome was a composite maternal morbidity within six weeks, which consisted of the following: wound infection, hematoma, seroma, separation of skin ≥1 cm, readmission for wound complications, endometritis, and postpartum hemorrhage. Statistical analyses included bivariate tests, t-tests, and non-parametric analyses. Results: Of 331 pregnant individuals consented prenatally and in labor, 72 eventually underwent cesarean delivery and were randomized, 34 to Cohen and 38 to Pfannenstiel skin incisions. The mean BMI was >42 kg/m2, about two thirds of the patients had a pannus, 56% were Black, 47% had diabetes, and 56% hypertensive disorders. The primary outcome of composite maternal morbidity occurred in 47.1% in the Cohen and 36.8% in the Pfannenstiel groups (RR 1.24, 95% CI 0.71-2.08), and was also similar regardless of the presence of a pannus, or by degree of obesity. Surgical site infection, hematoma, seroma, wound separation/dehiscence, endometritis, and postpartum hemorrhage were each similar between Cohen and Pfannenstiel participants. Neonatal outcomes were also similar between the Cohen and Pfannenstiel groups, except that the Cohen group was found to have statistically significant lower Apgar score at 5 minutes and higher need for respiratory support compared to the Pfannenstiel group, possibly related to the trend for a longer time from skin incision to delivery. Physicians were found to be significantly less satisfied with the Cohen compared to the Pfannenstiel incision. Conclusion: In pregnant patients with BMI of ≥35 kg/m2, obstetrical providers can chose from either a Cohen or an Pfannenstiel skin incision, as they are associated in general with similar outcomes, except for lower Apgar scores and lower physician satisfaction associated with the Cohen incision. The findings of this study are limited by its early cessation for logistical reasons, leading to an underpowered analysis. It is crucial to acknowledge that these results must be interpreted cautiously due to the reduced sample size and the circumstances surrounding the study's termination. These data can inform future trial design and implementation as well as fuel individual patient level meta-analyses on this topic.