Negative Psychosocial Consequences Research Articles

Mental Health Impact of COVID-19 on Quarantine Hotel Employees in China.

BackgroundThe COVID-19 pandemic has had a far-reaching and unprecedented influence on economies worldwide. It has also impacted on the global population’s mental health and caused negative psychosocial effects, which may lead to psychological crises. During the pandemic, the challenges for quarantine hotel employees are not only the increased workloads created by operating a quarantine hotel but also high psychological stress associated with job insecurity, risk of exposure and contagion for themselves, their friends and families. This research attempts to explore COVID-19-related depression, anxiety, and stress among quarantine hotel employees in China. The mental health of quarantine hotel employees, who have faced unprecedented changes, is paramount while they provide hospitality and care for healthcare workers and quarantine guests during mandatory quarantine periods.MethodsThis is a cross-sectional study that applied convenience sampling to collect questionnaire samples from 170 quarantine hotel employees in Xiamen, Fujian Province, China, during the COVID-19 pandemic, from May 20 to June 10, 2020. The Depression, Anxiety, and Stress Scale (DASS-21) was used to collect data. The study uses descriptive analysis, chi-square test and binary logistic regression to examine the sociodemographic factors associated with depression, anxiety and stress levels during the COVID-19 pandemic.ResultsThe results reveal that 43.5% of respondents report moderate to extremely severe symptoms of depression; 68.2% have moderate to extremely severe anxiety symptoms; and 8.2% indicated moderate to extremely severe stress symptoms. Quarantine hotel employees who have a higher level of education are less likely to experience anxiety, and those with higher incomes are less likely to experience depression.DiscussionIn order to mitigate the increasing levels of anxiety and depression among their staff, quarantine hoteliers or managers urgently need to implement mental health assistance programs, such as providing extra training in hygiene and knowledge about COVID-19, offering online counseling and psychological support services, training in positive thinking, encouraging staff to keep in touch with their personal support networks, and constructing a resilience model.

Psychosocial Effects of Corona Measures on Patients With Dementia, Mild Cognitive Impairment and Subjective Cognitive Decline.

Background: The recent COVID-19 pandemic is not only a major healthcare problem in itself, but also poses enormous social challenges. Though nursing homes increasingly receive attention, the majority of people with cognitive decline and dementia live at home. We aimed to explore the psychosocial effects of corona measures in memory clinic (pre-)dementia patients and their caregivers.Methods: Between April 28th and July 13th 2020, n = 389 patients of Alzheimer center Amsterdam [n = 121 symptomatic (age = 69 ± 6, 33%F, MMSE = 23 ± 5), n = 268 cognitively normal (age = 66 ± 8, 40% F, MMSE = 29 ± 1)] completed a survey on psychosocial effects of the corona measures. Questions related to social isolation, worries for faster cognitive decline, behavioral problems and discontinuation of care. In addition, n = 147 caregivers of symptomatic patients completed a similar survey with additional questions on caregiver burden.Results: Social isolation was experienced by n = 42 (35%) symptomatic and n = 67 (25%) cognitively normal patients and two third of patients [n = 129 (66%); n = 58 (75%) symptomatic, n = 71 (61%) cognitively normal] reported that care was discontinued. Worries for faster cognitive decline were existed in symptomatic patients [n = 44 (44%)] and caregivers [n = 73 (53%)], but were also reported by a subgroup of cognitively normal patients [n = 27 (14%)]. Both patients [n = 56 (46%) symptomatic, n = 102 (38%) cognitively normal] and caregivers [n = 72 (48%)] reported an increase in psychological symptoms. More than three quarter of caregivers [n = 111(76%)] reported an increase in patients' behavioral problems. A higher caregiver burden was experienced by n = 69 (56%) of caregivers and n = 43 (29%) of them reported that a need for more support. Discontinuation of care (OR = 3.3 [1.3–7.9]), psychological (OR = 4.0 [1.6–9.9]) and behavioral problems (OR = 3.0 [1.0–9.0]) strongly related to experiencing a higher caregiver burden. Lastly, social isolation (OR = 3.2 [1.2–8.1]) and psychological symptoms (OR = 8.1 [2.8–23.7]) were red flags for worries for faster cognitive decline.Conclusion: Not only symptomatic patients, but also cognitively normal patients express worries for faster cognitive decline and psychological symptoms. Moreover, we identified patients who are at risk of adverse outcomes of the corona measures, i.e., discontinued care, social isolation, psychological and behavioral problems. This underlines the need for health care professionals to provide ways to warrant the continuation of care and support (informal) networks surrounding patients and caregivers to mitigate the higher risk of negative psychosocial effects.

The co-occurrence of mental disorders among Dutch adolescents admitted for acute alcohol intoxication

Adolescents with substance use disorders are often diagnosed with co-occurring mental disorders. However, it is unknown if adolescent hospital admission for acute alcohol intoxication is also associated with co-occurring mental disorders. Therefore, the primary aim of this study is to estimate the prevalence of co-occurring mental disorders among Dutch adolescents admitted for acute alcohol intoxication. Secondly, this study aims to explore the cross-sectional relationship between the co-occurrence of mental disorders and patient characteristics, such as sex, age and blood alcohol concentration at admittance. Data were retrospectively collected from 726 adolescents admitted for acute alcohol intoxication. Overall, 245 (34%) of the 726 adolescents treated for acute alcohol intoxication were diagnosed with a co-occurring mental health disorder, such as attention-deficit hyperactivity disorder (13%) or autism spectrum disorder (2.1%). Attention-deficit hyperactivity disorder in particular seems to be more prevalent in the study population than in the general Dutch adolescent population.Conclusion: This study demonstrates that among adolescents admitted for acute alcohol intoxication, the prevalence of co-occurring mental disorders is a common and a relevant issue for treatment and prevention strategies.What is Known:• Alcohol consumption among adolescents has been associated with negative psychosocial effect.• Among adolescents admitted for acute alcohol intoxication, risk factors for psychological dysfunction appear to be inadequately assessed, documented and followed up.What is New:• The current study reports on the prevalence of co-occurring mental disorders among a substantial sample of adolescents admitted for acute alcohol intoxication.• Understanding the prevalence of co-occurring mental disorders is clinically relevant for the outpatient follow-up of adolescents admitted for acute alcohol intoxication.

Psychosocial consequences of potential overdiagnosis in prostate cancer a qualitative interview study

Background Prostate cancer is a frequently diagnosed cancer and made up 6% of male cancer deaths globally in 2008. Its incidence varies more than 25-fold worldwide, which is primarily attributed to the implementation of the prostate-specific antigen (PSA) test in developed countries. To reduce harm of overdiagnosis, most international guidelines recommend surveillance programmes. However, this approach can entail negative psychosocial consequences from being under surveillance for an (over)diagnosed prostate cancer. Aim To explore men’s feelings and experiences in a surveillance programme. Design and setting Qualitative study with Danish men diagnosed with asymptomatic prostate cancer Gleason score ≤ 6, who are in a surveillance programme Methods 12 semi-structured, individual interviews were conducted and analysed with systematic text condensation and selected theories. Results Most informants reported that they were astonished at the time of diagnosis. They were aware of the small likelihood of dying from cancer, but in some cases, the uncertainty created ambivalence between knowing and not knowing. The men expressed their risk awareness in different ways: a realization that life does not last forever, uncertainty towards the future, a feeling of powerlessness, and a need for control. Conclusions The men in this study had substantial psychosocial consequences from being labelled with a cancer diagnosis. Bearing these men’s high risk of overdiagnosis in mind, it is important to discuss whether the harms of this diagnosis outweigh the benefits. The psychosocial consequences of being in a prostate cancer surveillance programme should be explored further. KEY POINTS Current awareness: The number of men living with an asymptomatic prostate cancer has increased the last 20 years after the implementation of the PSA test. Main Statements: Men living with an asymptomatic, low-risk prostate cancer experience negative psychocosial consequences GPs should consider the possible negative psychosocial consequences in their decision-making of measuring the PSA level

"I Live in This Neighborhood Too, Though": the Psychosocial Effects of Gentrification on Low-Income Black Men Living in Washington, D.C.

Gentrification-the process by which middle-class individuals (often White) move into lower-income neighborhoods (often Black), consequently displacing existing residents and changing the neighborhood's social character-is a relatively new and rapid phenomenon in Washington, DC. From 2000 to 2010, DC had the second fastest rate of gentrification in the USA. Gentrification is a major and disproportionate source of disadvantage for low-income Black DC residents. In light of the relative dearth of psychological research focused on gentrification, this study sought to answer the following research questions: What are Black men's experiences with gentrification in DC and how are Black men psychosocially affected by the gentrification of their neighborhoods? Data used in this study were obtained in Fall 2013 via nine semi-structured focus groups from nine DC neighborhood clusters. Participants were 83 self-identified Black men between the ages of 18 and 48 (M=29.96, SD=6.90) who reported predominantly low socioeconomic status. Black men's experiences with gentrification in DC included experiencing changing demographics and spaces, being discriminated against by police, blaming the Black community for gentrification and displacement and recognizing the positives of gentrification. Gentrification had negative psychosocial effects on participants, including race-based social exclusion, restricted mobility, reduced social cohesion and sense of community belonging, loss of control, and internalized blame. It is imperative that psychologists and other health professionals recognize and further explore the psychosocial and health consequences of gentrification on longtime Black residents and promote solutions to reduce the stress associated with this understudied driver of racial/ethnic health inequities.

COVID-19 Home Confinement Negatively Impacts Social Participation and Life Satisfaction: A Worldwide Multicenter Study.

Public health recommendations and governmental measures during the new coronavirus disease (COVID-19) pandemic have enforced numerous restrictions on daily living including social distancing, isolation, and home confinement. While these measures are imperative to mitigate spreading of COVID-19, the impact of these restrictions on psychosocial health is undefined. Therefore, an international online survey was launched in April 2020 to elucidate the behavioral and lifestyle consequences of COVID-19 restrictions. This report presents the preliminary results from more than one thousand responders on social participation and life satisfaction. Methods: Thirty-five research organizations from Europe, North-Africa, Western Asia, and the Americas promoted the survey through their networks to the general society, in 7 languages (English, German, French, Arabic, Spanish, Portuguese, and Slovenian). Questions were presented in a differential format with questions related to responses “before” and “during” confinement conditions. Results: 1047 participations (54% women) from Asia (36%), Africa (40%), Europe (21%), and others (3%) were included in the analysis. Findings revealed psychosocial strain during the enforced COVID-19 home confinement. Large decreases (p < 0.001) in the amount of social activity through family (−58%), friends/neighbors (−44.9%), or entertainment (−46.7%) were triggered by the enforced confinement. These negative effects on social participation were also associated with lower life satisfaction (−30.5%) during the confinement period. Conversely, the social contact score through digital technologies significantly increased (p < 0.001) during the confinement period with more individuals (+24.8%) being socially connected through digital technology. Conclusion: These preliminary findings elucidate the risk of psychosocial strain during the early COVID-19 home confinement period in 2020. Therefore, in order to mitigate the negative psychosocial effects of home confinement, implementation of national strategies focused on promoting social inclusion through a technology-based solution is strongly suggested.

COVID-19 Pandemia: Neuropsychiatric Comorbidity and Consequences.

Infection with the new corona virus (SARS-CoV-2) was first registered in December 2019 in China, and then later spread rapidly to the rest of the world. On December 31, 2019, the World Health Organization (WHO) informed the public for the first time about causes of pneumonnia of unknown origin, in the city of Wuhan (Hubei Province, China), in people who were epidemiologically linked to a seafood and wet animal whole sale local market in Wuhan. Coronavrus disease, called COVID-19 (Corona virus disease 2019), after China quickly spread to most countries in the wold, and the WHO on March 11, 2020 declared a pandmic with this virus. SARS-CoV-2, has a high level of sequential similarities to the SARS-CoV-1 and uses the same receptors when it enters the human body (angiotensin-converting enzyme 2/ACE2). COVID-19 is respiratry infection that is primarily transmitted via respiratry droplets. Typical symptoms of COVID-19 infection can be very moderate (infected can be even asymptomatic) to very severe, with severe respiratory symptoms (bilateral severe pneumonia), septic schock, and fatal outcome. Numeous unknows regarding the biological, epidemilogical adn clinical characteristics of COVID-19, still exist, and make it impossible to predict with certainty the further course of the current pandemic. COVID-19 is primarily a disease of the respiratory system, but SARS-CoV-2, in a number of patients also penetrates the CNS, and apparently could be responsible for fatal outcome in some cases. The entrry of the virus into the brain can lead to neurological and psychiatric manifestationss, which are not uncommon, including headache, paresthesia, myalgia, impaired consciousnessm, confusion or delirum and cerebrovascular diseases. SARS-CoV-2 positive individuals should be evaluated in a timely manner for neurological and psychiatic symptoms because tretament of infection-related neurological and psychiatric complications is an important factor in better prognosis of severe COVID-19 patients.From the current point of view, it seems that in COVID-19 survivors, in the coming years and decades, the inflammatory systemic process and/or the inflammatory process of the brain could trigger long-term mechanisms that generally lead to an increase of neurological and neurodegenerative disorders. Psychosocial consequences as well as consequences for mental health are also significant, both for the general population and especially for health workers of all profiles. COVID-19 pandemia is associtaed with negative psychosocial consequences, including depressive symptoms, anxiety, anger and stress, sleep disorders, simpotms of posttrauamtic stres disorder, social isolation, loneliness and stigmatization.

The Relationship Between Physical Activity and Quality of Life During the Confinement Induced by COVID-19 Outbreak: A Pilot Study in Tunisia

The present study aimed to determine the relationship between physical activity (PA) and quality of life (QoL) during the confinement caused by the COVID-19 outbreak. A total of 216 participants (men: n = 112, women: n = 114) were included in the present study. They were divided into three groups [i.e., inactive group (IG): less than 600 metabolic equivalent of tasks (METs), n = 131; minimally active group (MAG): from 600 to 2,999 METs, n = 49; and health-enhancing PA group (HEPAG): 3,000 + METs, n = 36] based on their habitual PA level in the period of confinement. WHO Quality of Life Instrument-Short Form (WHOQOL-BREF) and International Physical Activity Questionnaire-BREF (IPAQ-BREF) questionnaires were used to assess QoL and PA intensities. The main findings of the present study showed that MAG and HEPAG have better total PA, physical, psychological, social, and environmental QoL domains scores than IG (all, p < 0.01). Small to large correlations (r ranging from 0.14 to 0.72) were also observed between total PA, total walking activity, total moderate-intensity PA, total vigorous-intensity PA, and QoL domains (all, p < 0.01). PA with light-, moderate-, and vigorous-intensities can be well recommended to decrease the negative psychosocial effect of confinement. However, longitudinal studies are needed to draw causal inferences and underpin more robust and evidence-based and informed recommendations.

Orthorexic tendencies in the general population: association with demographic data, psychiatric symptoms, and utilization of mental health services

PurposeOrthorexia nervosa (ON) is characterized by a preoccupation to eat healthily and restrictive eating habits despite negative psychosocial and physical consequences. As a relatively new construct, its prevalence and correlates in the general population and the associated utilization of mental health services are unclear.MethodsAdults from the general population completed the Düsseldorf Orthorexia Scale (DOS), the Patient Health Questionnaire (PHQ), the Short Eating Disorder Examination (SEED).ResultsFive-hundred eleven (63.4% female) participants with a mean age of 43.39 (SD = 18.06) completed the questionnaires. The prevalence of ON according to the DOS was 2.3%. Considering only effects of at least intermediate size, independent samples t-tests suggested higher DOS scores for persons with bulimia nervosa (p < .001, Cohen’s d = 1.14), somatoform syndrome (p = .012, d = .60), and major depressive syndrome (compared p < .001, d = 1.78) according to PHQ as well as those who reported to always experience fear of gaining weight (p < .001, d = 1.78). The DOS score correlated moderately strong and positively with the PHQ depression (r = .37, p < .001) and stress (r = .33, p < .001) scores as well as the SEED bulimia score (r = .32, p < .001). In multivariate logistic regression analyses, only PHQ depression scores were associated with past psychotherapeutic or psychiatric treatment (OR = 1.20, p = .002) and intake of psychotropic medication in the last year (OR = 1.22, p = .013).ConclusionsThe prevalence of ON was low compared to international studies but is in line with other non-representative German studies. Orthorexic tendencies related to general mental distress and eating disorder symptoms but were no independent reason for seeking treatment.Level of evidenceLevel V, cross-sectional descriptive study.

Psycho-social perspective of COVID-19 in Nepal

This ‘opinion article’ is based on World Health Organization (WHO) news and online publications along with the cases handled by the writer. It aims at overviewing psycho-social angle of collectivistic social structure of Nepal during the pandemic called COVID-19 caused by Coronavirus. Majority of Nepalese are dependent on agriculture, remaining on private or public services either in or out of the country. COVID-19 entered the world health threatening their existence, authority and leaving social system in halt. Coronavirus attacked breathing system and lungs claiming hundreds of thousand people’s lives around the world. No vaccine or medicine to combat it has been developed till date. Educational, professional and service organizations have been shut down leaving families isolated from friends and relatives. People are living with fear, denial, panic reactions, dissociation, depression, and socially distressed in ‘lockdown’ condition. It can damage trust in authority and socialization pattern as after-effect. Doctors, Politicians, educators, local government, social workers, psychologists and people themselves can reduce negative psycho-social effects occurring in future. Emotional management (situational awareness and acceptance), relationship management, meditation and relaxation exercises can contribute positively in reducing psychological problems of COVID-19.

Reconstructive surgery in strabismus patients and perceived quality of life

Purpose: Data of the subjective assessment of strabismus-related quality of life from patients with manifest strabismus are important in order to obtain the best possible treatment recommendations for affected people. The aim of this study is the analysis of the quality of life based on squinting Austrians with and without reconstructive strabismus surgery. Methods: The strabismus-specific AS-20 questionnaire was completed by 26 strabismus patients without reconstructive surgery, 27 strabismus patients with reconstructive surgery and 35 non-squinting people from Austria. These data were evaluated and analyzed. Results: In the German version of the AS-20, clear evidence could be provided for group differences of perceived strabismus-related quality of life after reconstructive strabismus surgery. In the two psychosocial sub-scales (self-perception &amp; interaction) significant differences were found in the comparison of the groups (p &lt; .001). Also in the functional subcategories (reading function &amp; general function), highly significant differences were determined (p &lt; .001). Conclusions: Untreated manifest strabismus leads to negative psychosocial effects on the quality of life of those affected. Reconstructive strabismus surgery reduces these discomforts and leads to a significant increase in the quality of life related to strabismus in both psychosocial and functional areas.

Assessing Diabetes Distress and Sleep Quality in Young Adults with Type 1 Diabetes Using FreeStyle Libre: A Prospective Cohort Study.

IntroductionThe burden of diabetes, its potential complications, and related self-care activities can induce negative psychosocial effects in patients with type 1 diabetes mellitus (T1DM). This prospective cohort study investigated the psychosocial benefits associated with 3 months of FreeStyle Libre (FSL) flash glucose monitoring use in young adults with T1DM in Saudi Arabia.MethodsPatients completed the Diabetes Distress Scale (DDS) and the Pittsburgh Sleep Quality Index (PSQI) questionnaires at baseline and 3 months. HbA1c, number of confirmed hypoglycemia episodes per month, and frequency of blood glucose testing were also collected at baseline and 3 months.ResultsOf 95 patients analyzed, significant reductions were observed in mean DDS (3.8 vs. 2.5; p < 0.001) and PSQI (8.7 vs. 3.9; p < 0.001) scores from baseline to 3 months. Furthermore, HbA1c and confirmed hypoglycemia episodes per month also decreased from baseline to 3 months (HbA1c 8.3 vs. 7.7% [67 vs. 61 mmol/mol], p < 0.001; hypoglycemia episodes 3.0 vs. 2.3, p < 0.001). In contrast, mean frequency of blood glucose testing per day increased from baseline to 3 months (2.5 vs. 5.2; p < 0.001).ConclusionThese data demonstrate improvements in diabetes distress and sleep quality as well as glycemic outcomes following 3 months’ FSL use in young adults with T1DM.

Psychosocial consequences of false positives in the Danish Lung Cancer CT Screening Trial: a nested matched cohort study

ObjectivesLung cancer CT screening can reduce lung cancer mortality, but high false-positive rates may cause adverse psychosocial consequences. The aim was to analyse the psychosocial consequences of false-positive lung cancer...

Predictive Factors of Cyberbullying Perpetration amongst Spanish Adolescents.

(1) Cyberbullying has gained increased attention from society and researchers due both to its negative psychosocial consequences and the problems that have risen relating to the misuse of technology. Despite the growing number of scientific studies, most research has focused on victims of cyberbullying rather than on the cyberbullies. This study examines the predictive value of personal resources (emotional intelligence, gratitude, and core self-evaluations) and risk factors (cybervictimization, problematic Internet use), and parental control in online activities on adolescents’ involvement in cyberbullying perpetration. (2) A total of 2039 Spanish adolescents between 12 and 18 years of age took part in this research (53.9% females). (3) Twenty-two percent of the sample was engaged in cyberbullying behaviors (more male adolescents). Insults and online social exclusion were the most frequent types of cyberbullying perpetration. Age, cybervictimization, problematic Internet use, and deficits in the use and regulation of emotions were the best predictors of cyberbullying perpetration. (4) Cyberbullying is a social reality in which personal and family variables converge on a particularly vulnerable age group. Our findings suggest that both well-known predictors of cyberbullying (cybervictimization and problematic Internet use) along with others less studied dimensions (i.e., emotional abilities) need to be taken into account in future school-based interventions aimed to prevent cyberbullying perpetration.

The Influence of Obesity on Outcomes After Pediatric Reduction Mammaplasty: A Retrospective Analysis of the Pediatric National Surgical Quality Improvement Program-Pediatric Database.

Symptomatic macromastia causes negative physical and psychosocial effects, which support the need for early intervention, even in the adolescent population (Plast Reconstr Surg 2012;130:785-789). Reduction mammaplasty is a proven treatment that reliably addresses symptoms from macromastia. The National Surgical Quality Improvement Program-Pediatric is the leading nationally validated, risk-adjusted, outcomes-based program to measure and improve the quality of surgical care (Pediatrics 2012;130:e339-e346). In adults, obesity is associated with increased early postoperative complications after mammaplasty (Pediatrics 2017;140(5)). We hypothesized that obesity would increase the incidence of postoperative complications in pediatric patients undergoing reduction mammaplasty. The National Surgical Quality Improvement Program-Pediatric database was queried for female patients 18 years or younger who underwent reduction mammaplasty from January 2012 to December 2017 using Current Procedural Terminology code 19318. Demographic, clinical, and outcomes data were abstracted from the database. A composite postoperative adverse events variable was created from a list of 21 individual adverse events. Patients were stratified by presence of obesity (body mass index ≥30 kg/m) on univariate analyses. Multivariable logistic regression was used to determine factors associated with any postoperative adverse events. A total of 542 female patients underwent reduction mammaplasty, with 48% of the cohort being obese. Patients were similar in age (median, 17 years) and comorbidities between obese and nonobese groups. Obese patients were more likely to be African American, have higher American Society of Anesthesiologists class, and endure longer operations. Composite adverse event rates were significantly higher in the obese group (7% vs 2%, P = 0.013). Individual adverse events were similar between groups, with the exception of 30-day readmissions, which was higher in the obese group (3% vs 1%, P = 0.04). On multivariable logistic regression, obesity increased the odds of having a postoperative adverse event by 3-fold after adjusting for operative duration. Obesity was significantly associated with greater postoperative adverse events in obese adolescent females after reduction mammaplasty compared with their nonobese counterparts. Although recorded rates of adverse events after reduction mammaplasty were low, preoperative weight loss programs may further improve outcomes for obese pediatric populations undergoing reduction mammaplasty.

Correlation between smartphone addiction and loneliness levels in nursing students.

This study aimed to determine the correlation between smartphone addiction and loneliness levels in nursing students. The study has a descriptive and cross-sectional study design and was carried out with 682 nursing students. In the study, a "Student Information Form", the "Smartphone Addiction Scale-Short Form", and the "University of California Los Angeles Loneliness Scale" were used. The study found that nursing students had moderate scores for smartphone addiction and lonelinessand that there was a positive correlation between smartphone addiction and loneliness. Nursing students are at risk of smartphone addiction and this may lead to negative psychosocial effects. Considering these results, interventions should be planned.

Socio-Economic Differences in the Development of Six-Year-Old Children in Rural Areas of East Poland

The aim of this study is to evaluate socio-economic differences in physical, cognitive, and motor development among six-year-old children living in rural areas. The study encompassed 228 children, including 118 girls and 110 boys living in different rural settlements in the Świętokrzyskie Province in Poland, who were selected through a combination of nonprobability and random sampling. The study was carried out from April to June 2014. A questionnaire was used to collect information from the parents of the children concerning the parents’ education, number of children in the family, and the number of persons per room. Based on the concept of socio-economic status (SES), three levels of quality of life conditions of each family, i.e., high, average, and low, were distinguished. The study noted considerable differences in BMI, and especially the cognitive development of the children with respect to the socio-economic status of their family. It was observed that children from rural areas who live in bad socio-economic conditions are exposed to a wide range of negative factors affecting their health, which leads to lower educational results and negative long-term biological and psychosocial consequences. The chance for more rapid alignment of development deficits for those children would have been their earlier cover of school duty.

Effectiveness of non-pharmacological falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke: protocol for an umbrella review

Background: Falls are common among people with neurological diseases and are associated with many negative physical, psychosocial and economic consequences. Implementation of single diagnosis falls prevention interventions is currently problematic due to lack of participants and resources. Given the similarities in falls risk factors across stroke, Parkinson’s Disease (PD) and Multiple Sclerosis (MS), the development of an intervention designed for mixed neurological populations seems plausible and may provide a solution to current implementation challenges. This umbrella review aims to summarise the totality of evidence regarding the effectiveness of non-pharmacological falls prevention interventions for people with MS, PD and stroke and to identify the commonalities and differences between interventions that are effective for each disease to inform the development of an intervention for mixed diagnoses. Methods: This umbrella review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Electronic databases and grey literature will be searched. Systematic reviews of randomised controlled trials (RCTS) and studies investigating the effects of non-pharmacological falls prevention interventions on falls outcomes among people with MS, PD and stroke will be included. Methodological quality of included reviews will be assessed using the Assessment of Multiple Systematic Reviews 2 tool. The Grading of Recommendations Assessments, Development and Evaluation framework will be used to rate the quality of evidence. A summary of evidence table and narrative synthesis will be utilised to clearly indicate the findings. Discussion: This umbrella review presents a novel and timely approach to synthesise existing falls literature to identify effective non-pharmacological interventions for people with MS, PD and stroke. Of importance, this umbrella review will use a robust methodology to explore the key differences and similarities in effective interventions for individuals with these neurological diseases to facilitate the development of an intervention for mixed neurological groups.

What are the needs of infertile Moroccan couples in Assisted Reproductive Technology?: Exploratory qualitative study in the first fertility public center in Morocco

Context: Infertility is one of the most painful experiences that can have a negative impact in many areas of an individual’s life. Providing quality care to infertile couples requires health professionals to explore their experiences and needs to plan effective supportive interventions.&#x0D; Objectives: To explore the experiences and needs of Moroccan infertile couples in Assisted Reproductive Technology.&#x0D; Material and Methods: This is a qualitative exploratory study. It involves 40 infertile couples (men and women) and 5 health professionals as key informants. Infertile couples were selected among those attending the first public center for Assisted Reproductive Technology in Morocco located in Rabat during the period 2017-2018. In-depth unstructured interviews, field notes were used with couples and semi-structured interviews with health professionals. The analysis of the interview data was based on a conventional content analysis method.&#x0D; Results: Five types of needs were identified among infertile Moroccan couples, namely: i. Infertility and social support; ii. Infertility and financial support; iii. Infertility and spiritual support; iv. Infertility and informational support; v. Infertility and emotional support.&#x0D; Conclusion: Infertile moroccan couples experienced many emotional, psychosocial and economic difficulties that can negatively affect their quality of life. Thus, to meet the needs and expectations of these couples alongside their medical treatment, it’s necessary to develop couple-centered approaches, which can improve their quality of life, treatment outcomes and mitigate negative psychosocial consequences.&#x0D; Bangladesh Journal of Medical Science Vol.19(4) 2020 p.697-704

Behavioural sleep interventions in infants: Plan B - Combining models of responsiveness to increase parental choice.

In families with infants between the ages of 6 and 18 months, sleep disruption can be significant, often putting parents at risk of a range of negative psychological and psychosocial consequences. Commonly prescribed sleep interventions typically involve 'extinction' methods, which require parents to completely or periodically ignore their infant's overnight cries. These methods can be effective in many, but not all cases. For over 40 years 30-40% of parents have consistently reported difficulty ignoring their child. For this group, ignoring their child is behaviourally and/or ideologically difficult with attrition often leading to a perceived sense of failure. For these parents the treatment may be worse than the problem. On the other hand, there is emerging evidence to support the use of more responsive methods for those who find extinction approaches behaviourally or ideologically challenging. In this paper we propose an integrated, less polarised approach to infant behavioural sleep interventions that better caters to those who have difficulty with extinction methods - our so-called 'Plan B'. This approach potentially resolves the often opposing ideological and theoretical perspectives of extinction versus responsiveness into a practical, complementary and pragmatic treatment framework. Recommendations on how best to implement Plan B are also presented. In our view, Plan B could provide practitioners with a logically integrated well-targeted suite of clinical interventions that could potentially improve compliance, reduce attrition and ultimately benefit the sleep and well-being of all infants and their parents, especially those who struggle with traditional extinction methodologies.