Study Participants Research Articles

Finnish translation and linguistic validation of the FACE-Q Head and Neck Cancer Module.

Head and neck cancer (HNC) and its treatment can result in permanent changes to a patient's appearance, speaking, eating, and psychosocial well-being. To better assess the impact of the disease on HNC patients, the FACE-Q Head and Neck Cancer Module, a health-related quality-of-life instrument, was developed. The aim of this study was to produce and linguistically validate a Finnish version of the module. The module was translated into Finnish following the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) guidelines. A total of 51 patients who had undergone tumour resection and reconstruction of the oral cavity, tonsil, or tongue area between 2019 and 2021 were approached for a pilot study. They completed the translated module and provided feedback on any linguistic issues. Adjustments were made based on the pilot study comments. The FACE-Q Head and Neck Cancer Module translated well into Finnish. Twenty-one (41%) patients participated in the survey, 12 men (57%) and nine women (43%) with a median age of 66 years (range 48-89 years). The median time since surgery was 3 years (range 1-4 years). Based on the feedback from the pilot study participants, one word was changed, and one question was rewritten. Otherwise, no deficiencies were identified in the language of the module. In summary, this study produced a linguistically valid Finnish version of the FACE-Q Head and Neck Cancer Module, enabling its application in evaluating the health-related quality-of-life among Finnish HNC patients who have undergone reconstructive surgery.

Real-world patterns in remote longitudinal study participation: A study of the Swiss Multiple Sclerosis Registry.

Remote longitudinal studies are on the rise and promise to increase reach and reduce participation barriers in chronic disease research. However, maintaining long-term retention in these studies remains challenging. Early identification of participants with different patterns of long-term retention offers the opportunity for tailored survey adaptations. Using data from the online arm of the Swiss Multiple Sclerosis Registry (SMSR), we assessed sociodemographic, health-related, and daily-life related baseline variables against measures of long-term retention in the follow-up surveys through multivariable logistic regressions and unsupervised clustering analyses. We further explored follow-up survey completion measures against survey requirements to inform future survey designs. Our analysis included data from 1,757 participants who completed a median of 4 (IQR 2-8) follow-up surveys after baseline with a maximum of 13 possible surveys. Survey start year, age, citizenship, MS type, symptom burden and independent driving were significant predictors of long-term retention at baseline. Three clusters of participants emerged, with no differences in long-term retention outcomes revealed across the clusters. Exploratory assessments of follow-up surveys suggest possible trends in increased survey complexity with lower rates of survey completion. Our findings offer insights into characteristics associated with long-term retention in remote longitudinal studies, yet they also highlight the possible influence of various unexplored factors on retention outcomes. Future studies should incorporate additional objective measures that reflect participants' individual contexts to understand their ability to remain engaged long-term and inform survey adaptations accordingly.

The Connection of Place, Routine Activity, and Financial Exploitation of Older Adults in a Large Retirement Community

ABSTRACT Financial exploitation of older adults is a rapidly growing social problem, and research in this area has largely focused on individual-level risk factors with the role of the community not considered. Given the rapid expansion of retirement communities across the United States, these areas may be emerging as hotspots for financial exploitation. This study presented officially reported administrative trend data on reported cases of financial exploitation and analyzed focus group and interview data collected from 80 residents of a large retirement community to assess the self-reported role of the community on older adults’ financial exploitation experiences and perceptions of risk. Study participants overwhelmingly expressed that they were targeted for financial exploitation immediately and repeatedly after moving into the retirement community and much more frequently than they had experienced before moving. Participants believed they were seen as vulnerable targets and adequate protection measures were not implemented by the retirement community’s management. Retirement community managers and local criminal justice officials should recognize that residents of retirement communities may be at risk for financial exploitation and implement prevention and response strategies.

Decoding Ethnic (Multi-National) Federalism: Its Influence on Conflict Dynamics and Sustainable Peace in Ethiopia

Since its introduction in Ethiopia, the benefits of ethnic federalism in addressing diversity, reducing tensions, and promoting sustainable peace have been debated. On the one hand, ethnic federalism recognizes the authority and right of ethnic groups and identities to self-governance. On the other hand, the country’s federalism has given some ethnic groups a greater advantage over others, even though they have long coexisted in the area and consider themselves owners of the ethnic homeland. The main objective of the study is to examine the impact of ethnic federalism on conflict dynamics and sustainable peace in Ethiopia. Centripetalism theory was employed to examine the impact of ethnic federalism on conflict dynamics and sustainable peace in Ethiopia. A qualitative research approach with a descriptive case study was applied, and interview and document analysis were used to collect data. A purposive and convenience sampling technique was used to select the study participants. The collected data was analyzed thematically. Even though the study’s finding shows mixed results, a significant majority of participants indicated that ethnic federalism has contributed to conflict and affected sustainable peace by exacerbating ethnic divisions, ethnic extremism, competitions among groups, and conflictual inter-regional relations, making some second-class citizens in a territory they consider their homeland. Hybrid federalism (a combination of both ethnic and civic elements) with emphasis on the people’s agreement is recommended as Ethiopia’s best government system.

Dignified care and associated factors among mothers who gave birth at public hospitals, in Sidama Regional State, southern Ethiopia, 2023

BackgroundDignified care is an important priority for childbearing mothers. Threats to this deteriorate the therapeutic relationship between healthcare providers and clients, which leads to a negative effect on the quality of care. However, little evidence is identified about dignified care and associated factors in the Ethiopian context. Therefore, this study aimed to assess dignified care and associated factors among mothers who gave birth at public hospitals in Sidama Regional States, southern Ethiopia, 2023.MethodAn institution-based cross-sectional study was conducted among 418 mothers who gave birth at public hospitals in Sidama Regional States from July 30 to August 30, 2023. A systematic random sampling technique was employed to select study participants. An interviewer-administered structured questionnaire was used, and the data was collected by Kobotool and analyzed using SPSS Version 25. Bivariable and multivariable logistic regression analyses were conducted, and the crude and adjusted odds ratios, together with their corresponding 95% confidence, were computed. A P value < 0.05 was considered a level of statistical significance in this study.ResultsIn this study, the overall study participants’ magnitude of dignified care was found to be 44.1%. Secondary education (AOR: 3.91, 95% CI: 1.56, 9.82), spontaneous vaginal delivery (AOR: 2.68, 95% CI: 1.31, 5.46), the presence of a companion during labor and delivery (AOR: 12.35, 95% CI : 7.08, 21.53), and less than two days hospital stay (AOR: 3.26, 95% CI: 1.37, 7.75), and midwife attendance of labour and delivery (AOR = 4.47 (1.40–14.25) were significantly associated with dignified care.ConclusionsThe findings of this study showed that the dignified care of mothers who gave birth at public hospitals in Sidama Regional State was relatively low to the pooled prevalence of respectful maternity care in Ethiopia. In light of these results, it is recommended to prioritize midwife attendance during labor and delivery, promote the presence of companions, facilitate a shorter hospital stay, and enhance educational opportunities.

Systemic immune-inflammation mediates the association between Klotho protein and metabolic syndrome: findings from a large-scale population-based study.

This study utilized large-scale population data from the National Health and Nutrition Examination Survey (NHANES) to elucidate the relationship between the Klotho protein and metabolic syndrome along with its components. We further investigated the possible mediating effect of inflammation on these relationships. Our objective was to identify biomarkers for risk stratification and potential therapeutic targets for metabolic syndrome. This study enrolled 13,119 participants aged 40-79 years, spanning five NHANES cycles from 2007 to 2016, with complete information on metabolic syndrome and the Klotho protein. The definition of metabolic syndrome followed the criteria of the National Cholesterol Education Program-Adult Treatment Panel III. Survey-weighted logistic regression and subgroup analysis were used to explore the associations between serum Klotho protein levels and metabolic syndrome, along with its components. Mediation analysis was performed to investigate the mediating effects of inflammation-related markers, including white blood cells, neutrophils, lymphocytes, monocytes, the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII) and the monocyte-to-HDL ratio (MHR), with the aim of elucidating how the Klotho protein influences the onset and progression of metabolic syndrome. The study participants had an average age of 56.06 years (95% CI: 55.76-56.37), with a Klotho protein concentration of 798.10 pg/ml (95% CI: 656.50-980.50) and a 43.77% prevalence of metabolic syndrome (n = 5742). In the crude model, Klotho was negatively correlated with metabolic syndrome and its components, including central obesity, hypertension, and hypertriglyceridemia. After adjusting for all confounding factors, Klotho was demonstrated to be negatively associated only with metabolic syndrome (OR: 0.82, 95% CI: 0.70-0.97), hypertension (OR: 0.83, 95% CI: 0.70-0.98), and hypertriglyceridemia (OR: 0.78, 95% CI: 0.67-0.91). Subgroup and interaction analyses revealed significant interactions between age, sex, race/ethnicity, body mass index, and Klotho. Additionally, mediation analysis demonstrated that leukocytes, neutrophils and monocytes accounted for 34.78%, 31.91% and 7.13%, respectively, of the associations between Klotho and metabolic syndrome. The serum concentration of Klotho protein was negatively associated with metabolic syndrome, with the relationship being partly mediated by systemic immune inflammation. The findings of this research revealed that the Klotho protein may be a valuable biomarker for risk stratification and a potential therapeutic target for metabolic syndrome.

Health-related quality of life and complications of corticosteroid treatment in patients with immune thrombocytopenia in two teaching hospitals in Ethiopia: a cross-sectional study

BackgroundThe treatment of immune thrombocytopenia (ITP) is a major clinical challenge and has a significant impact on health-related quality of life (HRQoL), and prolonged use of corticosteroids may have a negative impact on HRQoL.ObjectivesTo evaluate the impact of ITP on HRQoL and complications of corticosteroid treatment in patients with ITP in two teaching hospitals in Ethiopia.MethodsThe institution-based cross-sectional study was conducted from November 15, 2022, to March 15, 2023, to recruit 214 study participants during the study period (4 months). The ITP Life Quality Index (ILQI) in the Amharic version was used to assess the impact of ITP. Linear regression analysis models were also used, and a p-value of less than 0.05 was generally considered statistically significant.ResultsRegarding treatment, the majority 172 (80.4%) of study participants were taking prednisolone only, and 143 (66.8%) of study participants had at least one side effect of corticosteroids during the entire treatment period. Predictive factors for a higher impact of ITP on HRQoL; all correlated variables explained 36.5% (adjusted R-squared = 0.365, p &amp;lt; 0.0001) of the variance and had a moderate impact on HRQoL. Furthermore, predictive factors for an increasingly higher impact of ITP on HRQoL were the development of emotionally related corticosteroid side effects (β = 0.392, 95% CI: 5.160–9.961, p &amp;lt; 0.001), the presence of fatigue during the assessment (β = 0.326, 95% CI: 4.394–9.475, p &amp;lt; 0.001), patients not taking cotrimoxazole prophylaxis treatment (β = 0.236, 95% CI: 2.236–6.570, p &amp;lt; 0.001), living far from the hematology clinic (outside Addis Ababa) (β = 0166, 95% CI: 1.107–5.114 p = 0.003), having epistaxis and/or wet purpura (mucosal bleeding) (β = 0.191, 95% CI: 0.091–4.259, p = 0.001), and skin symptoms (petechiae and ecchymosis) (β = 0.041, 95% CI: 0.091–4.259 p = 0.041) during diagnosis.ConclusionThe impact of ITP on their energy levels and work life was high compared to the impact of ITP on daily life. The side effects of corticosteroids also affect the HRQoL of ITP patients.

The Effectiveness of Remote Exercise Rehabilitation Based on the "SCeiP" Model in Homebound Patients With Coronary Heart Disease: Randomized Controlled Trial.

While exercise rehabilitation is recognized as safe and effective, medium- to long-term compliance among patients with coronary heart disease (CHD) remains low. Therefore, promoting long-term adherence to exercise rehabilitation for these patients warrants significant attention. This study aims to investigate the impact of remote exercise rehabilitation on time investment and related cognitive levels in homebound patients with CHD. This study utilizes the SCeiP (Self-Evaluation/Condition of Exercise-Effect Perception-Internal Drive-Persistence Behavior) model, alongside WeChat and exercise bracelets. A total of 147 patients who underwent percutaneous coronary intervention in the cardiovascular department of a grade III hospital in Jiangsu Province from June 2022 to March 2023 were selected as study participants through convenience sampling. The patients were randomly divided into an experimental group and a control group. The experimental group received an exercise rehabilitation promotion strategy based on the "SCeiP" model through WeChat and exercise bracelets, while the control group followed rehabilitation training according to a standard exercise rehabilitation guide. The days and duration of exercise, levels of cardiac rehabilitation cognition, exercise planning, and exercise input were analyzed before the intervention and at 1 month and 3 months after the intervention. A total of 81 men (55.1%) and 66 women (44.9%) were recruited for the study. The completion rate of exercise days was significantly higher in the experimental group compared with the control group at both 1 month (t145=5.429, P<.001) and 3 months (t145=9.113, P<.001) after the intervention. Similarly, the completion rate of exercise duration was significantly greater in the experimental group (t145=3.471, P=.001) than in the control group (t145=5.574, P<.001). The levels of autonomy, exercise planning, and exercise input in the experimental group were significantly higher than those in the control group at both 1 month and 3 months after the intervention (P<.001). Additionally, the experimental group exhibited a significant reduction in both process anxiety and outcome anxiety scores (P<.001). Repeated measures ANOVA revealed significant differences in the trends of cognitive function related to cardiac rehabilitation between the 2 patient groups over time: autonomy, F1,145(time×group)=9.055 (P<.001); process anxiety, F1,145(time×group)=30.790 (P<.001); and outcome anxiety, F1,145(time×group)=28.186 (P<.001). As expected, the scores for exercise planning (t145=2.490, P=.01 and t145=3.379, P<.001, respectively) and exercise input (t145=2.255, P=.03 and t145=3.817, P<.001, respectively) consistently demonstrated superiority in the experimental group compared with the control group at both 1 and 3 months after the intervention. Interestingly, we observed that the levels of exercise planning and exercise input in both groups initially increased and then slightly decreased over time, although both remained higher than the preintervention levels (P<.001). The remote health intervention based on the "SCeiP" model effectively enhances exercise compliance, exercise planning, exercise input, and cognitive levels during cardiac rehabilitation in patients with CHD. Chinese Clinical Trial Registry ChiCTR2300069463; https://www.chictr.org.cn/showproj.html?proj=192461.

An exploration of attitudes regarding the use of a state tobacco Quitline for smoking cessation among low-income adults with a history of smoking.

Smoking rates among low-income smokers are significantly elevated. State tobacco quitlines offer free and evidence-based treatments for smokers living in that state. This study investigated knowledge, attitudes, and beliefs associated with engagement with the Illinois Tobacco Quitline among confirmed smoking patients at a Federally Qualified Health Center (FQHC). Further goals were to obtain recommendations for strategies to improve patient awareness and engagement. Data for this study were collected from August to October 2021 from patients receiving care in an FQHC in a large midwestern city in the USA. Clinic-based recruitment was used to enroll a sample of adult current smokers. In-depth interviews and brief surveys were completed with a volunteer sample of patients recruited from an FQHC. The interviews took approximately 60 minutes. Data analysis used descriptive statistics to summarize the responses to the study and deductive thematic analysis to analyze the qualitative interviews. Study participants (n=25) were primarily male, African American, and middle-aged (mean age: 52.5 years). The majority were daily smokers. Over half had heard about the Quitline from sources such as radio advertisements, but usage was low. Barriers to use included low motivation to quit, questions about effectiveness, and poor success with prior Quitline attempts. Participants described factors that would increase the appeal of the Quitline, including testimonials, personalization, and an empathetic approach. Participants were asked about the acceptability of receiving information about the Quitline via patient portals, and most were in support. Interventions are needed to raise awareness and utilization of Quitlines among patients receiving care in FQHC settings. Distribution of Quitline information via patient portals is an acceptable strategy for increasing awareness of services.

The Morality of Care: Female Family Caregivers' Motivations for Providing Care to Older Migrants.

Finding suitable long-term care arrangements for older migrants in Europe, including Norway, has been a major concern for healthcare policymakers in the last decade. However, many older people with migrant backgrounds, and to a certain extent their descendants, often prefer that care arrangements are managed within the family. Although caring for family members may be personally satisfying, it can also be a source of distress. This study explores the motivations of care among female family caregivers of older Pakistani migrants within the Norwegian Ahmadiyya community. Our data are derived from a qualitative study including individual and group interviews with 19 female family caregivers. The study participants were aged 25-62 and resided in Norway. The interviews were conducted in Urdu and English and later transcribed verbatim in English. Our findings resulted in four main themes regarding motivations for caregiving: (1) "Who else, if not the family?": care perceived as a family obligation; (2) The divine duty of caregiving; (3) Women are better at caregiving; and (4) "What will people say?": fear of judgments. The intersection of culture, religion, gender, and migration shaped caregiving as a moral practice, and those providing care were considered individuals with high moral identity. The moral identity assigned to the role of family caregivers appears to exacerbate rather than alleviate the care burden on women of migrant origin. Understanding the motivations for caregiving can shed light on ways in which better support can be provided to ethnic minority families with aging members.

Delirium risk profiles in a population-based study of United States older adults undergoing common noncardiac surgeries.

Older adults often require surgical care and are at elevated risk of delirium. We explored delirium risk profiles across the population of U.S. older adults who underwent one of 10 common noncardiac surgeries. We analyzed Health and Retirement Study (HRS) participants linked with Medicare billing data who underwent the following 10 noncardiac surgeries from 2000 to 2018 at age 65 or more: total knee arthroplasty (TKA), total hip arthroplasty (THA), spine surgery, cholecystectomy, colorectal surgery, hernia repair (ventral, umbilical, or incisional), endarterectomy, prostatectomy, transurethral resection of the prostate (TURP), and hysterectomy. Demographic and health covariates were obtained from the HRS dataset. Latent cognitive ability was calculated from cognitive testing, proxy reports, and demographics at the preoperative HRS interview. We compared standardized differences for delirium risk factors across the 10 surgeries and qualitatively clustered them into phenotypical subgroups. We analyzed 7424 older adults (mean age 76 ± 6 years, 45% male). Endarterectomy patients presented with the highest burden of nearly all health and cognitive factors, implying higher delirium risk (e.g., stroke, 22%; depressive symptoms, 30%; high school or less education, 73%; frailty, 42%; lowest latent cognitive ability). A second "general surgery" phenotype, including cholecystectomy, colorectal, and hernia surgery patients, experienced more frailty (29%-32%) and depressive symptoms (24%-26%), with moderate comorbidity burden. A third "pain" phenotype, which included TKA, THA, and spine surgery patients, commonly reported moderate or severe pain (47%-53%) and impairment in activities of daily living (ADL, 23%-30%), but fewer comorbid medical conditions. The remaining surgery types (hysterectomy, prostatectomy, TURP) were not phenotypically grouped and generally had lower risk features for delirium. In an epidemiological cohort of US older adults, we identified clinically meaningful heterogeneity in delirium risk profiles across different surgical types, which may have implications for delirium risk stratification and delirium prevention or treatment.

The psychological empowerment and quality of work life among Jordanian primary care nurses and midwives

IntroductionThe healthcare industry, particularly in the context of primary care, presents various challenges to nurses and midwives, influencing their psychological empowerment (PE) and quality of work life (QWL).ObjectiveThis study’s objective is to assess the levels of PE and QWL among Jordanian primary care nurses and midwives and explore the relationship between PE and QWL.MethodsUtilizing a descriptive correlational design, the study included 273 Jordanian primary care nurses and midwives through convenience sampling. The Psychological Empowerment Instrument and Brook’s Quality of Nursing Work Life Survey were used to measure PE and QWL. Data was analyzed using descriptive statistics to describe the study participant’s characteristics and inferential analysis such as Pearson correlation, and multiple regression to examine relationships and identify predictors of study variables.ResultsThe study found that the QWL scale had high reliability (Cronbach’s alpha = 0.954), and similarly, the PE scale demonstrated strong reliability (Cronbach’s alpha = 0.948). Moving on to the core findings, significant positive correlations were identified between PE and QWL, with a correlation coefficient of r = 0.568 (p &amp;lt; 0.01), indicating that higher levels of psychological empowerment were associated with better quality of work life. Furthermore, the regression analysis revealed that PE accounted for approximately 32.3% of the variability in QWL scores. Interestingly, participants holding diplomas reported the highest QWL scores (mean = 136.14), while those contemplating leaving the nursing profession displayed significantly lower QWL scores (mean = 114.14). No significant correlations were found between PE and sociodemographic variables such as age, income, and years of experience.ConclusionThis study reveals a crucial need to enhance PE and QWL. Key findings show moderate PE and QWL levels, with variations based on educational background and workplace. The positive correlation between PE and QWL identifies the benefits of fostering empowerment through professional development, job autonomy, and decision-making. These insights are vital for improving nursing practice and policy and enhancing nurse satisfaction and patient care.

Knowledge on Complications of Recurrent Tonsillitis and its Surgical Management among Parents/Guardian of Paediatric Patients Receiving Services at the Otorhinolaryngology Department at BMC Mwanza Tanzania

Background: Tonsillitis refers to inflammation of the palatine tonsil and most often occurs in children. Recurrent tonsillitis is defined as more than seven attacks within one year, more than five attacks a year within a two-year period, or more than three attacks a year within a three-year period. The global incidence and prevalence of tonsillitis are not completely known, the research indicates that 15-30% of sore throats in children and 5-10% of sore throats in adults are bacterial tonsillitis. Method: This is a cross-sectional descriptive study with span from May 2024 to August 2024. Results: 385 participants were enrolled in the study; 60.8%of the participants were aged from 21 years to 30 years which was the majority. About 317(82.3%) parents/guardians responded that recurrent tonsillitis has an effect on the child's health, whereas 68 (17.7%) reported that recurrent tonsillitis has no effect on the child's health. Complications of recurrent tonsilitis reported to be known by parent /guardian were snoring (sleep apnoea) 111 (28.8%), ear problems like otitis media 2(0.5%), hearing loss 1(0.3%) heart problem (0.8%), renal problem 3(0.8%), affect the growth of the child 6 (1.6%), missing school 11 (2.9%). 183(47.5%) of the study participants reported that they don’t know about any complications that their child may get after surgery, while other parents/guardians reported that the child can suffer pain after surgery 99(25.7%), intraoperative or postoperative bleeding 3(0.8%) others reported that the child can get pain during eating 8(2.1%)

Cannabinoids for obstructive sleep apnea: A systematic review.

Cannabinoids have emerged as a potential treatment for obstructive sleep apnea (OSA). This systematic review aimed to summarize the efficacy and safety of cannabinoids to treat OSA. Databases including Ovid MEDLINE, EMBASE, Scopus, PsycINFO, and International Pharmaceutical Abstracts were searched; experimental and observational studies were eligible for inclusion. One-hundred seventy unique records were screened, and nine studies included: five full-text studies and four published abstracts. The five full-text studies were judged for quality appraisal: two studies deemed at low risk for bias, one study deemed to have some concerns for bias, and two studies deemed to have high risk for bias. Seven of nine total studies were experimental designs and evaluated dronabinol, and the other two studies were observational designs evaluating cannabis. The range of cannabinoid therapy duration spanned from 1 to 6 weeks, and the median duration was 3 weeks. Eight of nine total studies reported statistically significant, positive OSA outcomes due to cannabinoid therapy including reductions in the apnea hypopnea index and improvements in patient-reported daytime sleepiness scales. Between 70% and 80% of study participants reported neuropsychiatric and gastrointestinal adverse events attributable to cannabinoids. The American Academy of Sleep Medicine does not recommend using cannabinoids to treat OSA due to a lack of long-term safety and efficacy data. This systematic review found similar limitations, with the median cannabinoid treatment duration being only 3 weeks. Adequately powered experimental trials over longer time frames are necessary to more completely assess the long-term efficacy and safety of cannabinoids in the treatment of OSA and its effects on common comorbid conditions, such as obesity and cardiovascular disease.

Adverse childhood experiences and ICD-11 complex posttraumatic stress disorder in Poland: a population-based study

ABSTRACT Background: Research on the prevalence of ICD-11-based complex posttraumatic stress disorder (CPTSD) in nationally representative samples is lacking, with no such studies conducted considering national Polish samples until now. Objectives: The primary aim of this study was to explore profiles of study participants in terms of either PTSD or CPTSD symptoms regarding to ICD-11 diagnosis with the aid of latent profile analysis. We also investigated the relationship between the types and cumulative number of adverse childhood experiences (ACEs) with the probability of CPTSD rate in a national sample of Poles. Methods: A representative sample of Polish adults (n = 3,557) participated in this study. ACEs were assessed using the Adverse Childhood Experiences Questionnaire, while the core features of PTSD and CPTSD were measured using the International Trauma Questionnaire. Results: The findings showed a 11% prevalence rate of probable CPTSD in the studied sample of Poles. Sexual abuse, emotional neglect, physical neglect and having the experience of a mentally ill household member were the most significant predictors of potential diagnosis. Furthermore, significant differences concerning lifestyle data were observed in the group of participants with CPTSD. Conclusions: The current rate of probable CPTSD in Poland is substantially higher than the respective data reported for other countries. We also noted that the ICD-11 diagnosis of CPTSD may not apply to all cultural environments. Finally, it was observed that the ACEs – CPTSD association may depend both on the ACEs types as well as on their overall cumulative character.

Fibromyalgia is associated with increased odds of prior pain-precipitated relapse among non-treatment-seeking individuals with opioid use disorder

Background/Objectives Chronic pain is an opioid use disorder (OUD) treatment barrier and associated with poor outcomes in OUD treatment including relapse. Fibromyalgia is a chronic pain condition related to central nervous system substrates that overlap with the brain disease model of OUD. We know of no studies that have looked at non-treatment seeking individuals, to see if fibromyalgia might represent a barrier to OUD treatment. Given many non-treatment-seeking individuals previously attempted recovery before experiencing relapse, and chronic pain is a known precipitant of relapse, fibromyalgia might be a currently unappreciated modifiable factor in OUD relapse and, potentially, a barrier to treatment reengagement among those not currently seeking treatment. This study aimed to determine if fibromyalgia is associated with greater odds of agreeing that ‘I have tried to stop using opioids before, but pain caused me to relapse’ among non-treatment seeking individuals with OUD. Methods This cross-sectional study recruited non-treatment-seeking individuals with OUD (n = 141) from a syringe service program. Ordinal logistic regression was used to determine if the presence of fibromyalgia increased the odds of agreement with prior pain-precipitated relapse. Results Fibromyalgia was identified in 35% of study participants and associated with 125% greater odds of strongly agreeing that pain had previously caused them to relapse, even after accounting for relevant covariates, including age, sex, depression, anxiety, OUD severity, and pain severity. Conclusions This study provides early evidence that the presence of fibromyalgia may be associated with increased odds of pain-precipitated OUD relapse.

Knowledge, attitude, and practices towards hepatitis infection and its associated factors among adults in Gondar town, northwest Ethiopia; a community-based study, 2021

BackgroundHepatitis virus infection remains a serious public health concern worldwide. Percutaneous, mucosal, or non-intact skin exposure to infectious blood, semen, and other body fluids are the major routes of infection in endemic areas, including Ethiopia, where little is known about the community’s knowledge, attitudes, and practice toward hepatitis infection. Thus, this study aimed to determine the knowledge, attitude, and practices towards hepatitis infection among adults in Gondar town.MethodsA community-based cross-sectional study was conducted from July to August 2021 on a total of 390 participants. Proportional sample allocation was used in 3 randomly selected sub-cities. Then, study participants from randomly selected households were recruited by using a systematic random sampling technique. Socio-demographic data and questions regarding KAP were collected via a self-administered and interviewer-administered questionnaire. Statistical analysis was performed using SPSS version 20. Logistic regression analyses were used to identify the associated factors and a p-value < 0.05 was considered statistically significant.ResultsThe mean age of the study participants was 30 ± 8.43 years and more than half ½ (53.3%) ranged from 26 to 40 years old. In this study, 335 (85.9%) of study participants had poor knowledge about hepatitis infection. About 344 (88.2%) had a negative attitude toward hepatitis infections, and 344 (88.2%) of the participants had a poor practice to prevent hepatitis infections. Multivariate analysis affirmed that having vaccination for hepatitis infection was significantly associated with a positive attitude (AOR, with 95% CI: 2.135 (1.006–4.532) and good practice levels (AOR, with 95% CI: 22.623 (0.032–0.156).Conclusions and recommendationsIn this study majority of the participants have poor knowledge, attitudes, and practices toward hepatitis infection. Therefore, targeted community-based interventions are necessary. However, this study revealed that having vaccination for hepatitis infection was significantly associated with a positive attitude and good practice levels among the study participants.

Self vs. Other in Affective Forecasting: The Role of Psychological Distance and Decision from Experience

This work tests self–other differences in the impact bias using the perspectives of psychological distance and decision from description vs. experience. Two studies compared the bias participants made for themselves and for others in a sequential gambling task. The task involved two identical gambles where the first gamble was mandatory and participants made decisions (accept or reject) for the second gamble. Planned decisions were made anticipating a gain or loss in the first gamble, and revised decisions were made following the actual experience of gain or loss. Study 1 compared decisions for self, abstract other, and a close friend. Study 2 replicated the comparison between the self and a close friend and added a measure of empathy. Both studies demonstrated an impact bias indicating that participants tended to overestimate the impact of anticipated outcomes on their tendency towards risk. Specifically, revised decisions indicated risk-aversion shifts after experienced gain and risk-seeking shifts after experienced loss. A reversed pattern emerged for close friends, indicating risky shifts after gain and cautious shifts after loss in Study 1 and for highly empathetic participants in Study 2. Assessing the utility functions that underlie participants’ decisions revealed a qualitative difference. The utility function for the self was consistent with prospect theory (with moderate intensity and diminishing sensitivity), while the utility function for others was more intense with little or no diminishing sensitivity. This research offers new insights regarding the roles of psychological distance and description vs. experience in affective forecasting and impact bias for self vs. other.

Using normalisation process theory (NPT) to explore implementation of the maternal perinatal death surveillance and response (MPDSR) policy in Uganda: a reflection

BackgroundThe implementation of the maternal perinatal death surveillance and response (MPDSR) policy is among the envisaged strategies to reduce the high global burden of maternal and perinatal mortality and morbidity. However, implementation of this policy across various contexts is inconsistent. Theoretically informed approaches to process evaluation can support assessment the implementation of policy interventions such as MPDSR, particularly in understanding what the actors involved actually do. In this article, we reflect on how the normalisation process theory (NPT) was used to explore implementation of the MPDSR policy in Uganda. NPT is a sociological theory concerned with the social organisation of the work (implementation) of making practices routine elements of everyday life (embedding) and of sustaining embedded practices in their social contexts (integration).MethodsThis qualitative multiple case study conducted across eight districts in Uganda and among 10 health facilities (cases) representing four out of the seven levels of the Uganda health care system. NPT was utilised in several ways including informing the study design, structuring the data collection tools (semi-structured interview guides), providing an organising framework for analysis, interpreting and reporting of study findings as well as making recommendations. Study participants were purposely selected to reflect the range of actors involved in the policy implementation process. This included direct care providers located at each of the cases, the Ministry of Health and from agencies and professional associations. Data were collected using semi-structured, in-depth interviews and were inductively and deductively analysed using NPT constructs and subconstructs.Results and conclusionNPT served useful for process evaluation, particularly in identifying factors that contribute to variations in policy implementation. Considering the NPT focus on the agency of people involved in implementation, additional efforts are required to understand how recipients of the policy intervention influence how the intervention becomes embedded within the various contexts.

Exploring the multifaceted impact of breast cancer on the body image

AbstractThe goal of the study is to describe variables contributing to body image concerns among breast cancer survivors to foster positive body image. Participants for this qualitative study were recruited through convenience sampling (N = 10). The participants' ages ranged from 48 to 80, with an average of 64 years old. Data were analyzed using reflexive thematic analysis. Four themes concerned with body image were age at diagnosis, intimate partnership, preparedness for physical changes, and mental fluidity. Results from this study were used to develop strategies that can be adopted to improve the body image of cancer patients and survivors.