Psychological Consequences Research Articles

A systematic review of suicide among Iranians physicians, etiology and solutions

Suicide is a multifaceted public health problem that, unfortunately, remains the leading cause of death worldwide. Studies show that the rate of mental illness, particularly suicide, is higher among doctors than among the public, and the risk of depression and suicide among doctors has also increased. Interventions such as resilience and mindfulness programs can reduce suicidal thoughts among medical students. Suicide prevention programs should target high-risk groups, such as physicians. Studies have shown that medical students and physicians are at higher risk of suicide than the general population. The prevalence of mental health issues and suicidal thoughts increases during medical school. Psychological factors, such as burnout, depression, anxiety, and hopelessness, can lead to suicidal thoughts. Considering the worldwide significance of this issue and the recent increase in mortality among youthful Iranian physicians, we conducted and investigated the prevalence and possible causes of suicidal ideation among Iranian medical students and graduates in this study. The problem of suicides among Iranian doctors and the sudden increase in the deaths of doctors, especially young people, is dangerous. Suicides among Iranian medical, dental, and pharmacy students have increased in recent years. It may be beneficial to support populations at high risk for suicidal ideation and provide screening for early intervention, as well as raise awareness of the prevalence and impact of suicidal thoughts among male students, school officials, and teachers. Screening should include individuals with a family history of mental health issues and those who are separated from their parents, as these individuals are at increased risk for suicidal thoughts. Reducing the prevalence of suicidal ideation may benefit from smoking cessation interventions and stress-reducing curricula. In addition, studies show that work stress among Iranian doctors and dentists can affect their work and treatment. Controlling and managing occupational stress is vital to prevent future problems, as it can have physical and psychological consequences. High levels of occupational stress among these doctors can also pose a danger to their patients. Identifying the causes of physician suicide can help to control and manage it.

Appearance-related cyberbullying and its association with the desire to alter physical appearance among adolescent females

Cyberbullying is associated with various mental health concerns in adolescents, including body dissatisfaction and disordered eating behaviours. However, there is a significant research gap concerning the unique effects of appearance-related cyberbullying (ARC) on adolescent mental health. This study examined the prevalence and psychological consequences of ARC among middle to late adolescent females (aged 14–19 years, Mage = 15.98, N = 336). Participants completed an online survey regarding their experiences of ARC, body image variables, and eating disorder symptomology. Findings indicate the widespread occurrence of ARC among adolescent females, with body shape and size emerging as predominant targets. Experiences of ARC-victimisation positively correlated with increased concerns about body shape, body shame, and eating disorder symptomology. Conversely, experiences of ARC-victimisation were negatively correlated with body esteem and body appreciation. Finally, appearance-related cybervictimisation was significantly associated with adolescent females’ desire to pursue appearance alterations through methods such as dieting and exercising, altering self-presentation, and undergoing cosmetic procedures due to perceived experiences of ARC. These findings highlight the urgent need for preventative measures, such as age-appropriate social media policies and health promotion programs that encourage positive online behaviour, and strategies to address the impacts of ARC to protect the mental well-being of adolescent females.

A latent profile analysis and network analysis of anxiety and depression symptoms in Chinese widowed elderly

BackgroundWidowhood, as a traumatic event in the aging process, may lead to adverse psychological consequences such as anxiety and depression. However, the heterogeneity of anxiety and depression comorbidity patterns in widowed elderly and the interrelationships between symptoms have not been adequately studied. Method10,239 elderly aged 65 years and older were screened from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2017–2018), to assess depression and anxiety using the Center for Epidemiologic Studies Depression Scale (CESD) and the 7-item Generalized Anxiety Disorder Questionnaire (GAD). The subgroups of widowed elderly with similar patterns of symptoms were identified by latent profile analysis (LPA). The structure of anxiety-depressive comorbidity network was characterized using “bridge expected influence” as centrality indices. Network stability was tested using a case drop bootstrap program. A network comparison test (NCT) was performed to examine the differences in network characteristics across LPA subgroups. ResultLPA identified dichotomous profiles: low comorbid (n = 4457) and high comorbid (n = 692). NCT revealed a significant difference in the global strength between networks (S = 0.631, p < 0.001). GAD1 (Nervousness or anxiety) is the common bridging symptom for both networks, while the bridging symptom for the high comorbidity network also includes GAD3 (Generalized worry). LimitationsCross-sectional methods are unable to verify causal relationships, and further randomized controlled trials are warranted. ConclusionAnxiety-depressive pattern in Chinese widowed elderly can be categorized into a low comorbid or a high comorbid group. GAD3 (Generalized worry) can be used as the core intervention target during intervention.

Psychological Fallout of Sexual Harassment on Women across Various Social Contexts

Sexual harassment (SH) poses a significant threat to mental health, causing profound emotional distress, particularly among women. Despite legal frameworks, the psychological consequences of SH are inadequately addressed. This study examines the prevalence, manifestations and effects of SH through a structured literature review, using sources such as Google Scholar, PsycINFO and PubMed for articles published after 2018 on the psychological effects of SH. The review process included initial screening based on relevance and quality, methodological evaluation and narrative synthesis. The findings reveal SH’s severe psychological impact across various settings, including workplaces, educational institutions and intimate relationships, with consequences like fear, anxiety, shame, depression and confidence erosion. Reluctance to report SH further exacerbates the psychological toll. The study highlights the need for comprehensive strategies, recommending accessible mental health services, educational campaigns and stronger policies. Fostering a culture of respect, equality and inclusion can enhance survivors’ well-being and create a supportive environment.

Intimate Partner Violence and Help-Seeking Among Iranian Women: Exploring the Role of Compassion and Psychological Consequences

Intimate partner violence (IPV) is pervasive in Iran, with limited research exploring help-seeking. Using path analysis we investigated the extent of IPV, help-seeking, and distress along with compassion for oneself and one’s spouse. Direct effects revealed: (1) IPV was positively associated with help-seeking, distress, and compassion for one’s partner, and negatively related to self-compassion, (2) Help-seeking was positively related to distress and compassion for one’s partner, (3) Self-compassion was negatively related to distress, whereas compassion for one’s partner was positively related. Indirect effects were found between (1) IPV and help-seeking through compassion for one’s partner, (2) IPV and distress through help-seeking, self-compassion, and compassion for one’s partner, and (3) each form of compassion and distress through help-seeking.

Teachers and Counselors Talk: The Psychological Impact of COVID-19 School Closures on Secondary School Students.

The COVID-19 pandemic significantly impacted students' education, mental health, and social well-being. Our research explores the experiences and perceptions of teachers and counselors of the psychological impact of COVID-19 school closures on secondary school students after returning to school. In this qualitative study, 21 teachers and counselors in Iran were purposefully involved and interviewed in-depth using a semi-structured format. The data was analyzed using Van Manen's 6-step phenomenological method, and Lincoln and Guba's criteria were implemented to maintain accuracy and trustworthiness. We have identified 15 categories and 6 themes. These themes encompass issues such as low self-esteem due to emotional or psychological damage, instability within schools, challenges faced by students with family problems, lack of motivation and patience among students, frustration experienced by students, and emotional detachment. To effectively guide and educate students, teachers and counselors must prioritize the psychological well-being of students absent from school due to illness or pandemics. They must also take adequate measures to address any arising psychological complications. Teachers and counselors must recognize and consider the psychological consequences of students absent; this will help develop effective measures to address and alleviate psychological complications.

The Attend-PE model: A feasibility study of a structured follow-up care model for patients with pulmonary embolism.

BackgroundPulmonary embolism may have both physical and psychological consequences for the affected person. Guidelines recommend structured follow-up care, yet this is still not widely practised. Therefore, a national research project was initiated in Denmark in 2021, with the aim of developing, testing, implementing, and evaluating a structured post-pulmonary embolism follow-up care model, ‘Attend-PE’. The objective of this feasibility study was to examine the fidelity, acceptability, and appropriateness of the Attend-PE model in a Danish hospital setting. MethodsThis feasibility study was conducted in two Danish hospitals, using a prospective study design with six months' follow-up. The fidelity, acceptability, and appropriateness of the Attend-PE model's components were evaluated using surveys, registrations sheets, and interviews with two physicians, three nurses, and 29 patients. Qualitative data were analysed using a deductive content analysis, while quantitative data were analysed using descriptive statistics. ResultsFidelity with the Attend-PE model was good, with a high participation rate of patients in all components of the model. Acceptability was likewise good, as both patients and health care professionals expressed a high level of satisfaction with the model. The health care professionals considered the model to be relevant and suitable in a Danish hospital setting, confirming appropriateness of the model. ConclusionThis study showed that the Attend-PE model for patients with pulmonary embolism is feasible and acceptable in a Danish hospital setting.

Childhood environment and patience: Early-life resource scarcity and current threat influence duration estimation and persistence

Childhood environment has a significant influence on individuals' psychology and behaviors. Those who grow up in harsh environments with resource scarcity and uncertainty tend to develop impatience and prefer investing resources in the present rather than the future. We hypothesized that childhood environment also affects patience in terms of duration estimation. In this research, we explored the effects of childhood resource scarcity and economic threat on the duration estimation and the persistence through three studies. Study 1 and Study 3 found that individuals growing up in resource-scarce environments tended to overestimate time and exhibited lower persistence in the economic threat situation. Moreover, duration estimation mediated the influence of childhood socioeconomic status on persistence. Study 2 provided causal evidence that priming childhood resource scarcity affected the duration estimation. The findings showed that individuals growing up in resource-scarce environments tended to overestimate the time cost of the task when facing threats, which led to impatient behavior. The present research investigated the effect of childhood resource scarcity on duration estimation for the first time, offering a novel perspective on time perception to comprehend the psychological and behavioral consequences of life history strategies.

Narrative Time and Moral Injury in Daniel Defoe’s The Fortunate Mistress

ABSTRACT This paper explores the deliberate use of temporal ambiguities and discrepancies in Defoe’s The Fortunate Mistress to convey the disturbed retrospections of a guilt/shame-ridden narrator and the relationship between moral injury and temporal narrative techniques, highlighting the gendered nature of the fictional narrator’s moral injury. Drawing on Pederson’s model of moral injury in literature, which deals with perpetrator trauma, it argues that the narrator’s moral injury and its temporal reflexes in the narrative serve to reinforce the thematic and narratorial (re)iterations of female trauma and subsequent moral injury. Ultimately, this analysis provides compelling evidence of Defoe’s astute understanding of the psychology of shame, guilt, and narration, as well as his preference for psychological realism over traditional sequential narration, as he crafts stories that explore the human and psychological consequences of traumatic experiences.

Effectiveness of the Life Enhancement and Advancement Program for Weight Management in Overweight and Obese Females.

Obesity has been shown to have many deleterious physical and psychological consequences. This study examined the effectiveness of adding the Life Enhancement and Advancement Program (LEAP) to a weight management program. To evaluate the different components of a weight loss program, this study included four groups: (1) dieting, exercise, and LEAP; (2) dieting, exercise, and sham training; (3) dieting and exercise; and (4) exercise only. An assessment was administered at baseline, post-intervention, and a three-month follow-up. Forty female participants with a body mass index (BMI) ≥ 25 were recruited from a local sports center. They provided informed consent and were randomly assigned to one of the four groups. Participants' heights were recorded at baseline, and their weight, waist circumference (WC), and BMI were measured at each of the three assessments. Participants completed the Personal Concerns Inventory (PCI) to assess their adaptive motivation at all three assessments. A MANCOVA indicated that participants who received LEAP along with dieting and exercise had a greater reduction in BMI and WC and improved more in adaptive motivation than the other groups. The results suggest that adding LEAP to a weight management program enhanced participants' ability to achieve and maintain weight loss. LEAP enabled participants to pursue and achieve their important goals successfully.

PSTD Treatment of Joint Forces Operation Combatants: A Case Study.

The participation of military personnel in operations like the Anti-Terrorist Operation (ATO)/Joint Forces Operations (JFO) can lead to significant psychological trauma, potentially resulting in posttraumatic stress disorder (PTSD). Understanding the effectiveness of psychotherapy in treating PTSD among ATO/JFO participants is crucial given its profound impact on personal relationships, life scenarios, and overall well-being. This study evaluates how acceptance and commitment therapy can alleviate PTSD symptoms and enhance well-being in Ukrainian military personnel with combat-related PTSD. The main research method was a psychological experiment, and the case study method was used as an auxiliary research method. The study revealed the following: combatants in the ATO/JFO who have been diagnosed with PTSD should be classified as persons with disabilities due to certain limitations in their life activities, namely, the inability to control their behavior, and difficulties in work and communication. This study proves that cognitive-behavioral psychotherapy has a clear advantage in overcoming PTSD in the military, as it allows transforming psychological trauma into posttraumatic growth. Attachment and acceptance therapy, a form of behavioral therapy, has emerged as one of the most effective treatments for PTSD. It focuses on diagnosing and addressing the psychological consequences of war by analyzing the connections among cognition, affect, and behavior. Given the protracted nature of PTSD, the practical significance of the study is to develop effective psychotherapeutic interventions for the expected recovery of ATO/JFO participants affected by combat operations.

Childhood Maltreatment and Perinatal Complications: A Scoping Review of Official Health Data.

Child maltreatment (CM) poses significant risks to victims, resulting in enduring physical, psychological, and developmental consequences. Adult survivors of CM seem especially vulnerable to perinatal complications. However, existing research on perinatal outcomes presents mixed results and relies heavily on self-reported data, which may not align with official medical data. Hence, a systematic review using official health data may provide clarity on this association; it may orient future research and the provision of perinatal services. This scoping review aimed to synthesize and evaluate the quality of the literature that utilizes official health data to explore associations between CM and perinatal complications. Following Arksey and O'Malley's model, searches across four databases (PsycINFO, MEDLINE, Scopus, and ProQuest Dissertations/Thesis) produced 8,870 articles. After screening, 23 articles met the inclusion criteria (e.g., recorded perinatal complications using official health data, and peer-reviewed studies or dissertation). Evidence indicates CM survivors have less prenatal care visits, more fetal loss and preterm births, lower gestational age, and increases in emergency cesarean sections. Adults had more cervical insufficiency, lower episiotomies and sphincter ruptures, and overall pregnancy and postpartum complications while adolescents had lower Apgar scores. No associations were observed on other outcomes (e.g., vaginal bleeding, group B streptococcus, and fetal distress). Mixed findings emerged for other perinatal and maternal health concerns such as birth weight and blood pressure. CM survivors may face an increased risk of experiencing perinatal complications. Findings point to the relevance of leveraging health data for CM research and adopting trauma-informed practices in perinatal services.

Supervisor’s neuroticism and problematic Internet use among graduate students: the mediating role of supervisor-student relationship quality and the moderating role of fear of the supervisor’s negative evaluation

BackgroundGraduate students exhibit vulnerability to problematic Internet use, which can result in adverse physical, psychological, and social consequences. However, limited studies have addressed this issue among graduate students, and even fewer have explored the unique factors contributing to their problematic Internet use. Therefore, to address this gap, the current study aims to probe the relationship between supervisor’s neuroticism and problematic Internet use among graduate students, the mediating effect of the supervisor-student relationship quality, as well as the moderating effect of fear of the supervisor’s negative evaluation.MethodsA cross-sectional study was conducted in 2018 at three universities in Beijing, China. Anonymous data from 448 graduate students were collected regarding problematic Internet use, supervisor’s neuroticism, supervisor-student relationship quality, and the fear of the supervisor’s negative evaluation. A moderated mediation analysis was performed using Hayes’ PROCESS macro (Model 14).ResultsSupervisor’s neuroticism was positively linked to graduate students’ problematic Internet use, supervisor-student relationship quality mediated the linkage, and fear of the supervisor’s negative evaluation played a moderating role in the second stage. Specifically, for students lower in fear of the supervisor’s negative evaluation, supervisor-student relationship quality negatively predicted students’ problematic Internet use. While for the graduate students higher in fear of the supervisor’s negative evaluation, supervisor-student relationship quality could not significantly predict students’ problematic Internet use. The mediating effect was only significant for graduate students lower in fear of the supervisor’s negative evaluation.ConclusionsThis study established a theoretical model linking supervisor’s neuroticism to graduate students’ problematic Internet use, highlighting the potential roles of supervisor-student relationship quality and fear of the supervisor’s negative evaluation. Reducing the neuroticism level of the supervisor, enhancing the quality of the supervisor-student relationship, and mitigating students’ fear of the supervisor’s negative evaluation will contribute to the reduction of problematic Internet use among graduate students.

Mindfulness-based eating awareness training versus itself plus implementation intention model: a randomized clinical trial

BackgroundObesity causes many physical and mental illnesses. This study compares mindfulness-based eating awareness training (MB-EAT) versus MB-EAT plus implementation intention model for effectiveness on body mass index (BMI), weight self-efficacy, and physical activity in obese women with BMIs ≤ 25 (n = 52).MethodsIn this randomized clinical trial, the participants were selected by the simple random sampling method and randomly divided into three groups. A 12-session MB-EAT of 150 min per session was performed for experimental group I. The experimental group II received MB-EAT alone for physical activity planning and MB-EAT plus implementation intention; also, both groups were compared to the control group. Data were measured by the scales, a questionnaire, and a checklist, and the P-values are based on the results of the generalized estimating equation (GEE) test. P < 0.001 were considered the significance level.ResultsThe MB-EAT and MB-EAT + implementation intention effectiveness on the two experimental groups’ BMI, weight self-efficacy, and physical activity was significantly different from the control group. In the integrated group versus the MB-EAT group, BMI, physical activity, and physical discomfort, were more effective than the weight self-efficacy subscales. Both intervention groups were effective on BMI, weight self-efficacy, and physical activity, but the integrated group's effectiveness was more.ConclusionsThe MB-EAT effectiveness trial is theory-based, reducing weight and the psychological and behavioral consequences of overweight and obese adults. The MB-EAT + the Implementation intention model is to plan regular and daily exercise according to each individual's specific circumstances.Trial registration: The trial registration number: (IRCT20200919048767N1).

Chronic pain in breast cancer survivors is linked with an impairment on emotion-based decisions and fatalistic time orientation

AbstractAfter breast cancer diagnosis, individuals have to cope with various psychological, social, and physical consequences. One such consequence is chronic pain, which can persist even after the completion of active treatments and detrimentally impact quality of life. The published literature highlights the impact of chronic pain on cognitive functions and on decision-making processes. However, little is known about the imbalance in decision-making among cancer survivors suffering from chronic pain. This study aims to explore the cognitive impairment associated with risky decision-making in breast cancer survivors experiencing chronic pain, using the Iowa Gambling Task (IGT). Sixty women voluntarily participated in this prospective, cross-sectional study. Among them, twenty had a history of breast cancer and exhibited a significant level of chronic pain, twenty had previously received a cancer diagnosis but did not experience chronic pain, and twenty had not been diagnosed with cancer. The results revealed that women with chronic pain tend to make significantly more disadvantageous choices in the IGT compared to the other groups. Moreover, participants with chronic pain tend to believe that circumstances will change regardless of their efforts to achieve something. This way of thinking may contribute to reinforcing the observed imbalance in decision-making. Our hypothesis suggests that chronic pain may trigger a “Cascade Effect”, exerting multiple influences on decision-making and behaviors. The cognitive overload provoked by chronic pain in breast cancer survivors may not only affect individual cognitive functions, but also have a “Cascade Effect” on other psychological dimensions.

Occupational Stress in Healthcare Professionals in Spain: A Multicenter Study.

Introduction: Occupational stress significantly impacts healthcare professionals in the Spanish public hospital system. This study, conducted from April to June 2022, focuses on analyzing stress levels using the Nursing Stress Scale through an online survey. Methods: A cross-sectional study was carried out using an online survey from April to June 2022 in four hospitals. The Nursing Stress Scale was used to comprehensively assess stress levels among healthcare professionals. Results: The findings revealed a substantial contrast in stress outcomes based on personal circumstances. Healthcare professionals in stable partnerships and with children exhibited lower stress levels, acting as protective factors during the pandemic. Conversely, those engaged in rotating shifts, especially those working over 60 h per week, showed a sevenfold increase in high-stress probability (p < 0.05). Temporary contract holders and those with heightened exposure to COVID-19 reported elevated stress levels, highlighting the complex dynamics impacting the mental well-being of healthcare workers. Conclusions: Findings emphasize the necessity for targeted interventions to safeguard healthcare professionals' well-being, focusing on the psychological consequences of factors like rotating shifts and extended working hours. Protective elements such as stable partnerships and parenthood could serve as a foundation for initiatives supporting work-life balance, potentially involving government policies and hospital management.

The relationship between person-centred care and well-being and satisfaction with care of patients living with obesity.

Person-centred care (PCC) is associated with improved patient well-being and higher levels of satisfaction with care but its impact on individuals living with obesity is not well-established. The main aim of this study was to assess the relationship between PCC and the physical and social well-being of patients living with obesity, as well as their satisfaction with care. This study is based on a cross-sectional, web-based survey administered among a representative panel of Dutch individuals living with obesity. The primary outcomes were physical and social well-being and satisfaction with care. The primary exposure was a rating of overall PCC, encompassing its eight dimensions. In addition, covariates considered in the analyses included sex, age, marital status, education level, BMI, and chronic illness. The data from a total of 590 participants were analysed using descriptive statistics, correlation analyses, and multiple regression analyses. Among PCC dimensions, participants rated 'access to care' the highest (M 4.1, SD 0.6), while 'coordination of care' (M 3.5, SD 0.8) was rated lower than all other dimensions. Participants' overall PCC ratings were positively correlated with their physical (r = 0.255, P<0.001) and social well-being (r = 0.289, P<0.001) and their satisfaction with care (r = 0.788, P<0.001), as were the separate dimension scores. After controlling for sex, age, marital status, education level, BMI, and chronic illness in the regression analyses, participants' overall PCC ratings were positively related to their physical (β = 0.24, P<0.001) and social well-being (β = 0.26, P<0.001), and satisfaction with care (β = 0.79, P<0.001). PCC holds promise for improved outcomes among patients living with obesity, both in terms of physical and social well-being, as well as satisfaction with care. This is an important finding, particularly when considering the profound physical, social, and psychological consequences associated with obesity. In addition to highlighting the potential benefits of PCC in the healthcare of individuals living with obesity, the findings offer valuable insights into strategies for further refining the provision of PCC to meet the specific needs of these patients.

A RACIO-LINGUISTIC PERSPECTIVE OF LANGUAGE DISCRIMINATORY INSTANCES IN SCOTLAND

Racism has evolved to include not only skin colour but also linguistic discrimination, specifically targeting the use of the English language. Hence, educators and scholars have started acknowledging the language encounters of immigrants in Western society. This study intends to broaden the understanding of language discrimination experienced by immigrants in Scotland by examining the concepts of 'Linguistic strategy of resistance', 'ethnic accent bullying', and 'linguistic stereotyping'. The study uses questionnaires to elicit responses from 40 respondents and adopts a quantitative analytical approach for its analysis. Findings reveal that a significant proportion of migrants have encountered linguistic racism in many forms, including both explicit and implicit instances and in both formal and informal contexts. Some individuals can devise strategies to fight being abused or discriminated against linguistically, while others admit to allowing it to go unchallenged, resulting in psychological consequences. In conclusion, the study postulates that racism has indeed extended to the use of language, and despite the Western world's assertion of being post-racial, migrants in Scotland still face language-related discriminatory experiences daily.&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/soc/0770/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

The Burden, Challenges, and Prospects of Hand Surgery Practice in South Eastern Nigeria

Abstract Background: Hand injuries sometimes cause significant loss of function with psychological and functional consequences. The national status on dedicated specialised hand surgery units, hand surgery fellowship programmes, and outcome of operative hand surgery cases is generally lacking. Aims: To determine the current state of hand surgery practice in south eastern Nigeria and identify the major challenges to its practice and proffer realistic solutions. Methods: This was a prospective and cross-sectional study conducted amongst accredited hospitals for plastic surgery training in south eastern Nigeria amongst plastic surgery senior residents. Data were collected using a well-structured online questionnaire validated by a panel of investigators created as a Google form. Data analysis was carried out using Statistical package for Social Sciences by IBM, version 22. Ethical approval was obtained from the health, research, and ethical committee of the University of Enugu Teaching Hospital, Enugu, Nigeria. Results: There was a 70.59% response rate with 24 residents filling and submitting the questionnaire. Lack of fellowship training opportunities in hand surgery represents the most important challenge of hand surgery practice, followed by lack of appropriate facilities in government institutions in contrast to a lack of funding in private ones. Other major challenges include lack of adequate funding, lack of facilities, late presentation of cases, and lack of appropriate follow-up physiotherapy protocol. Availability of competent hand surgery specialists was significantly correlated with the frequency of hand surgery cases in the facilities (P = 0.000; χ2 = 20.400). Conclusion/Recommendation: The current state of hand surgery practice in south eastern Nigeria is not yet optimal. The creation of more hand fellowship trainings and courses bagged first place in recommended solutions by nearly half of the respondents. Provision of modern facilities, creation of dedicated hand surgical units, and better funding to the specialty were other suggestions.

Protocol for a discrete choice experiment: understanding preferences for seeking health services for survivors of sexual violence in Uganda

IntroductionSexual violence is a significant public health concern with severe physical, social and psychological consequences, which can be mitigated by health service utilisation. However, in Uganda and much of sub-Saharan...