Severe Health Conditions Research Articles

Decorated crown ethers as selective ion traps: Solvent’s role in crown’s preference towards a specific ion

Deviation of sodium and potassium concentrations from their optimal values in living organisms is associated with severe health conditions, thus their precise determination in blood samples requires design of sensitive sensors. Additionally, excess of the two alkali cations should be removed from drinking water. Crown ethers are well-known metal ion traps, as careful choice of crown’s size and its substituents might tune it towards favoring a specific ion. It has been proved experimentally that dibrominated bithiophene crown ethers with five and six oxygen atoms selectively capture the Na+ and the K+ ion, respectively (Giovannitti et al., Adv. Funct. Mater. 26, 2016, 514) in acetonitrile solution. In the present contribution, we analyzed the nature of ion–crown, ion–solvent, and crown–solvent interactions, and demonstrated that the solvent molecules are responsible for the decorated crown’s preference for a particular alkali cation. While past research focused on the ring size and the ion radius compatibillity, which is important for a formation of a stable ion–crown complex, our findings highlight the decisive role of solvent molecules in the selectivity of crown ethers toward particular cations.

The Effectiveness of Online Mental Health First Aid Training in Community Rugby: A Mixed-Methods Approach

Mental Health First Aid (MHFA) training exists to improve supportive behaviours towards peers, increase mental health literacy, and reduce stigma. Community sport clubs have potential to successfully deliver mental health programs. This study investigated the effectiveness of online MHFA training undertaken by members of the rugby community and evaluated the feasibility and usefulness of the online delivery mode and users' engagement with it. A mixed-methods approach was used to provide depth of understanding through qualitative analysis, combined with quantitative outcomes. Online surveys examining participants' knowledge and perceptions were administered pre- and post-MHFA training. Significant improvements (p < 0.05) across all assessed domains were observed post- compared to pre-MHFA training. A large effect size was identified in relation to advice giving and sign and symptom identification. A moderate effect size pre- to post-improvement was identified for users' perceptions of therapy's effectiveness, the ability of people with severe mental health conditions to recover, and benefit of a healthcare professional. Participants endorsed the MHFA program to improve mental health literacy, advance non-technical skills, and improve confidence. MHFA training can increase the awareness and knowledge of mental health issues in key individuals in community sport clubs and enable them to aid people with mental health concerns. Online MHFA training is associated with improved mental health literacy and may be a suitable and economically sustainable model for community sport.

Telemedicine Sebagai Platform Konsultasi Kesehatan Mental di Era Industri 4.0

Telemedicine technology is a highly developed digital transformation in the health sector today. Telemedicine is widely used in various countries because of the perceived benefits of this technology, one of which is mental health. Mental health consultations with medical personnel can be done virtually or remotely. This study aims to determine the use of telemedicine in facilitating mental health problems. The design of this study used a literature review by looking at 13 articles which were then analyzed. The results of this study indicate that the use of telemedicine is influenced by cost factors, geographical factors, and ease of use factors affect the use of telemedicine for mental health consultations. The Covid-19 Pandemic has also caused a shift in treatment methods that use health facilities, some of which have switched to telemedicine due to divisions in activities and physical distancing. The cost factor is also related to telemedicine because patients who wish to consult about their health do not need to pay to visit a health facility. After all, it can be done online. The use of telemedicine greatly helps the geographical factors of people who are far from health facilities. Finally, the ease of use factor, because every element of society is now technologically literate, telemedicine will not be difficult. This study states that consultation or therapy via telemedicine has as good results as face-to-face therapy for mild and moderate mental health. However, a more in-depth research is needed for severe mental health conditions such as cognitive, behavioral, and sensory impairments.

Deep neural network for food image classification and nutrient identification: A systematic review.

Technology impacts human life in both the aspects such as positive and negative, which helps in better communication and eliminating geographical boundaries. However, social media and mobile devices may lead to severe health conditions such as sleep problems, depression, obesity, etc. A systematic review is conducted to analyze health issues by tracking food intake by considering positive aspects using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Guidelines. The major scientific databases (such as Web of Science, Scopus, and IEEE explore) are explored to search the image recognition and analysis articles. The search query is applied to the databases using keywords like "Food Image," "Food Image Classification," "Nutrient Identification," "Nutrient Estimation," and using "Machine Learning," etc. 771 articles are extracted from these databases, and 56 are identified for final consideration after rigorous screening. A few investigations are extracted based on available food image datasets, hyperparameters tuning, a technique used, performance metrics, and challenges of Food Image Classification (FIC). This study discusses different investigations with their proposed FIC and nutrient estimation solution. Finally, this intensive research presents a case study using FIC and object detection techniques to estimate nutrition with food image analysis.

Identifying the asthma research priorities of people with asthma, their carers and other stakeholders.

People living with asthma, their carers, clinicians and policymakers are the end-users of research and need research that address their individual healthcare needs. We aimed to understand the research priorities of end-users of asthma research. A national cross-sectional mixed-methods study was conducted. The study included an online survey that engaged patients, carers, healthcare professionals and policymakers to provide statements to free-text questions about what they would like to see answered by research to improve living with asthma on a day-to-day basis. Responses where thematically analysed followed by three online priority setting consensus workshops. There were 593 respondents who provided 1446 text comments. Participants prioritized 10 asthma research themes which were: (1) asthma in children, (2) COVID 19 and asthma, (3) asthma care and self-management, (4) diagnosis and medication, (5) managing asthma attacks, (6) causes, prevention and features of asthma, (7) mental health, (8) asthma and ageing, (9) severe asthma, (10) asthma and other health conditions. Each theme comprises specific research questions. This project successfully established 10 priority research themes for asthma, reflecting the collective voice of the end-users of this research. These novel data can be used to address the documented mismatch in research prioritization between the research community and the end-users of research.

Experiences of Every Mind Matters, Public Health England’s adult mental health literacy campaign: a qualitative interview study

BackgroundEvery Mind Matters (EMM) is a publicly funded health campaign, launched in England in 2019, to equip adults to look after their mental health, and that of others, by offering online information about common problems: anxiety, low mood, sleep, and stress. This study is one component of an independent evaluation of EMM conducted by the NIHR Mental Health Policy Research Unit. Its aim is to explore individuals’ experiences of the EMM campaign and website.MethodsFour researchers, including three with lived experience of using mental health services, conducted 20, one-off, semi-structured, online interviews with a range of adult participants, including a sample of EMM users and a purposively recruited sub-sample known to have severe or long-term mental health conditions. A codebook thematic analysis was undertaken, and four main themes were identified.FindingsThere was an expectation from the name Every Mind Matters that its advice would address everyone. Almost all participants had experience of mental distress and looked to EMM for help with a current problem for themselves. All participants were complimentary about the EMM website and found it to be user-friendly (theme 1) and personalised (theme 2) especially the interactive feature Your Mind Plan quiz which responds with suggested actions to improve wellbeing and follows up with reminder emails. A few participants found the website information and/or Mind Plan suggestions to be life changing. Some participants wanted EMM to better acknowledge the contexts in which they live (theme 3) such as the limitations of health conditions and health services, and difficulties of crowded housing, social policy, and climate change. Many participants would like EMM to do more (theme 4), offer more interactivity, more choice, more information about available treatments, and more stratified advice to cover more severe mental health conditions.ConclusionEMM is available to all, including people with common or severe mental disorders. In the context of overwhelmed mental health services, people with severe mental illness expect more from EMM than advice about common problems. EMM could build on its success by extending its remit to address a wider range of needs so that everyone is included.

Association of Accelerometer-Measured Physical Activity Level With Risks of Hospitalization for 25 Common Health Conditions in UK Adults

Higher physical activity levels are associated with lower risks of cancer, cardiovascular disease, and diabetes, but associations with many common and less severe health conditions are not known. These conditions impose large health care burdens and reduce quality of life. To investigate the association between accelerometer-measured physical activity and the subsequent risk of hospitalization for 25 common reasons for hospitalization and to estimate the proportion of these hospitalizations that might have been prevented if participants had higher levels of physical activity. This prospective cohort study used data from a subset of 81 717 UK Biobank participants aged 42 to 78 years. Participants wore an accelerometer for 1 week (between June 1, 2013, and December 23, 2015) and were followed up over a median (IQR) of 6.8 (6.2-7.3) years; follow-up for the current study ended in 2021 (exact date varied by location). Mean total and intensity-specific accelerometer-measured physical activity. Hospitalization for the most common health conditions. Cox proportional hazards regression analysis was used to estimate hazard ratios (HRs) and 95% CIs for mean accelerometer-measured physical activity (per 1-SD increment) and risks of hospitalization for 25 conditions. Population-attributable risks were used to estimate the proportion of hospitalizations for each condition that might be prevented if participants increased their moderate to vigorous physical activity (MVPA) by 20 minutes per day. Among 81 717 participants, the mean (SD) age at accelerometer assessment was 61.5 (7.9) years; 56.4% were female, and 97.0% self-identified as White. Higher levels of accelerometer-measured physical activity were associated with lower risks of hospitalization for 9 conditions: gallbladder disease (HR per 1 SD, 0.74; 95% CI, 0.69-0.79), urinary tract infections (HR per 1 SD, 0.76; 95% CI, 0.69-0.84), diabetes (HR per 1 SD, 0.79; 95% CI, 0.74-0.84), venous thromboembolism (HR per 1 SD, 0.82; 95% CI, 0.75-0.90), pneumonia (HR per 1 SD, 0.83; 95% CI, 0.77-0.89), ischemic stroke (HR per 1 SD, 0.85; 95% CI, 0.76-0.95), iron deficiency anemia (HR per 1 SD, 0.91; 95% CI, 0.84-0.98), diverticular disease (HR per 1 SD, 0.94; 95% CI, 0.90-0.99), and colon polyps (HR per 1 SD, 0.96; 95% CI, 0.94-0.99). Positive associations were observed between overall physical activity and carpal tunnel syndrome (HR per 1 SD, 1.28; 95% CI, 1.18-1.40), osteoarthritis (HR per 1 SD, 1.15; 95% CI, 1.10-1.19), and inguinal hernia (HR per 1 SD, 1.13; 95% CI, 1.07-1.19), which were primarily induced by light physical activity. Increasing MVPA by 20 minutes per day was associated with reductions in hospitalization ranging from 3.8% (95% CI, 1.8%-5.7%) for colon polyps to 23.0% (95% CI, 17.1%-28.9%) for diabetes. In this cohort study of UK Biobank participants, those with higher physical activity levels had lower risks of hospitalization across a broad range of health conditions. These findings suggest that aiming to increase MVPA by 20 minutes per day may be a useful nonpharmaceutical intervention to reduce health care burdens and improve quality of life.

Risk of suicide after diagnosis of severe physical health conditions: A retrospective cohort study of 47 million people.

The diagnosis of a severe physical health condition can cause psychological distress and lead to severe depression. The association between severe physical health conditions and the risk of suicide, and how the risk of suicide changes in the months following diagnosis, are not clear. We estimated whether a diagnosis of severe physical health conditions is associated with an increase in the risk of death by suicide using a dataset based on the 2011 Census linked to hospital records and death registration records covering 47,354,696 people alive on 1 January 2017 in England. Patients diagnosed with a low-survival cancer, chronic ischaemic heart disease, chronic obstructive pulmonary disease, or degenerative neurological condition were matched to individuals using socio-demographic characteristics from the Census. Using the Aalen-Johansen estimator, we estimated the cumulative incidence of death by suicide occurring between 1 January 2017 and 31 December 2021 (registered by 31 December 2021) in patients and matched controls, adjusted for other potential confounders using inverse probability weighting. Diagnosis of severe conditions was associated with an increased risk of dying by suicide. One year after diagnosis, the rate of suicide was 21.6 (95% confidence intervals: 14.9-28.4, number of events (N): 39) per 100,000 low-survival cancer patients compared to 9.5 (5.6-14.6, N:16) per 100,000 matched controls. For COPD patients, the one-year suicide rate was 22.4 (19.4-25.5, N:208) per 100,000 COPD patients (matched controls: 10.6, 8.3-13.0, N:85), for ischaemic heart disease 16.1 (14.1-18.2, N:225) per 100,000 patients (matched controls: 8.8, 7.1-10.4, N:128), for degenerative neurological conditions 114.5 (49.6-194.7, N:11) per 100,000 patients. The increase in risk was more pronounced in the first six months after diagnosis or first treatment. A diagnosis of severe physical illness is associated with higher suicide risk. The interaction of physical and mental illness emphasises the importance of collaborative physical and mental health care in these patients. The Office for National Statistics. KES is the Laing Galazka chair in palliative care at King's College London, funded by an endowment from Cicely Saunders International and the Kirby Laing Foundation.

Ethical implications for children’s exclusion in the initial COVID-19 vaccination in Ghana

ABSTRACTBioethics provides various models of fair allocation of scarce health resources like COVID-19 vaccines. Even though these models are grounded in some ethical principles like justice and beneficence, there were severe inequalities in global access to COVID-19 vaccines. In Ghana, about 21.5 million COVID-19-doses have been administered but comprise mainly members of the adult population. As a result, ethical issues related to vaccinating children have been largely ignored in the country. This paper explores some of the ethical implications related to children’s exclusion in the initial COVID-19 vaccination programs in Ghana. It provides a general overview of the COVID-19 pandemic in Ghana and how it related to children and discusses the risks to which Ghanaian children were exposed by delaying their COVID-19 vaccination. A guide to facilitating the full rollout of COVID-19 vaccination in Ghana for children has been proposed that indicates that a fair vaccine distribution for children should prioritize children on admission at health facilities, those diagnosed with severe underlying health conditions, and children who could play an instrumental role in promoting vaccine uptake. It concludes that children must not be placed at the peripheries of the COVID-19 vaccination program in Ghana.

NIR-responsive carrier-free nanoparticles based on berberine hydrochloride and indocyanine green for synergistic antibacterial therapy and promoting infected wound healing.

Bacterial infections cause severe health conditions, resulting in a significant economic burden for the public health system. Although natural phytochemicals are considered promising anti-bacterial agents, they suffer from several limitations, such as poor water solubility and low bioavailability in vivo, severely restricting their wide application. Herein, we constructed a near-infrared (NIR)-responsive carrier-free berberine hydrochloride (BH, phytochemicals)/indocyanine green (ICG, photosensitizer) nanoparticles (BI NPs) for synergistic antibacterial of an infected wound. Through electrostatic interaction and π-π stacking, the hydrophobic BH and amphiphilic ICG are initially self-assembled to generate carrier-free nanoparticles. The obtained BI NPs demonstrated NIR-responsive drug release behavior and better photothermal conversion efficiency of up to 36%. In addition, BI NPs stimulated by NIR laser exhibited remarkable antibacterial activity, which realized the synergistic antibacterial treatment and promoted infected wound healing. In summary, the current research results provided a candidate strategy for self-assembling new BI NPs to treat bacterial infections synergistically.

COVID-19 vaccination coverage and vaccine hesitancy among Australians with disability and long-term health conditions.

COVID-19 vaccination is the cornerstone of managing Australia's COVID-19 pandemic and the success of the vaccination program depends on high vaccination coverage. This paper examined differences in COVID-19 vaccination coverage and vaccine hesitancy for people with disability, long-term health conditions, and carers - subgroups that were prioritised in Australia's vaccination program. Using data from 2400 Australians who participated in two waves of the Taking the Pulse of the Nation survey in April and May 2021, we described vaccination coverage and hesitancy among people with disability, severe mental health conditions, severe long-term health conditions, frequent need for assistance with everyday activities, and carers. Vaccination coverage was estimated to be 8.2% in the population overall and was similar for people with disability, those with frequent need for assistance, and carers. It was higher for people with severe long-term health conditions (13.4%) and lower for people with severe mental health conditions (4.3%). Vaccine hesitancy was high overall (35.6%) and was similarly high across the priority groups, with only small differences for people with disability, severe long-term health conditions and frequent need for assistance. This study highlights a lack of difference in vaccination coverage for people with disability, long-term health conditions, and carers compared to the general population. So what? Sub-optimal vaccination coverage for people in the priority groups leaves many people at significant risk of serious disease or death if exposed to COVID-19, particularly in light of easing of disease-control restrictions across Australia and the emergence of new variants.

Investigating nurses’ knowledge and attitudes about delirium in older persons: a cross-sectional study

IntroductionDelirium is the most common emergency for older hospitalized patients that demands urgent treatment, otherwise it can lead to more severe health conditions. Nurses play a crucial part in diagnosing delirium and their competencies facilitate the appropriate treatment and management of the condition.AimThis study aims to enhance the understanding of delirium care by exploring both knowledge and attitudes of nurses toward patients in acute care hospital wards and the possible association between these two variables.MethodThe Nurses Knowledge of Delirium Questionnaire (NKD) and the Attitude Tool of Delirium (ATOD) that were created for the said inquiry, were disseminated to 835 nurses in the four largest Public Hospitals of the Republic. These tools focused particularly on departments with increased frequency of delirium (response rate = 67%).ResultsOverall nurses have limited knowledge of acute confusion/delirium. The average of correct answers was 42.2%. Only 38% of the participants reported a correct definition of delirium, 41.6 correctly reported the tools to identify delirium and 42.5 answered correctly on the factors leading to delirium development. The results of the attitudes’ questionnaire confirmed that attitudes towards patients with delirium may not be supportive enough. A correlation between the level of nurses’ knowledge and their attitude was also found. The main factors influencing the level of knowledge and attitudes were gender, education, and workplace.ConclusionThe findings of this study are useful for the international audience since they can be used to develop and modify educational programmes in order to rectify the knowledge deficits and uninformed attitudes towards patients with delirium. The development of a valid and reliable instrument for the evaluation of attitudes will help to further assess nurses’ attitudes. Furthermore, the results are even more important and useful on a national level since there is no prior data on the subject area, making this study the first of its kind.

The recovery process and access to the social capital of people with severe mental health problems: a secondary analysis of a six months follow-up study in five Community Mental Health Teams in England.

Background: Many developed nations have made recovery-oriented practice a central part of their mental health policy, though less is known about whether mental health outpatients’ access to social capital can improve their recovery process. Aims: This study investigates the relationship between the recovery process and access to social capital for people with severe mental health conditions. Methods: This is a secondary analysis of a six-month follow-up study. Service users were recruited from five Community Mental Health Teams in England and interviewed at baseline (n=151) and six-month follow-up (n=127). The recovery process was assessed using the Questionnaire about the Process of Recovery (QPR). All statistical analyses (Pearson’s correlations and multiple regression) were conducted at two different points in time (p&lt; 0.05). Results: The participants’ experience of recovery increased slightly from baseline (M=45.2, SD=12.18) to six-month follow-up (M=49.72, SD=12.52), which is indicative of recovery. At follow-up, their access to social capital was positively associated with service users’ experience of recovery (B=0.40 p&lt;0.01). People with higher mental well-being scores and more social connections had a better experience of recovery. Conclusions: This study supports the idea that the experience of recovery can be measured and should be defined by service users. People with higher mental well-being scores and more social connections had a better experience of recovery. This study is a contribution to the international endorsement of recovery-oriented practice which focuses on developing a person-centred rather than a clinician-centred model of recovery for people with severe mental health conditions.

Sleep Duration, Midday Napping, and Serum Homocysteine Levels: A Gene-Environment Interaction Study.

The associations of sleep duration and midday napping with homocysteine (Hcy) levels, and whether these sleep behaviors modify the association between genetic predisposition and Hcy levels, has yet to be investigated. We included 19,426 participants without severe health conditions at baseline from the Dongfeng−Tongji cohort. In a subgroup of 15,126 participants with genetic data, a genetic risk score (GRS) based on 18 Hcy-related loci was constructed to test the gene−sleep interactions in Hcy. Hcy levels were higher in subjects with a long sleep duration (≥9 h) and midday napping (>90 min), as compared to those who reported a moderate sleep duration (7 to <8 h) and midday napping (1−30 min) (all p values < 0.05). A long sleep duration and midday napping showed a joint effect in increasing Hcy (p for trend < 0.001). Significant interactions regarding Hcy levels were observed for a long sleep duration with GRS and MTHFR rs1801133, and long midday napping with DPEP1 rs12921383 (all p values for interaction < 0.05). Overall findings indicated that a long sleep duration and midday napping were associated with elevated serum Hcy levels, independently and jointly, and amplified the genetic susceptibility to higher Hcy.

Waste Management Framework Using Brainy Litter Basket

Due to the increased number of individuals disposing of their waste, the sanitation of the waste management system has decreased. The persistent act of disposing waste in shared spaces by individuals may result in significant ramifications for the nearby ecological system. The existence of such circumstances in the vicinity has the capability to aggravate an extensive array of severe health conditions. The aforementioned phenomenon will lead to a decrease in the value of the impacted region. Effective waste management practises are necessary to address the issue of waste disposal and maintain cleanliness. The present investigation presents a novel waste management framework that leverages Internet of Things (IoT)-enabled sensor devices to monitor and record the quantity of refuse deposited into receptacles. Upon detection, the system promptly entered an alarm state that was exclusively operable through GSM/GPRS technology. The microcontroller establishes a connection between the GSM/GPRS system and the sensor system in the present system. The smart garbage bin additionally encourages recycling by categorising various types of waste (wet and dry). This guarantees prompt waste collection, lessens litter and unhealthy conditions. This led to the environment becoming more green and to support for Swachh Bharat for cleanliness.

Discovery of genomic loci associated with sleep apnea risk through multi-trait GWAS analysis with snoring.

Despite its association with severe health conditions, the etiology of sleep apnea (SA) remains understudied. This study sought to identify genetic variants robustly associated with SA risk. We performed a genome-wide association study (GWAS) meta-analysis of SA across five cohorts (NTotal = 523 366), followed by a multi-trait analysis of GWAS (multi-trait analysis of genome-wide association summary statistics [MTAG]) to boost power, leveraging the high genetic correlation between SA and snoring. We then adjusted our results for the genetic effects of body mass index (BMI) using multi-trait-based conditional and joint analysis (mtCOJO) and sought replication of lead hits in a large cohort of participants from 23andMe, Inc (NTotal = 1 477 352; Ncases = 175 522). We also explored genetic correlations with other complex traits and performed a phenome-wide screen for causally associated phenotypes using the latent causal variable method. Our SA meta-analysis identified five independent variants with evidence of association beyond genome-wide significance. After adjustment for BMI, only one genome-wide significant variant was identified. MTAG analyses uncovered 49 significant independent loci associated with SA risk. Twenty-nine variants were replicated in the 23andMe GWAS adjusting for BMI. We observed genetic correlations with several complex traits, including multisite chronic pain, diabetes, eye disorders, high blood pressure, osteoarthritis, chronic obstructive pulmonary disease, and BMI-associated conditions. Our study uncovered multiple genetic loci associated with SA risk, thus increasing our understanding of the etiology of this condition and its relationship with other complex traits.

Severe, life-threatening, and fatal chronic health conditions after allogeneic blood or marrow transplantation in childhood.

A comprehensive assessment of morbidity after allogeneic bone marrow transplantation (BMT) performed in childhood remains understudied. Seven hundred eighty-nine allogeneic BMT recipients who had survived ≥2years after BMT performed between 1974 and 2014 at age <22years and 690 siblings completed a 255-item survey self-reporting sociodemographics and chronic health conditions. A severity score (grade 3 [severe], 4 [life-threatening], or 5 [fatal]) was assigned to the conditions using Common Terminology Criteria for Adverse Events, version 5.0. For the BMT cohort, the cumulative incidence of chronic health conditions was calculated as a function of time from BMT. Proportional subdistribution hazards models were used to determine predictors of grade 3-5 conditions. Logistic regression was used to estimate the risk of grade 3-4 conditions in BMT recipients who were alive at the time of this study compared with siblings. The median age at transplantation was 11.3years (range, 0.4-22.0 years), and the median length of follow-up was 11.7years (range, 2.0-45.3 years). The most prevalent primary diagnoses were acute lymphoblastic leukemia (30.7%), and acute myeloid leukemia/myelodysplastic syndrome (26.9%). At age 35years, the cumulative incidence of a grade 3-4 condition was 53.8% (95% CI, 46.7%-60.3%). The adjusted odds ratio of a grade 3-4 condition was 15.1 in survivors (95% CI, 9.5-24.0) compared with siblings. The risk of a grade 3-5 condition increased with age at BMT (hazard ratio [HR], 1.03; 95% CI, 1.01-1.05) and was higher among females (HR, 1.27; 95% CI, 1.02-1.59), patients who received total body irradiation (HR, 1.71; 95% CI, 1.27-2.31), and those reporting chronic graft-versus-host disease (HR, 1.38; 95% CI, 1.09-1.74). Two-year survivors of allogeneic BMT in childhood have an increased risk of grade 3-4 chronic health conditions compared with siblings, suggesting the need for long-term follow-up.

Når behandling gjør vondt verre – erfaringer fra basal eksponeringsterapi (BET)

Background and aim: Basal exposure therapy (BET) is an inpatient treatment for people with severe mental health conditions and long treatment histories in mental healthcare. Although preliminary group evaluation data for BET are positive, some patients report negative experiences with the treatment. The overall aim was to gain new knowledge about patients’ reported negative experiences of BET in order to further develop this treatment. Method: We interviewed nine former female patients and analysed the data thematically, using an inductive, semantic approach. Three researchers and two research advisors with patient experiences in BET conducted the study. Results: Participants experienced, first, that their expectations of BET did not match their actual experiences. Second, patients experienced their relationships with BET therapists as unsafe, instrumental, mechanic and lacking in human warmth. Third, patients perceived a gap between their expectations and therapists’ intentions, leading to insecurity and a heavy sense of responsibility. Fourth, they felt that their symptoms were exacerbated during BET treatment in the form of more shame, self-hatred and loneliness. Implications: Participants’ experiences showed that the intended effects of the treatment did not always match patients’ experiences. It is imperative to further investigate patients’ experiences in order to develop BET as well as other treatments for these patients. Keywords: Basal Exposure Therapy, service user involvement, specialised mental healthcare services, evaluation, patient experiences, negative experiences

Examining Loneliness and Its Correlates in a Sample of People with Spinal Cord Injury

<h3>Research Objectives</h3> To examine loneliness among individuals with SCI and explore its relation to demographic, disability, health-related, and social characteristics. <h3>Design</h3> Cross-sectional survey study. <h3>Setting</h3> Online survey with alternate formats offered. <h3>Participants</h3> A diverse national sample of 346 people with SCI. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> We measured loneliness using the UCLA Loneliness Scale-v3. Measures of health included the SF-36 General Health Scale, the SCI Secondary Conditions Scale, and pain and pain interference items. Measures of social connections and social participation included the CHART Social Integration Scale, an 8-item MOS Social Support Scale, and the SCI-QoL Satisfaction with Participation Scale. <h3>Results</h3> Confirmatory factor analysis supported the bi-factor structure of the UCLA-v3 found in other populations. Loneliness scores in our sample were high (Mean=46.15, SD=13.87, range 20-79) with a majority of participants reporting that they "sometimes" or "often" feel alone, left out, isolated, lacking in companionship, that others are around them but not with them, and that their interests and ideas are not shared by those around them. Women reported greater loneliness than men, and loneliness was inversely related to time since injury. Loneliness was higher among those reporting poorer health, more severe secondary health conditions, and greater pain and pain interference. Social support and social participation were most strongly related to loneliness and accounted for the greatest variance in regression models. <h3>Conclusions</h3> The construct of loneliness appears similar to that in other populations based on a similar factor structure on the UCLA-v3. Our findings suggest that loneliness is a significant problem for people with SCI and underscores a pressing need for intervention development to address this issue in this at-risk population. <h3>Author(s) Disclosures</h3> None.

Recruitment and enrolment feasibility of the Luci risk reduction study in Québec

AbstractBackgroundEvidence suggests that lifestyle interventions can reduce the incidence of cognitive decline in older adults. Multidomain lifestyle intervention thus generates major interest. Luci is a Web‐based multidomain coach‐assisted dementia risk reduction program. Although such a technology‐based delivery mode represents a scalability opportunity, reaching the target population may be a challenge. A main goal of the Luci pilot feasibility study was to evaluate recruitment and enrolment rates.MethodThis is an ongoing 24‐week, Luci vs waitlist randomized, single‐blind pilot feasibility study to enrol cognitively healthy individuals aged 50‐70 with ≥1 lifestyle risk factor (physical activity, diet, cognitive engagement). Exclusion criteria comprised severe health conditions (e.g., neurocognitive, psychiatric) and logistical reasons (e.g., no device or internet). We aimed to recruit 120 participants at a rate of ≥30 participants/month over 4 months, and to achieve a screening‐to‐enrolment ratio of ≥48%. Participants were recruited in weekly waves from a list of volunteers obtained through a media campaign on the Luci project, and a research centre database.ResultOf the 178 people invited to complete screening, 157 (88.2%) did so, and 124 (78.9%) met inclusion/exclusion criteria. The recruitment of the 120 participants was achieved over 1 week, and screening‐to‐enrolment ratio was 76.4%. Reasons for exclusion were not having any lifestyle risk factor (18.9%), exceeding study capacity (10.8%), logistical (24.3%) and health (45.9%) reasons. Included participants had a mean age of 60.7 (SD = 5.6) and 16.7 (SD = 3.4) years of education; 85% were female. Within enrolled individuals, 71.7% were living with someone, 37.5% were retired, and 66.7% had a household income greater than the Quebec median. 75.0% had ≥2 lifestyle risk factors.ConclusionOur recruitment and enrolment goals were met. Eligibility slightly exceeded our enrolment aim, a situation not unexpected. Almost all individuals who completed the screening had dementia risk factors suitable for Luci preventive interventions. However, some subgroups are not well represented in our sample, and in particular, men, individuals who are older (≥65 years), less educated, with a low‐income, and living alone. Results highlight the need to develop recruitment strategies to reach a more diverse population, and that specifically target individuals facing social inequities.