Mean Total Score Research Articles

French validation of the oMtFSFI Questionnaire for assessing the sexual function of Transgender women after vulvo-vaginoplasty

IntroductionThe Operated Male-to-Female Sexual Function Index (oMtFSFI) questionnaire is the first scoring system developed to assess sexual function after gender-affirming vulvo-vaginoplasty, and was initially developed and validated in Italian. The aim of this study was to provide linguistic validation of the questionnaire in French through several steps including use of the questionnaires across a series of patients who had undergone gender-affirming vulvo-vaginoplasty between 2020 and 2022 at two French academic centers. MethodThe French version of the oMtFSFI questionnaire was obtained through a double translation (Italian to French) and a back-translation (French to Italian), validated by a scientific committee, and cognitively assessed by a panel of expert patients. The questionnaire was then distributed to transgender male to female patients who had undergone genital gender affirming surgery at two French academic centers. ResultsThe oMtFSFI score consists of 18 questions exploring 7 domains (genital self-image, desire, arousal, lubrication, orgasm, satisfaction, sexual pain). Among the sixty-four patients who responded to the questionnaire, 16 patients (25%) reported abstaining from sexual activity involving vaginal penetration at the time of the study were excluded. The mean total score was 37, corresponding to mild to moderate sexual dysfunction and 60.4% of the patients reported normal overall sexual function. The level of sexual satisfaction was normal for 68.8% of the patients and the genital self-image was normal for 52.1%. Most of the patients (79.2%) reported at least mild dyspareunia and 10.4% had critical sexual dysfunction. Surgery improved gender dysphoria in 96.7% of patients. There was a strong correlation between the overall oMtFSFI score and the happiness Visual Analog Scale (VAS) (P<0.001) as well as with the quality of life VAS (P<0.001). ConclusionThe French version of the oMtFSFI questionnaire is the only scoring system specifically developed to assess sexual function after vulvo-vaginoplasty in transgender women linguistically validated in French. Its validation in French language makes it an interesting tool for research and clinical practice. Level of evidence3.

Risk of behavioral disturbances in pediatric patients with epilepsy and mild to moderate cognitive impairment: A cross-sectional study.

The aim of the study was to assess whether children and adolescents with epilepsy are at higher risk of behavioral disturbances when they have concomitant cognitive disturbances. Behavioral scores were generated using the Child Behavior Checklist (CBCL). Cognitive evaluation was applied by using different age appropriate versions of the Wechsler Intelligence Scale. CBCL scores (total, externalizing, internalizing) were compared between patients with and without intellectual disability (IQ score < 70 and ≥70, respectively). 144 (10.2 mean age, 6.0-17.9 range) patients were recruited for the study. Patients with mild to moderate intellectual disability (full-scale intelligence quotient (FSIQ) < 70) were not at higher risk of behavioral disturbances (total CBCL score ≥ 63) than patients without cognitive impairment. The mean total CBCL score was 62.0 ± 10.6 (range 42.0-83.5, 95% CI 57.9-62.0) and 59.3 ± 10.3 (range 38.0-80.0, CI 57.4-61.2) for patients with FSIQ < 70 and ≥70, respectively. There was no correlation between FSIQ and total CBCL scores. These findings were true for all IQ subcategories. Behavioral disturbances among children and adolescents with epilepsy occur despite the presence or absence of intellectual dysfunction with respect to full-scale IQ.

Comparing the reliability of inter- and intra-grader using digital scanning vs. traditional visual method for evaluating preclinical class II composite preparation

ObjectiveThis study aimed to evaluate the intra- and inter-grader reliability of four evaluators using three different digital intraoral scanners and visual methods for typodontic Class II composite preparations. Materials and methodsNinety-five typodont teeth of Class II composite preparations were evaluated using traditional visual grading methods (VGM) and digital grading methods (DGM) using the same rubric. Three intraoral scanners were used to scan the Class II cavity preparation for the composite: i700 (Medit, Korea), Trios 4 (3Shape, Denmark), and Shinning 3D (Shinning 3D, China). The same rubric was used to score the visual and digital evaluations by calibrated examiners. Two-way ANOVA was used to compare method- and evaluator-based scores, accounting for the scanner type used. ResultsThe scores of the prepped typodont teeth were subjected to an interaction between the examiner and the evaluation technique. In addition, the mean total prepped teeth scores differed between examiners using VGM. A statistically significant interaction emerged between examiners and the evaluation technique employed to assess the total score of the prepped teeth:F(9, 1504) = 3.893,P = 0.001, partial η2 = 0.023. The total prepped tooth score differed between the VGM and DGM groups. Lower (P < 0.05) intra-grader consistency was observed for the final scores when Class II preparations were evaluated using the VGM; however, this consistency improved when using the DGM. ConclusionExaminers and evaluation methods affect student performance in Class II cavity preparations. The DGM may be more reliable and consistent within and between evaluators than the VGM is.

Timing and Modality of Hemorrhoidal Prolapse Impact on Patients' Quality of Life.

Background: The aim of this study was to assess whether the frequency and presentation modality of hemorrhoidal prolapse may have an impact on patients' quality of life, leading to a different categorization of patients. Methods: A consecutive series of patients affected by primary hemorrhoidal disease were administered specific questionnaires to assess the severity of symptoms and their quality of life. The frequency/modality of prolapse was also assessed, and the classification of the patients into five categories was hypothesized. The severity of disease was assessed using a validated patient-reported score, while the health-related quality of life was evaluated with the Short Health Scale for hemorrhoidal disease. Results: A total of 122 patients were enrolled. The evaluation of the prolapse modality led to the following classification: type I, 5 patients (4.1%); type II, 9 (7.4%), type IIIa, 48 (39.3%); type IIIb, 52 (42.6%); and type IV, 8 (6.6%). The mean total hemorrhoidal disease score was 9.8 ± 3.3, while the mean total Short Health Scale score was 18.6 ± 5.2. Both scores progressively increased in the five types of prolapse identified, thus showing a worsening of symptoms and quality of life related to the increase in the frequency and modality of prolapse. The assessment of the quality of life showed that all four domains of the Short Health Scale score and the total score were significantly worse in group IIIb compared to IIIa. Conclusions: The frequency and modality of hemorrhoidal prolapse has an impact on the quality of life and allows the identification of new types of patients.

Gustatory Function in Patients with Chronic Rhinosinusitis with Nasal Polyposis

Abstract Background Many patients with chronic rhinosinusitis (CRS) describe disturbances in taste. Recent research has shown that taste receptors in airway epithelial cells are involved in defending against upper respiratory tract infection. The aim of the present study was to investigate gustatory function in patients with chronic rhinosinusitis (CRS). Methods Taste function was assessed using the taste strip test in 63 patients with CRS (Study Group) (mean age was 42.05± 14, ranging between 19 to 68 years. More than half of cases (68.3%) were males) and 63 healthy controls (The mean age was 40.9± 13.6, ranging between 18 to 67 years. More than half of cases (68.3%) were males). Results The mean Sweet, Salt, Sour, Bitter, and Umami score among the study group was 3.6± 0.6, 3.9± 0.3, 3.8± 0.4, 3.4± 0.8, 3.5± 0.7 and 18.4± 2.6 respectively with a median equal to 4 among all of them. The mean total Taste score was 18.4± 2.6 with a median of 20 while The mean Sweet, Salt, Sour, Bitter, and Umami score among control group was 4± 0, with a median equal to 4 among all of them. The mean total taste score was 20± 0 with a median of 0 Conclusion Taste dysfunction is a common complaint in CRS. Patients with CRS have decreased gustatory function.

Arabic Translation of The Caregiver Priorities and Child Health Index of Life with Disabilities CPCHILD Scale

Abstract Background Children with cerebral palsy have difficulties in daily life activities (feeding, toilet training, dressing), communication, and mobility. The children’s independence and quality of life decrease when their performance in activities of daily living is reduced. Evaluation of motor function for affected children with cerebral palsy (CP), individual needs and goals of these patients and their parents is still lacking and needs to be further addressed. The CPCHILD is a multidimensional patient centered assessment tool. Aim of the Work Our aim is to translate and provide an Arabic version of the CPCHILD for assessing the caregivers’ perceptions of the health status, comfort, wellbeing, functional abilities, and quality of life for their children with cerebral palsy. Patient and Methods This study was a cross sectional study, conducted at Pediatric Neurology Clinic at Children’s Hospital, and Physical Medicine Outpatient Clinic at Ain Shams University Hospitals. The CPCHILD was translated from English to Arabic with the agreement of the scale's owner. The Arabic version was provided through translation and back translation process, which was then presented to the caregivers of CP children for evaluation of the perspectives and quality of life for their children. Results An Arabic version of the CPCHILD scale was created. The enrolled caregivers for children with CP were the biological mothers. The mothers of the CP children were able to understand and respond to the translated scale and reported poor mean total CPCHILD score 26.45 (0-58.3). Conclusion The Arabic version of the scale was provided through translation and back translation process and the version was prepared for subsequent validation tests. The translated version will help in applying the scale in the caregivers' language in a culture proper setting and can be helpful in the assessment of health-related quality of life of children with CP.

P-454 The effects of PLISSIT model based sexual counseling on sexual function and satisfaction in infertile couples

Abstract Study question Does a sexual counseling program based on the PLISSIT model improve the sexual function and satisfaction in infertile men and women? Summary answer PLISSIT model based sexual counseling for infertile couples with sexual dysfunction and low sexual satisfaction, positively affected the sexual function and satisfaction of the couples. What is known already Studies indicate that infertile couples experience more sexual problems than fertile couples due to the physical, psychological, and marital challenges of assisted reproductive technology treatments. Several sexual counseling models are recommended for discussing sexual problems with patients. PLISSIT model (Permission, Limited Information, Specific Suggestions, and Intensive Therapy) have been demonstrated to be effective in improving sexual function. However the effects of PLISSIT model has not been evaluated in infertile couples with sexual problems. Study design, size, duration This randomized-controlled study was conducted between August 2019 - February 2020 in a fertility clinic of a university hospital in Istanbul. With a pre-study screening, 60 infertile couples with sexual dysfunction (women with a total score of ≤ 26.55 on the Female Sexual Function Index-FSFI and men with a score of ≥ 11 on the Arizona Sexual Experiences Scale-ASEX were included in the study. Participants were randomized for the counselling (30 couples) and control (30 couples) groups. Participants/materials, setting, methods Couples in counselling group were interviewed in 6 sessions (first assessment, 3 counseling sessions one week apart, 1 phone call in the second month and last assessment in the third month), and couples in control group were interviewed in 3 sessions (first assessment - 1 phone call in the second month and last assessment in the third month). FSFI, ASEX, Beck Depression Inventory-BDI, New Sexual Satisfaction Inventory-NSSI, Fertility Problem Stress Scale-FPSS were used for evaluation. Main results and the role of chance BDI total mean scores of women and men in the first asessments were similar in the counselling and control groups. In the final evaluations of the groups, women who received sexual counseling had better total scale scores and sub-dimension scores of FSFI and NSSI than the control group, and the ISS total scale scores and sub-dimension scores of women were lower than the control group. In the final evaluations of men in counselling group, mean ASEX score was positively lower, the total scale and sub-dimension scores of the NSSI were higher and the ISS total scale and sub-dimension scores were lower than the control group. Limitations, reasons for caution The long-term results of sexual counseling were not followed and the long term intensive therapy phase could not be carried out in this study. Results are limited to primary infertile couples with sexual problems in the setting of this reserch. Wider implications of the findings In order to comprehensively evaluate couples while providing sexual education and counseling with a planned and systematic approach, using counselling models for sexual function such as the PLISSIT model is recommended. Trial registration number ClinicalTrials Protocol ID: 13022260-300-108795

Investigating perceived core disaster competencies of nurses in Iran: A case study of northwest hospitals.

This study was carried out to investigate the perception of the main competencies of disaster management in Iranian emergency department nurses in 2023 in hospitals affiliated with Kermanshah University of Medical Sciences. The present study was conducted to explore the perceived core disaster competencies in nurses of hospitals affiliated with Kermanshah University of Medical Sciences in 2023. Due to the rise in natural disasters, their escalating severity and associated regulatory response necessitate a closer look at the preparedness and core competencies of nursing personnel. The main competencies of nurses are necessary to deal with disasters in unexpected events, and they are expected to use their professional expertise to provide the required nursing services to reduce the risks caused by disasters. This descriptive-analytical study was conducted cross-sectionally between May and September 2023. In the study, a sample of 384 nurses working in the departments of four hospitals affiliated with Kermanshah University of Medical Sciences was selected through a random stratification. The data collection instrument was a 45-item scale of nurses' perceived core competencies (NPDCC) in handling disasters. The data were analyzed using the Mann-Whitney U-test, Kruskal-Wallis test, and independent samples t-test. The significance level was set at 5%. The mean total score of perceived core disaster competencies was 139.11±37.65. The technical skills subscale got the highest score (51.81±11.28) and critical thinking skills received the lowest (9.74±3.92). Also, "technical skills" had the highest average and "critical thinking skills" had the lowest average in all three age groups. The results found a significant difference between the scores of nurses in perceived core disaster competencies in age groups, work environments, education degrees, marital statuses, and experiences of attending disaster workshops (p ≤ 0.05). The results showed that nurses had different levels of core disaster competencies in the department. There are gaps in the core disaster nursing competencies that need to be filled. Nursing managers should consistently evaluate the core nursing competencies to achieve efficacious disaster preparedness. To this aim, it is recommended that authorities implement training courses and programs to enhance the preparedness of nurses in responding to disasters.

Evaluation of the effectiveness of a video-based educational intervention on perinatal mental health related stigma reduction strategies for healthcare professionals: A single group pre-test-post-test pilot study

BackgroundHealthcare professionals have a role to play in reducing perinatal mental health related stigma. AimTo assess the effectiveness of a video-based educational intervention developed to provide guidance to healthcare professionals on perinatal mental health related stigma reduction strategies. DesignA single group pre-test-post-test pilot study with no control group. Setting(s)A university affiliated maternity hospital in Ireland ParticipantsA convenience sample of registered midwives, nurses and doctors (n = 60) recruited from October 2020-January 2021. InterventionA twenty-minute video-based educational intervention. MethodsRespondents (n = 60) completed a pre-test (time point one) and post-test (time point-two) questionnaire, and a three-month follow-up post-test questionnaire (time point-three) (n = 39). The questionnaire included the Mental Illness Clinicians' Attitudes Scale, Reported and Intended Behaviour Scale, Reynolds Empathy Scale and open-ended questions. Wilcoxon Signed Rank Test was selected to evaluate the pre-test post-test scores. ResultsThe difference in mean Mental Illness: Clinicians' Attitudes-4 scores were statistically significant between time points one and three (z = 3.27, df=36, P = 0.0007) suggesting more positive attitudes towards people with mental health conditions after the intervention. The mean total score for the Reported and Intended Behaviour Scale increased from 18.7 (SD 1.87) at time point one to 19.2 (SD 1.60) at time point two (z= -3.368, df=59, P = 0.0004) suggesting an increase in positive intended behaviours towards those with mental health issues immediately following the intervention. These findings were also corroborated by responses to open-ended survey questions. ConclusionsFurther research with a larger sample of healthcare professionals evaluated over a longer period would provide further evidence for the sustainability of the intervention. TweetableAbstract: A video-based intervention can increase healthcare professionals’ knowledge of perinatal #mentalhealth related stigma reduction strategies @Journal. Link to article

Nursing students' pain management self-efficacy and attitude towards patients with chronic pain: What can be done better in education? A cross-sectional study

AimThis study has been conducted to determine nursing students' pain management self-efficacy and attitudes towards patients with chronic pain. BackgroundPain is a significant phenomenon that often leads individuals to seek medical attention, influenced by various factors and commonly encountered by healthcare professionals. Adequate knowledge and positive attitudes among nurses play a crucial role in the thorough assessment and effective management of pain, resulting in favorable outcomes for hospitalized individuals. DesignThis study used a descriptive cross-sectional design. MethodsThe research was conducted with 322 undergraduate students who were continuing their education in the autumn semester of the 2023–2024 academic year at Aksaray University, Faculty of Health Sciences, Department of Nursing. Data have been collected by using Student Information Form, Pain Management Self-Efficacy Questionnaire (PMSEQ) and the Attitude of Healthcare Professionals towards Patients with Chronic Pain Scale. Mann-Whitney U, Kruskal-Wallis significance test and Spearman Correlation analysis have been used to evaluate the data. ResultsThe mean total score of the PMSEQ was 62.91 (SD 15.58) and the mean total score of the Attitude of Healthcare Professionals Towards Patients with Chronic Pain Scale was 3.94 (SD.52). Those students who willingly opted for the nursing profession, perceived themselves as proficient in managing chronic pain, administered care to patients experiencing pain during clinical placements, believed they received sufficient education in pain management throughout their studies and rated their overall health status as "very poor" demonstrated higher levels of self-efficacy in pain management (p<0.05). As a result of the analysis performed according to the mean scores of the Attitude of Healthcare Professionals Towards Chronic Pain Patients Scale and its sub-dimensions of the students participating in the study, a statistically significant difference has been found according to their gender, academic year and self-sufficiency in pain management (p<0.05). It has been determined that there is a weak positive correlation between the total mean scores of the participants' PMSEQ and the Attitude of Healthcare Professionals Towards Patients with Chronic Pain scale (r=.260; p<0.01). ConclusionsIn this study, as nursing students' self-confidence in pain management self-efficacy increased, their attitudes towards patients with pain also increased positively. In the nursing curriculum, there is a necessity for integrating pain management education and fostering awareness to adequately equip nursing students in addressing the pain requirements of patients.

The Impact of Diagnosed Chronic Sleep Disorders on Outcomes Following Total Knee Arthroplasty

BackgroundUp to 20% of patients undergoing total knee arthroplasty (TKA) remain dissatisfied with their outcome, leading to the identification of risk factors for poor outcomes. The purpose of this study was to analyze the effect of chronic sleep disorders on patient-reported outcomes after primary TKA. MethodsA retrospective review of patients undergoing primary TKA was conducted using a prospectively collected database of patients from a single institution between 2018 and 2022. The cohort was split based on the presence of documented chronic sleep disorders, identified preoperatively from the electronic medical record using current procedural terminology codes. The sample was further restricted to include all patients who have sleep disorders (SDs), as well as a 3:1 propensity-matched (on age, sex, body mass index, and American Society of Anesthesiologists class) cohort of patients who had no documented SDs (NSDs) prior to surgery. The final sample included 172 patients (SD: 43; NSD: 129). Repeated-measures linear mixed model analysis was used to analyze the progression of Knee Injury and Osteoarthritis Outcome Score (KOOS) through time between groups. ResultsThose who had SDs had a lower preoperative mean total KOOS score (40.2) than the NSD group (44.1); however, this was not significantly different (P = .108). At 1 year postoperatively, those who had an SD had a significantly higher mean total KOOS score (87.2) than the NSD group (80.4), P = .005. When comparing total KOOS scores by group, over each time period, the SD group showed a better progression when compared to the NSD group, P = .001. ConclusionsCompared to patients who did not have documented chronic sleep disorders, patients who had a prior history of chronic sleep disorders reported significantly greater improvements in most KOOS domains in the 12-month period following TKA.

EMDR Flash Technique in adolescents with depression: A twelve-week follow-up study.

This study aims to investigate the specific effects of the EMDR Flash Technique on adolescents with depression. This follow-up study consists of 32 adolescents, 12-17years of age (M = 14.34, SD = 1.56), including 7 males and 25 females. They were evaluated with Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present, the Beck Depression Inventory (BDI), and Children Revised Impact of Event Scale-8 (Crıes-8). These were administered at baseline, at the end of the 4th and 12th weeks of treatment. The EMDR Flash Technique which can be utilized in the preparation phase of Eye Movement Desensitization and Reprocessing (EMDR) to reduce the intensity of highly distressing memories rapidly and relatively painlessly was applied for 12weeks, one session per week as a free-standing intervention. Also, the EMDR Flash Technique can be effective in decreasing the rate of noncompliance and drop-outs of adolescents. The baseline means of total BDI scores decreased from 48.19 to 2.16 at the end of the 12th week of treatment. Also, the CRIES scores decreased from 31.78 to 0.44 at the end of the 12th week of treatment. In addition, the baseline means of SUD scores decreased from 9.53 to zero at the end of the 12th week of treatment. Overall, our results underscore the effectiveness of the EMDR-Flash Technique in adolescents with depression.

Effectiveness of combined approach to recurrent respiratory papillomatosis (RRP).

Recent approaches for recurrent respiratory papillomatosis including local injection of bevacizumab and HPV vaccination show promise in reducing the need for frequent surgeries. In this study we propose a new combined approach of surgery, intralesional injection of 25mg bevacizumab and HPV vaccine that can lead to resolution of RRP. Our study involved 5 patients treated with a combination of transoral microsurgery, intralesional injection of 25mg bevacizumab, and HPV vaccination with Gardasil 9 between April 2020 and May 2023. Standard video laryngoscopy was performed to assess the presence of papilloma and Derkay score was used to assess the severity of disease. All 5 patients completed the study successfully and a complete response was achieved by all. The follow-up ranged from 8 to 45months. The mean total Derkay score before treatment was 41 (range 25 to 52) and after the combined approach was 0 both anatomically and clinically in all patients. This study demonstrates the effectiveness of a combined treatment approach for RRP involving surgical intervention, intralesional injection of bevacizumab, and HPV vaccination.

The Relationship Between Health Literacy, Quality of Life, and Physical Activity Level of Hemodialysis Patients with Chronic Kidney Disease: Cross-Sectional Study

Objective: The aim of this study was to assess the health literacy of patients receiving hemodialysis and to determine the relationship between health literacy, quality of life, and physical activity level. Methods: The study was conducted in a cross-sectional design with 113 hemodialysis patients who met the inclusion criteria and who were treated at a Private Dialysis Center between September and October 2023. Personal Information Form, European Health Literacy Scale Turkish Adaptation, International Physical Activity Questionnaire Short Form, and Kidney Disease Quality of Life Scale were used for data collection. Data were analyzed using percentage distributions, means, standard deviation, median values, Pearson and Spearman Correlation Analysis, Chi-Square Test, One-Way Analysis of Variance, Kruskal-Wallis Analysis of Variance, and p&amp;lt;0.05 was accepted as the cut-off value for statistical significance. Results: The health literacy level of hemodialysis patients was found to be "problematic" with a mean total scale score of 25.9±82 points. 48.7% of the patients had low physical activity level. Statistical differences were found between personal characteristics such as age, marital status and educational status and health literacy dimensions (p&amp;lt;0.05). While a statistically significant relationship was found between health literacy and physical activity value (p&amp;lt;0.05), no statistically significant relationship was found with quality of life (p&amp;gt;0.05). Conclusions: Hemodialysis patients should be evaluated at regular intervals individualized interventions should be developed and patients should be guided to increase their health literacy and physical activity levels.

Comparing research attitudes in Down syndrome and non-Down syndrome research decision-makers.

Recruitment challenges in people with and without Down syndrome (DS) can delay research progress and risk sample bias. This study identified and quantified differences in research attitudes across populations of research enrollment decision-makers for individuals with and without DS. We performed analyses using data from two registries: the University of California, Irvine Consent-to-Contact (C2C) Registry and DS-Connect. The former represented a sample of non-DS decision-makers (N = 4818), while for the latter, we excluded individuals with DS, leaving a population of DS family decision-makers (N = 976). We assessed scores on the Research Attitudes Questionnaire (RAQ) between DS and non-DS decision-makers. We compared total RAQ scores using linear regression and assessed item-level RAQ differences using proportional odds regression. Mean total RAQ scores were not statistically different between decision-makers in the two registries, after adjusting for age, sex, race and ethnicity, education, and the coronavirus disease 2019 (COVID-19) time frame (Est. Diff = 0.11, 95% confidence interval [CI]: -0.22, 0.43; p = 0.531). However, in a pre-specified analysis, we did find evidence of differential attitudes on item-level RAQ scores. Specifically, decision-makers for participants with DS had increased odds of a more favorable response to the question of responsibility to help others (DS vs. non-DS: odds ratio [OR] = 1.26, 95% CI: 1.08, 1.48) and decreased odds of a more favorable response to the question regarding the belief that medical research would find cures for major diseases during their lifetime (DS vs. non-DS: OR = 0.77, 95% CI: 0.66, 0.90). Our findings provide insights for researchers to develop strategies for recruiting individuals with and without DS into clinical research. The observed item-level differences warrant further investigation to instruct precise recruitment strategies. Research attitudes between decision-makers for individuals with Down syndrome (DS) and decision-makers without DS were observed to be similar on average.Item-level differences in research attitudes were observed to differ for DS and non-DS decision-makers.These results can help facilitate precise recruitment strategies for populations with DS.

Focused Acceptance and Commitment Therapy Skills Training (FACT-ST) program for paraprofessionals serving families of children with special health care needs: A service evaluation study

Addressing mental health needs among parents of children with Special Health Care Needs (SHCN) requires improved access to effective interventions. This study assessed the satisfaction, skills implementation intention, and psychological flexibility of frontline paraprofessionals providing family and child rehabilitation services for families of children with SHCN in Hong Kong following participation in a Focused Acceptance and Commitment Therapy Skills Training (FACT-ST) program. The training program comprised two phases: an initial foundation training stage (i.e., the FT group), which provided theoretical instruction on ACT, and a subsequent supervised practice stage (i.e., the FT + SP group), during which participants were required to conduct at least three video-conferencing FACT sessions with parents of children with SHCN under supervision. A diverse sample of 317 paraprofessionals participated, with 246 completing the foundation training and an additional 71 completing both training phases. The FACT-ST program was positively received, as indicated by high average client satisfaction questionnaire scores. In the FT + SP group, paired sample t-test indicated that the mean total skills implementation intention score remained consistent at the 3-month follow-up (M = 36.65, SD = 7.56) when compared to the 2-week follow-up (M = 36.00, SD = 8.28, P = 0.063). Repeated measures analysis of covariance showed significant improvements in psychological flexibility from baseline to the 3-month follow-up in both the FT (F = 57.57, P = < 0.001, ηp2 = 0.20) and the FT + SP groups (F = 19.06, P = < 0.001, ηp2 = 0.24). Qualitative feedback highlighted the utility of live demonstrations, experiential exercises, and collaborative interactions during training. Our findings are one of the first affirming both the feasibility and acceptability of the FACT-ST program for paraprofessionals working with parents of children with SHCN. The findings underscore the potential of paraprofessionals to become crucial contributors to the mental health care system, addressing service gaps within the community.

Disability and long-term breathlessness: a cross-sectional, population study

IntroductionDisability, resulting from altered interactions between individuals and their environment, is a worldwide issue causing inequities and suffering. Many diseases associated with breathlessness cause disability but the relationship between disability...

Montreal Cognitive Assessment (MoCA): Normative Data for the State of Kerala, South India.

Montreal cognitive assessment (MoCA) is a tool that is widely accepted across the world to measure mild cognitive impairment (MCI). The original cut-off score of MoCA falsely screens a large population of Indians as having MCI. The aim of this study was to develop the normative data for MoCA for the older population of Kerala, South India. We conducted the study among 959 cognitively normal older individuals of Kalliyoor village of Thiruvananthapuram district, Kerala. The validated Malayalam version of MoCA [MoCA-M] was administered by trained volunteers. The mean, median, and 10th percentile of the scores [domain-specific and total] were calculated in various age and educational groups. The mean (SD) MoCA score was 19.4 (7.3). The 10th percentile for the total MoCA score was 9. The 10th percentile for all domains was zero, except for orientation. As age advanced, MoCA scores significantly reduced. The mean total MoCA scores dropped from 20.1 (7) [for ages between 65 and 75 years] to 7.4 (1.6) [for ages above 85 years]. We also obtained a significant improvement in scores among subjects with higher educational standards. The study throws light into the performance of MoCA among the Indian population. This study defines the norms for the Indian population and suggests redefining the threshold for positively screening for MCI using MoCA-M.

Development of an electronic health record-integrated patient-reported outcome-based shared decision-making dashboard in oncology.

Patient-reported outcomes (PROs) describe a patient's unique experiences with disease or treatment, yet effective use of this information during clinical encounters remains challenging. This project sought to build a PRO based dashboard within the electronic health record (EHR), prioritizing interpretability and utility of PROs for clinical decision-making. Codesign principles were used to define the goal, features, and visualization of the data elements on the dashboard. Codesign sessions occurred between February 2019 and May 2020 and involved a diverse group of stakeholders. Pilot evaluation of dashboard usability was performed with patients and clinicians not involved in the codesign process through qualitative interviews and the Systems Usability Scale. The dashboard was placed into a single tab in the EHR and included select PROM scores, clinical data elements, and goals of care questions. Real-time data analytics and enhanced visualization of data was necessary for the dashboard to provide meaningful feedback to clinicians and patients for decision-making during clinic visits. During soft launch, the dashboard demonstrated "good" usability in patients and clinicians at 3 and 6 months (mean total SUS score >70). The current dashboard had good usability and made PRO scores more clinically understandable to patients and clinicians. This paper highlights the development, necessary data elements, and workflow considerations to implement this dashboard at an academic cancer center. As the use of PROs in clinical care is increasing, patient- and clinician-centered tools are needed to ensure that this information is used in meaningful ways.

Impact of Kono-S anastomosis on quality of life after ileocolic resection in Crohn's disease: an analysis from the SuPREMe-CD trial.

Crohn's disease has debilitating effects on patients' quality of life. Currently, there are limited data on the effect of anastomotic configuration on health-related quality of life after ileocaecal resection for Crohn's disease. This study aimed to assess the impact of Kono-S anastomosis on quality of life after ileocolic resection, compared to the conventional side-to-side anastomosis. Patients with primary or recurrent Crohn's disease participating in the ongoing SuPREMe-CD trial were interviewed about quality of life using the Inflammatory Bowel Disease Questionnaire (IBDQ). The primary endpoint was disease-specific quality of life, assessed with IBDQ. Secondary outcomes were quality of life related to bowel symptoms, systemic symptoms, social function and emotional function. Of the 94 patients included, 51 (54%) received the conventional side-to-side anastomosis and 43 (46%) the Kono-S anastomosis. Demographics were comparable between the two groups. The IBDQ was assessed at a mean follow-up of 54.0 ± 18.7 months from surgical intervention. The mean total IBDQ score was 155.1 ± 28.07 in the conventional group and 163.8 ± 25.23 in the Kono-S group (P = 0.11). When considering bowel symptoms and social function, mean scores were 50.7 and 23.5 in the conventional group, and 56.3 and 26.5 in the Kono-S group (P = 0.002 and P = 0.02, respectively). Kono-S anastomosis was independently associated with improved quality of life regarding bowel symptoms (P = 0.006) and social function (P = 0.03) after correcting for other confounding factors on linear regression analysis. Compared to conventional side-to-side anastomosis, patients with Kono-S anastomosis presented significantly better bowel symptoms and social function scores at 54 months after surgery.