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Previous studies have demonstrated that respiratory dysfunction has a potential association with low back pain (LBP). Despite the role of the diaphragm for respiration and spinal stability, knowledge of the function of both sides of the diaphragm in subjects with LBP is still limited. This study aimed to compare the structural integrity and function of the right and left hemidiaphragm by ultrasonography (USG) in subjects with and without nonspecific chronic low back pain (NS-CLBP). A total of 37 subjects with NS-CLBP and 34 healthy subjects participated in this case-control study. The thickness, thickness change, and excursion of the right and left hemidiaphragm were compared within and between the groups during quiet breathing (QB) and deep breathing (DB) through B-mode and M-mode ultrasound imaging. The LBP group had a significantly smaller degree of right hemidiaphragm thickness change (P =.001) compared with the healthy control group, with a strong effect size. Nevertheless, there was no significant change for diaphragm thickness and excursion between the two groups. The result showed that, in the healthy group, the right hemidiaphragm had a significantly smaller thickness at expiration and larger thickness change compared with the left hemidiaphragm, with a moderate effect size. Based on the multivariate prediction analysis, the right hemidiaphragm thickness change might significantly predict LBP. We found that participants with LBP had a smaller degree of right hemidiaphragm thickness change. Also, the right hemidiaphragm thickness change might significantly predict LBP. [ABSTRACT FROM AUTHOR]

The Arthritis Self-Efficacy Scale-8 (ASES-8) is one of the most commonly used scales to measure patient-reported arthritis-specific self-efficacy. However, evidence about the validity and reliability of ASES-8 in an Arabic-speaking arthritis population is lacking. This study aimed to cross-culturally adapt and assess aspects of validity and reliability of the Arabic version of the ASES-8. The ASES-8 was translated into the Arabic language using the back-translation method, and administered to 67 patients with rheumatoid arthritis (RA). Construct validation methods used exploratory factor analysis and correlating the ASES-8 scores with disease-related variables expected to be related to the arthritis self-efficacy construct. An internal consistency test was conducted. Floor and ceiling effects were considered present if more than 15% of patients achieved high (=10) and low (=1) scores on the Arabic ASES-8 for both the scale and item scores. Exploratory factor analysis demonstrated a one-factor solution (factor loadings: 0.54–0.81). ASES-8 scores were correlated with all measures assessed (r = −0.24 to −0.57 and r = 0.06–0.66), demonstrating construct validity. Internal consistency was acceptable for measures of Cronbach's alpha (0.86–0.88). The scale did not exhibit ceiling or floor effects. The Arabic version of ASES-8 is valid and reliable for evaluating self-efficacy in patients with rheumatoid arthritis. The Arthritis Self-Efficacy Scale (ASES-8) questionnaire was translated and adapted for use in Arabic language. This questionnaire is a valid and reliable instrument for evaluating self-efficacy among Arabic individuals with rheumatoid arthritis. This will support greater use of this tool worldwide in clinical and research practices that include Arabic people. [ABSTRACT FROM AUTHOR]

To report the volumetric measures of the paralyzed vocal fold in patients undergoing injection laryngoplasty. All the medical records of patients with unilateral vocal fold paralysis who had high resolution computerized tomography scan of the neck and chest prior to injection laryngoplasty between October 2015 and May 2018 were included. Volumetric evaluation of the vocal folds was performed by measuring the vocal fold height using coronal images and the vocal fold length and width using axial images. A total of 21 patients divided into 13 males and 8 females were identified. The mean age was 56.66 ± 20.94 years. The mean volume of the paralyzed vocal fold was significantly smaller than that of the non-paralyzed vocal fold (p <.05). Similarly, the mean length and height of the paralyzed vocal folds were smaller than those of the non-paralyzed vocal folds (p <.05). Volumetric measurements of the paralyzed vocal fold in comparison to the normal vocal fold in a group of 21 patients with unilateral vocal fold paralysis shows the presence of significant difference between the normal and affected site, and the presence of large inter-subject variation. Information on the volume difference between the two vocal folds may be used to better estimate the amount that needs to be injected in medialization procedures. [ABSTRACT FROM AUTHOR]

Background: The Syrian conflict has resulted in major humanitarian crises. The risk is particularly high amongst female children who face additional gendered risks, such as harassment and sexual violence, including a rise in prevalence of child marriage. Despite the importance of this topic, current literature remains relatively scarce. Objectives: This study aims to explore the social and healthcare repercussions of Syrian refugee child marriages in Jordan and Lebanon. Methods: A systematic review of the literature was carried out to gather evidence, from a total of eight articles. Data analysis was conducted using the Critical Appraisal Skills Programme check tool to systematically assess the trustworthiness, relevance and results of the included papers. Results: The findings of this research identify tradition, honour, economics, fear, and protection-related factors as drivers of child marriage of refugees in Jordan and Lebanon. These motives overlap with findings regarding access to reproductive health and reproductive rights. The lack of autonomy of the child to give informed consent is augmented in the context of protracted violence and displacement. Conclusion: There is a need for a holistic approach to provide safe spaces, education, and protection to young girls and their families to reduce their acceptance of child marriage. [ABSTRACT FROM AUTHOR]

Objectives:Patients with cancer experience a lot of emotional, mental, social, and spiritual crises. However, not much has been done to meet these needs. The aim of this study was to evaluate the influence of spiritual group therapy on hope and the mental and spiritual health of patients with colorectal cancer. Design and methods:This quasi-experimental study was carried out in 2013 in Kerman, Iran, on 80 colorectal cancer patients, who fulfilled the eligibility criteria. After the pre-test of both groups, eight sessions of 1.5 h were held once a week for spiritual group therapy, and finally both groups underwent the post-test. To collect data, Snyder’s hope scale, the Paloutzian–Ellison 20-item spiritual health questionnaire, and the Goldberg Health Questionnaire were used. The data were analysed using the SPSS statistical software version 16. Results:Comparing the mean scores of hope, mental health, and spiritual health before and after the intervention showed a significant difference (P < 0.001) in the test group. In the control group, no significant difference was found before and after the study. This indicates the benefits of the spiritual group therapy in cancer patients. Conclusion:The study results show that spiritual group therapy has a significant positive impact on the mental and spiritual health of patients with colorectal cancer, and that it also gives them hope. Thus, the use of spiritual therapy is suggested as a good way to improve the spiritual and mental health and hope in patients with colorectal cancer. [ABSTRACT FROM PUBLISHER]

HIV-infected patients receiving antiretroviral therapy have increased risk of metabolic syndrome, including dyslipidemia. In this study, we determined whether individual nutritional counseling reduced dyslipidemia, particularly low-density lipoprotein (LDL) cholesterol, among HIV-infected patients with dyslipidemia not currently taking lipid-lowering medication. We conducted a randomized 24-week trial among HIV-infected patients with dyslipidemia who were on antiretroviral therapy and were eligible to initiate therapeutic lifestyle changes according to the Thai National Cholesterol Education Program. Participants were randomly assigned to an intervention group that received individual counseling with a nutritionist for seven sessions (baseline, weeks 2, 4, 8, 12, 18, and 24) and a control group that received standard verbal diet information at baseline and nutritional counseling only at week 24. A 24-h recall technique was used to assess dietary intake for both groups at baseline and week 24. Lipid profile (total cholesterol, LDL, high-density lipoprotein (HDL), and triglyceride) was measured at baseline and after 12 and 24 weeks of therapy. An intention-to-treat and linear mixed model were used. Seventy-two patients were randomly assigned, and 62 (86%) participants completed their lipid profile test. After 12 weeks of follow-up, there were significant reductions in the intervention group for total cholesterol (−14.4 ± 4.6 mg/dL,P = .002), LDL cholesterol (−13.7 ± 4.1 mg/dL,P = .001), and triglyceride (−30.4 ± 13.8 mg/dL,P = .03). A significant reduction in LDL cholesterol was also observed in the control group (−7.7 ± 3.8 mg/dL,P = .04), but there were no significant differences in change of mean lipid levels between the groups at 12 weeks of follow-up. After 24 weeks, participants assigned to the intervention group demonstrated significantly greater decreases in serum total cholesterol (−19.0 ± 4.6 vs. 0.2 ± 4.3 mg/dL,P = .003) and LDL cholesterol (−21.5 ± 4.1 vs. −6.8 ± 3.8 mg/dL,P = .009). There were no significant changes in HDL cholesterol or triglyceride levels in either group. [ABSTRACT FROM PUBLISHER]