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Quality of life is widely acknowledged as one of the most important outcomes in autism research, but few measures of this construct have been validated for use in autistic people. The goal of the current study was to examine the psychometric properties of the Patient-Reported Outcomes Measurement Information System Global–10, an established self-report measure of health-related quality of life, in a sample of 901 autistic adults (predominantly female and adult-diagnosed) recruited from the Simons Foundation Powering Autism Research for Knowledge cohort. Using an item response theory framework, we performed a comprehensive psychometric evaluation of the Patient-Reported Outcomes Measurement Information System Global–10 in this sample, examining its latent structure, differential item functioning, reliability, and construct validity. After developing an autism-specific measurement model, the Patient-Reported Outcomes Measurement Information System Global–10 demonstrated excellent psychometric properties in the current sample, including excellent model-data fit, high reliability, minimal differential item functioning across subgroups of autistic adults, and an expected pattern of correlations with external variables. Exploratory analyses indicated that lower quality of life was associated with female sex and identified as a sexual/gender minority. A free online score calculator has been created to facilitate the use and interpretation of normed Patient-Reported Outcomes Measurement Information System Global–10 general quality of life latent trait scores for clinical and research applications (available at https://asdmeasures.shinyapps.io/promis_qol ). Lay Abstract Quality of Life an outcome that both researchers and autistic advocates agree is extremely important to consider when implementing services, interventions, and supports for autistic people. However, there has been little research on the topic of how quality of life can best be measured in autistic people or whether existing quality of life questionnaires are appropriate for use in the autistic population. This study aimed to validate an established quality of life measure, the Patient-Reported Outcomes Measurement Information System Global–10, in a large sample of autistic adults recruited online. We created a new way to score the Patient-Reported Outcomes Measurement Information System Global–10 scale and generate a “General quality of life” score specific to autistic adults. This new score performed very well in this sample, showing very little measurement error and relating in expected ways to similar constructs, such as physical health and emotional distress. Exploratory analyses found that lower quality of life was associated with female sex and self-identification as a sexual or gender minority (i.e. LGBTQ + identity). These findings suggest that the new Patient-Reported Outcomes Measurement Information System Global–10 quality of life score is a reliable and valid measure of quality of life in autistic adults, although additional studies are necessary to further explore its measurement properties in other subsets of the autistic population, such as individuals with intellectual disabilities. This measure is freely available for use as an outcome in both research and clinical practice, and an online score calculator is available to support the use of this measure in real-world applications.

Quilombola communities are present in many Brazilian states living in precarious health conditions. This is due to geographic isolation, limitations to the access of the area in which they live in, and the lack of quality in the service when it is needed to be provided. Therefore, the aim of this study was to analyze the quality of life of women from a quilombola community in northeastern Brazil. It is an observational, cross-sectional and descriptive study. 160 adult women were first interviewed through a form to collect a profile and then it was applied the WHOQOL Quality of Life questionnaire – bref. It was observed that the women were on average 40.7 years old (±17.25), married, self-declared black, who did not finish elementary school, housewife, had no income, with their own masonry house, with up to 6 rooms, supplied by a box of community treated water. Quality of Life had median scores in the domains: physical (3.18), psychological (3.4), social relationships (3.45) and environment (2.59). With this research, it was possible to characterize the quilombola community of Santa Luzia do Norte-AL regarding the difficulties of access to health and income generation, issues that affect their health condition. The problems described in this study can contribute to health actions being planned and carried out in order to improve socioeconomic and health conditions in this community, considering the social, political and environmental context, valuing their traditional knowledge and practices. Resumo As comunidades quilombolas, estão presentes em diversos estados brasileiros, vivendo em condições de saúde mais precárias. Isto ocorre por conta do isolamento geográfico, das limitações de acesso e da falta de qualidade no serviço quando este é prestado. Nesse sentido, o objetivo do estudo foi analisar a qualidade de vida de mulheres de uma comunidade quilombola do nordeste brasileiro. Estudo observacional, transversal e descritivo. Foram entrevistadas 160 mulheres adultas, através de um formulário para a coleta de perfil e do questionário de Qualidade de Vida WHOQOL – bref. Foi observado que as mulheres tinham em média 40,7 anos (±17,25), casadas, autodeclaradas negras, com fundamental incompleto, do lar, sem renda, com moradia de alvenaria, própria, com até 6 cômodos, abastecidas por caixa de água comunitária, tratada. A Qualidade de Vida, apresentou escores medianos nos domínios: físico (3,18), psicológico (3,4), relações sociais (3,45) e meio ambiente (2,59). Com a realização desta pesquisa foi possível caracterizar a comunidade quilombola de Santa Luzia do Norte-AL quanto as dificuldades de acesso a saúde e geração de renda, fatos que repercutem na sua condição de saúde. Os problemas descritos neste estudo podem contribuir para que ações de saúde sejam planejadas e efetivadas com o intuito de melhorar as condições socioeconômicas e de saúde nessa comunidade, considerando-se o contexto social, político e ambiental, valorizando seus saberes e práticas tradicionais.

Sharp edge eye syndrome (SEES), sometimes known as visual looming syndrome, is a condition in which the patient experiences ocular pain or discomfort when viewing or mentally picturing sharp objects and edges. Patients may present for medical care because they perceive the condition to represent an ophthalmic problem or a sign of a more serious underlying condition. An individual case report of SEES is included to aid in illustrating syndrome characteristics. Our aim is to describe the syndrome, vision-related quality of life (VRQOL), and psychosocial characteristics in patients with self-identified SEES.A cross-sectional web-based survey was made available on social media webpages dedicated to SEES. The study included 22 questions developed by the research team, demographic questions, and 4 standardized questionnaires [ID Migraine, the National Eye Institute's Visual Function Questionnaire (NEI-VFQ-25), General Anxiety Disorder-2 (GAD-2), and Patient Health Questionnaire (depression) Scale-2].Seventy-seven respondents had an average age of 29 and were 57% male. 92% reported symptoms before age 18. The main site of pain or discomfort was the eyes, with onset resulting from viewing or thinking of sharp objects and edges. Symptoms lasted from seconds to hours and could be prolonged even after closing eyes or avoiding viewing the trigger. The composite and subscale scores on the NEI-VFQ-25 were low, with a mean composite score of 78 and selected subscores of general health (61), general vision (73), ocular pain (68), driving (79), mental health (61), and role difficulties (72). Anxiety was reported in 58% of participants, and depression in 57%. Migraine or headache was reported in 46% of participants. Participants reported Alice in Wonderland syndrome, visual snow, obsessive-compulsive disorder, attention deficit hyperactivity disorder, stripe-induced visual discomfort, and synesthesia.From this survey, we have the beginnings of an understanding of the characteristics of SEES, as well as VRQOL impacts. These survey responses lead us to postulate that SEES may be a distinct visual phenomenon and to propose SEES criteria. Systematic studies of this condition's clinical features and treatment responses will be additional steps toward improving patient care.

Background The consequences of a single point-in-time compared to cumulative exposure to psychosocial work conditions (PWCs) for young adults’ mental health have received relatively little attention. This study investigates (i) the associations between single and cumulative exposure to adverse PWCs at ages 22 and 26 with mental health problems (MHPs) among young adults at age 29 and (ii) the effect of early life MHPs on MHPs at age 29. Methods Data were used from 362 participants in the TRacking Adolescents’ Individual Lives Survey (TRAILS), a Dutch prospective cohort study with 18-year follow-up. PWCs were assessed at ages 22 and 26 with the Copenhagen Psychosocial Questionnaire. Internalizing (i.e. depressive and somatic complaints, anxiety) and externalizing MHPs (i.e. aggressive and rule-breaking behaviour) were measured by the Youth/Adult Self-Report at ages 11, 13, 16, 19, 22 and 29. Regression analyses were conducted to examine the associations between single and cumulative exposure to PWCs and MHPs. Results Single exposure to high work demands at ages 22 or 26 and high-strain jobs at age 22 were associated with internalizing problems at age 29; the association attenuated after adjustment for early life internalizing problems but remained significant. No associations were found between cumulative exposures and internalizing problems. No associations were found between single or cumulative exposures to PWCs and externalizing problems at age 29. Conclusions In view of the mental health burden in working populations our findings call for early implementation of programmes targeting both work demands and MHPs to keep young adults working.

The aim of this study was to assess health inequalities by sexual attraction in the 2016-2017 Barcelona population, stratifying by sex. Methods: Data came from the 2016-2017 Barcelona Health Survey, where 3362 adults answered among other instruments the EuroQol-5 dimensions-5 levels (EQ-5D-5L), which measures five dimensions and summarizes health-related quality of life into a single utility index score. To assess health differences by sexual attraction, we constructed Tobit models for the EQ-5D index score and Poisson regression models for the EQ-5D dimensions. Nested models were constructed to examine the mediating role of discrimination and health-related variables. Results: After adjusting for sociodemographic variables, women feeling attraction to more than one sex showed a lower EQ-5D index score (worse health) than those with only other sex attraction (-0.042, p = 0.012), and higher prevalence of problems with mobility, usual activities, and anxiety/depression with the following adjusted prevalence ratios (aPR) and confidence intervals (CIs): 1.79 (95% CI 1.05-3.05), 1.84 (95% CI 1.05-3.21), and 1.76 (95% CI 1.27-2.43). Women feeling attraction only to their same sex also presented higher prevalence of anxiety/depression (aPR = 1.46, CI 95% 1.10-1.92). In contrast, differences were not observed for men. Conclusion: Women, but not men, feeling attraction to more than one sex and only same-sex attraction in Barcelona in 2016-2017 presented worse health than those feeling only other sex attraction, with discrimination playing a mediating role in explaining such inequalities. These results among women indicate the need to develop public health strategies in Barcelona addressed to lesbian and bisexual women, considering the intersection of gender and sexual orientation.

OBJECTIVE: Examine how executive functioning (EF), healthcare management, and self-efficacy relate to college students’ health-related quality of life (HRQOL). PARTICIPANTS: Undergraduates completed questionnaires at baseline (Time 1; n=387) and 18–24 months later (Time 2; n=102). METHODS: Participants reported on their EF and healthcare management skills at Time 1 and self-efficacy and mental and physical HRQOL at Time 2. RESULTS: Students with fewer EF problems reported higher mental and physical HRQOL at both timepoints and those with higher healthcare management skills had higher mental and physical HRQOL at Time 1. Higher self-efficacy mediated the relation between EF and mental HRQOL, and the relation between healthcare management and mental HRQOL. CONCLUSIONS: Findings illustrate two potential pathways by which self-management, in healthcare settings or daily living, contributes to mental HRQOL during emerging adulthood. Assessing EF and healthcare management could help identify those at risk of low HRQOL and provide information that can inform interventions in college settings.

Short sleep duration and evening chronotype are independently associated with negative health outcomes. However, it is unclear how adolescent sleep duration and chronotype are longitudinally associated with health outcomes during early adulthood.Participants from the NEXT Generation Health Study (n = 2,783; 54.5% female) completed measures of sleep duration (scheduled day and unscheduled day) and chronotype in high school. Sleep duration, chronotype, general health, depressive symptoms, and psychosomatic symptoms were also assessed 4 years after high school. Latent variables estimated high school scheduled-day sleep duration, unscheduled-day sleep duration, and chronotype using the during high school measures. Two path analyses tested the prospective associations between high school sleep duration (separate models for scheduled and unscheduled days) and chronotype with 4 years after high school health outcomes as mediated by concurrent sleep duration and chronotype.In the scheduled-day model, longer high school sleep duration and later chronotype were associated with longer duration and later chronotype in early adulthood. Longer high school sleep duration was directly associated with fewer psychosomatic symptoms and indirectly associated with fewer depressive and psychosomatic symptoms through longer sleep duration in early adulthood. Later chronotype in high school was indirectly associated with poorer general health, greater depressive symptoms, and greater psychosomatic symptoms in early adulthood through later chronotype.Findings highlight the roles of scheduled-day sleep duration and evening chronotype in shaping health outcomes and suggest the importance of chronotype and optimal sleep habits among adolescents.Maultsby KD, Temmen CD, Lewin D, et al. Longitudinal associations between high school sleep characteristics and young adult health outcomes.

Several crucial reasons exist to identify whether an adult has had reading disorder (RD) and to predict a child’s likelihood of developing RD, which is known to be primarily genetically transmitted. The Adult Reading History Questionnaire (ARHQ) is among the most commonly used self-reported questionnaires. High ARHQ scores indicate an increased likelihood that an adult had RD as a child, and that their children may develop RD. This study focused on whether using a subset of ARHQ items (ARHQ-brief) could be equally effective and efficient in assessing adults’ reading history. We used a machine learning approach, lasso (known as L1 regularization), and identified 6 of 23 items that resulted in the ARHQ-brief. Data from 97 adults and 47 children were included. With the ARHQ-brief, we report a threshold of 0.323 as suitable to identify past likelihood of RD in adults with a sensitivity of 72.4% and a specificity of 81.5%. Comparison of predictive performances between ARHQ-brief and the full ARHQ showed that ARHQ-brief explained an additional 10-35.2% of the variance in adult and child reading. Further, we validated ARHQ-brief’s superior ability to predict reading ability using an independent sample of 28 children. We close by discussing limitations and future directions.

Discordance between physicians and patients’ health beliefs can impede health communication efforts. However, little research considers physicians’ perceptions of patient beliefs, despite the impor...

We examined the moderating role of posttraumatic stress disorder (PTSD) in the association between trauma and impulsive behaviors. Adult women ( N = 97) with a history of childhood sexual abuse (CSA; n = 26), rape in adulthood ( n = 21), both CSA and adult rape ( n = 25), or no history of sexual trauma ( n = 25) completed self-report questionnaires. PTSD symptoms were positively associated with self-harm and with stealing and accident proneness, but not with sexual impulsivity. Trauma group had no independent associations with impulsive behaviors. PTSD reexperiencing symptoms interacted with trauma group such that reexperiencing symptoms were positively associated with self-harm for the two trauma groups that included CSA but not for the control and adult rape-only groups. Overall, results indicate that PTSD symptoms-more so than the occurrence of trauma itself-associate with impulsive behavior. Results highlight the importance of assessing posttraumatic symptomatology, and not just trauma occurrence, when aiming to prevent or treat impulsive behaviors.

Personalized feedback interventions are effective in reducing alcohol consumption and related problems. However, little is known about the role of choice in outcomes. The current study sought to (a) characterize individuals who opt in for brief alcohol-related feedback, (b) assess participants' consistency in that choice over two time points, and (c) evaluate changes in peak alcohol consumption among those who did and did not receive feedback.Participants reporting past-12-month alcohol consumption were recruited through Prolific. At the outset of the survey, participants were asked if they would like to receive feedback on their drinking at the end of the survey ("opt in"). Participants at Time 1 (T1;Those reporting higher maximum drinks and more drug use were more likely to opt in to feedback than those with lower use. Further, 85% of participants were consistent in their choice of whether to receive feedback across T1 and T2 (κ = .65). Among heavy drinking participants with T1 and T2 data (Individuals who engage in heavy alcohol use are more likely to opt in to personalized alcohol feedback, and most do so consistently. Among heavy drinkers, feedback at T1 reduced intensity of consumption at T2, but the effect was small and requires future replication in more diverse samples.

Personal networks undergo changes in structure and composition throughout the life span, adapting to developmental transitions and changing circumstances in a dynamic way. This study examines stability and change in social convoys from childhood to adulthood and variation in trajectories of convoy characteristics by gender and race. Multilevel models for convoy structure and composition characteristics were estimated using three waves of longitudinal data spanning 23 years. The regionally representative sample included 193 children aged 8 to 12 in Wave 1 (1992) who were surveyed again in their 20s (Wave 2) and 30s (Wave 3). The Wave 1 sample comprised 52% girls, 32% Black children, and 59% White children with average maternal educational attainment of 13 years. Overall, changes in composition, proximity, and contact frequency were observed at each wave. Between Waves 1 and 2, the changes reflect age-normative trends toward network diversification typical of the transition to adulthood, whereas between Waves 2 and 3, the changes were consistent with those expected as young adults settle into stable roles. We also identified convoy characteristics that differed between men and women and between Black and White individuals, emphasizing the importance of considering personal characteristics to fully understand form and function of social relations. Social convoy trajectories early in the life span provide direction for more in-depth examinations of the implications of social ties during these critical life periods. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Aim: Complementary therapies are being increasingly preferred in patients receiving anticancer therapy to strengthen the effect of chemotherapy and control cancer-related symptoms. In this study, we investigated the prevalence of complementary therapy (CT), the factors associated with its use, physician-patient information sharing about CT use, and the effect of CT on the survival and treatment process in lung cancer patients receiving chemotherapy. Methods: This study was designed as a cross-sectional study including patients who underwent chemotherapy for lung cancer between November 2020 and March 2022 in the department of medical oncology at Tekirdag Namik Kemal University. A structured questionnaire with twenty questions was used. Fluor-18-fluorodeoxyglucose positron emission tomography/CT, and brain magnetic resonance imaging were used to stage the patients. The stages were grouped as early (stages 1B-3A) and advanced (stages 3B-4A). Results: A total of 242 patients included in the study. One hundred and forty-seven (60.7%) patients reported using at least one type of CT since the first diagnosis. “Families/relatives” (n=128; 63.7%) and “other patients” (n=67; 33.3%) were the primary sources from which patients obtained CT information. The most widely used CT methods were recorded as phytotherapy (79.6%) and apitherapy (59.2%). 125 (85%) of the patients said that they used CT to support their existing anticancer treatments. Of the patients using CT, 94 (63.9%) stated that they did not disclose their use of CT to their physicians. The majority of patients stated that their physicians did not inquire about using CT. In the cox regression analysis performed to determine survival benefit, no survival benefit from the use of CT was determined (hazard ratio=0.86, p=0.495). In the subgroup analysis, the use of CT was associated with survival in early-stage patients, but no survival relationship was found in advanced-stage patients (log-rank p=0.027 and p=0.842, respectively). Conclusion: The use of CT in conjunction with medical treatment is common among patients with lung cancer. The influence of the oncologist in guiding the use of CT in cancer patients is weak. Additionally, the use of CT does not provide benefits in terms of survival. © 2023 by The Medical Bulletin of Istanbul Haseki Training and Research Hospital The Medical Bulletin of Haseki published by Galenos Yayinevi.

Although at-home coronavirus disease-2019 (COVID-19) testing offers several benefits in a relatively cost-effective and less risky manner, evidence suggests that at-home COVID-19 test kits have a high rate of false negatives. One way to improve the accuracy and acceptance of COVID-19 screening is to combine existing at-home physical test kits with an easily accessible, electronic, self-diagnostic tool. The objective of the current study was to test the acceptability and usability of an artificial intelligence (AI)-enabled COVID-19 testing tool that combines a web-based symptom diagnostic screening survey and a physical at-home test kit to test differences across adults from varying races, ages, genders, educational, and income levels in the United States.A total of 822 people from Richmond, Virginia, were included in the study. Data were collected from employees and patients of Virginia Commonwealth University Health Center as well as the surrounding community in June through October 2021. Data were weighted to reflect the demographic distribution of patients in United States. Descriptive statistics and repeated independent t tests were run to evaluate the differences in the acceptability and usability of an AI-enabled COVID-19 testing tool.Across all participants, there was a reasonable degree of acceptability and usability of the AI-enabled COVID-19 testing tool that included a physical test kit and symptom screening website. The AI-enabled COVID-19 testing tool demonstrated overall good acceptability and usability across race, age, gender, and educational background. Notably, participants preferred both components of the AI-enabled COVID-19 testing tool to the in-clinic testing.Overall, these findings suggest that our AI-enabled COVID-19 testing approach has great potential to improve the quality of remote COVID testing at low cost and high accessibility for diverse demographic populations in the United States.

Patient-centered communication (PCC) is a key indicator of healthcare quality and is critical to patient-centered care. The purpose of this study is to examine the trends in PCC over the past decade and determine if differences in PCC by subpopulation remain METHODS: We used nationally representative survey data from the Health Information National Trends Study (HINTS) to examine PCC. We conducted trend and multivariate regression analyses to understand the changes of PCC scores and differences in PCC by key sociodemographic groups.PCC reported among adults minimally increased with the largest increases in participants involved in making decisions regarding their healthcare. Participants who were non-Hispanic Black, older, had less than a high school education, or rural residents reported more positive perceptions of PCC CONCLUSION: Our findings indicate improvements to PCC over time. These findings also indicate that differences in patients' perceptions of PCC continue to persist and it's possible that personal expectations may influence a person's perception of the quality of PCC experienced PRACTICE IMPLICATIONS: This study highlights the continued need for provider education in patient emotional support and providing patients with the skills and resources to engage in high quality PCC.

During Ramadan, Muslims fast from dawn to dusk for the duration of the month. The current literature focuses on adults who fast, with little attention to pediatric practices. An anonymous, digital survey was conducted using Qualtrics software and distributed to residents, fellows, or attendings in Michigan in 2019. Overall, 278 participants were included in the analysis, with 87% (242/278) identifying as pediatric trained physicians. In all, 82% (228/278) of physicians identified as non-Muslim and 76% (211/278) had never partaken in the Muslim fast. About 52% (141/273) of participants had at least a moderate amount of exposure to Muslim pediatric patients in their clinical practice. Most physicians (66%; 175/265) reported they never asked their pediatric patients or their families about fasting. About 61% (167/273) of participants rated their understanding of fasting as minimal to none. Another 52% (142/273) of participants reported feeling somewhat or extremely uncomfortable discussing fasting recommendations with their pediatric patients and their families. Our study is the first of its kind in assessing current knowledge and practice regarding pediatric Muslim fasting among physicians in the United States. In addition, it highlights a gap in physicians' understanding and comfort in providing anticipatory guidance for their Muslim patients.

Despite the need for the heads of departments to implement the labor functions of a clinician and manager, the study of personal growth and perceived ability to work in this category of medical workers was not carried out.determining the relationship of personal growth and perceived ability to work of heads of departments of medical organizations, as well as the impact on self-esteem of various characteristics of this category of respondents.A correspondence survey was conducted of 216 heads of clinical departments in the section «personal growth» of the questionnaire «psychological well-being of Riff» and the questionnaire «perceived ability to work» of the Institute of Social Research of the University of Michigan. The personal growth index is the average score according to the statements of the 1st questionnaire. The index of ability to work is the sum of points for each of the statements of the 2nd questionnaire. The average length of service is 23.1 ± 8.60 years, the average age is 47.9 ± 8.08 years. 123 (56.9%) men, 117 (54.2%) worked in a hospital, 114 (52.8%) worked in the «red zone», 111 (51.4%) have a second higher education, 138 (63.89%) have a qualification category, 63 (29.1%) have an academic degree. The Spearman correlation coefficients and the Student's criterion are calculated to assess the relationship and significance of differences between indices and characteristics.The personal growth index is 4.89 ± 0.818, the work ability index is 33.60 ± 4.564 points. Respondents aged 41-50 have significantly (p0.001) lower indices. There was no significant difference between the index of personal growth and the index of ability to work in respondents of different sexes (р = 0.864 and р = 0.951), those who worked in inpatient and outpatient settings (р = 0.834 and р = 0.848); those who worked in the «red zone» (р = 0.727 and р = 0.775), respondents with a qualification category (р = 0.543 and р = 0.404), with an academic degree (р = 0.871 and р = 0.898), with the second highest education (р = 0.443 and р = 0.588). There is an average direct correlation of personal growth indices and perceived ability to work (r = 0.6; p0.001).The relationship between personal growth indices and perceived ability to work, significantly lower indices in the group of 41-50 years and over 60 years must be taken into account to ensure the professional development of department heads.Введение. Несмотря на необходимость реализации заведующими отделениями трудовых функций врача-клинициста и менеджера, изучение личностного роста и воспринимаемой способности к труду у данной категории медицинских работников не проводилось.Цель исследования: определение связи личностного роста и воспринимаемой способности к работе заведующих отделениями медицинских организаций, а также влияние на самооценку различных характеристик данной категории респондентов.Материалы и методы. Выполнено заочное анкетирование 216 заведующих клиническими отделениями по разделу «личностный рост» опросника «психологического благополучия Риффа» и опросника «воспринимаемой способности к работе» Института социальных исследований университета Мичигана. Индекс личного роста - средний балл по утверждениям 1-й анкеты. Индекс способности к работе - сумма баллов по каждому из утверждений 2-й анкеты. Средний стаж 23,1 ± 8,60 года, средний возраст 47,9 ± 8,08 года. Мужчин - 123 (56,9%) человека, работали в стационаре 117 (54,2%), в «красной зоне» - 114 (52,8%), имеют второе высшее образование 111 (51,4%), квалификационную категорию 138 (63,89%), учёную степень 63 (29,1%). Рассчитаны коэффициенты корреляции Спирмена, критерии Стьюдента для оценки связи и значимости различий индексов с характеристиками.Результаты. Индекс личностного роста равен 4,89 ± 0,818, индекс способности к работе 33,60 ± 4,56 балла. Значимо (р0,001) меньшие индексы имеют респонденты 41-50 лет. Не обнаружено значимой разницы индекса личностного роста и индекса способности к работе у респондентов разного пола (р = 0,864 и р = 0,951), у работавших в стационарных и амбулаторных условиях (р = 0,834 и р = 0,848); у работавших в «красной зоне» (р = 0,727 и р = 0,775), респондентов с квалификационной категорией (р = 0,543 и р = 0,404), с учёной степенью (р=0,871 и р=0,898), со вторым высшим образованием (р = 0,443 и р = 0,588). Имеется средней силы прямая корреляция индексов личностного роста и воспринимаемой способности к работе (r = 0,6; р0,001).Заключение. Связь индексов личностного роста и воспринимаемой способности к работе, значимо более низкие индексы в группе 41-50 лет и старше 60 лет необходимо учитывать для обеспечения профессионального развития заведующих отделениями.

Tuberculosis is a communicable mycobacterial disease of humans and animals caused by members of Mycobacterium tuberculosis complex, highly impacting the public health and economy of the country in endemic areas. Retrospective and cross-sectional study was conducted between March and August 2021. For knowledge, attitude, and practices study, five villages were randomly selected using simple random sampling. To quantify the public health burden, one-year data were collected from Jarso Health Center, and unregistered patients were identified using snowball method, and the estimation was based on disability-adjusted life years. Younger age groups (18-40 years) had shown 105.8 times more odds of knowledge towards tuberculosis than the older (>60 years). Moreover, tertiary levels of education had 9395.1 times more odds of knowledge towards tuberculosis compared to illiterates. The estimated economic burden was 7,731.25US$. Of the 51 tuberculosis patients, two died from the disease, resulting in 45.03 disability-adjusted life years. Communities of the study district were heard about tuberculosis, however, unaware of the cause and sources of the infection. Therefore, further strategic and continuous community-based health education and awareness should be given for effective control and prevention of tuberculosis in the study area.

Emerging adults (EAs) with type 1 diabetes (T1D) often experience challenges in diabetes management, in particular transitioning to financial independence. EAs 18-30 years of age with T1D completed online surveys about diabetes distress and an open-ended query about the most important worry among survey questions. Most of the 287 respondents (89.5%) endorsed "Agree" or "Somewhat agree" to the statement "I worry about the cost of diabetes." Responses did not differ by gender, age, diabetes duration, race/ethnicity, diabetes technology use, student status, income, or insurance status. However, a greater proportion of those not endorsing cost as a substantial burden achieved A1c7% (92.9%) versus those who were neutral (46.2%) or who endorsed cost as a burden (50.6%) (

The purpose of this study was to describe and validate the association between patient's self-administered correct site checklist and perceptions of importance for safe surgery.A multisite nonexperimental, quantitative, descriptive study.A convenience sample of 173 adult patients from four different geographical multisite hospitals was included in the study. Inclusion criteria were age 18 to 75 years old, scheduled for surgery/procedure with laterality and ability to follow instructions. After IRB approval, investigators explained the purpose of the study, process and obtained consent from willing participants. Participants with clinical or behavioral limitations were excluded from the study. Participants completed a 24 item survey before and during surgery using a four-point Likert scale from one (not important) to four (extremely important). Descriptive data was analyzed using means, standard deviations, and percentage. All data was summarized and analyzed with STATA 12.Most of the participants perceived the importance of the survey checklist items positively implying that the active engagement is an important role for safe surgery. However, a few participants reported some of the items as not important/somewhat important: "It is on my left or right side" (6.9%); "surgery on my: (state your limb) and (right or left site) (1.9-3%); "check electronic access or copy of imaging with correct name and site" (14.9%); "state your name and birthday" (4%), "check correct ID bracelet information" (2.9%) and "believe in having an active role in preventing error" (2.3%). Some participants responded, "My surgeon knows it or surgery has been scheduled". Findings indicated that even though the importance of correct site surgery is critical for patient's surgery, a few patients reported it as noncritical and relied on healthcare team for their safety.This study validated the importance of the patients' perceived roles in promoting safe, correct site surgery and by engaging patients in mitigating correct site surgical errors. Therefore, inclusion of patients as an integral part of the healthcare team is necessary through education and encouragement to speak out.

This cross-sectional study aimed (a) to explore levels of compassion satisfaction, secondary traumatic stress, and symptoms of burnout among Ugandan mental health nurses working in regional referral hospitals in Uganda during the Covid-19 pandemic, and (b) to investigate associations between compassion satisfaction, secondary traumatic stress, and symptoms of burnout and sedentary levels, physical activity (PA) levels, sleep quality, and harmful drinking.In total 108 mental health nurses from 8 regional referral hospitals across Uganda (age = 34.8 ± 10.0 years; 55.6 % female) completed the Professional Quality of Life Scale-5, (PQoLS-5), the Simple Physical Activity Questionnaire (SIMPAQ), Physical Activity Vital Sign (PAVS), Pittsburgh Sleep Quality Index (PSQI), and Alcohol Use Disorder Identification Test - Concise (AUDIT-C). Spearman Rho correlations and Mann-Whitney U tests were applied.ProQOL-5 compassion satisfaction correlated significantly with SIMPAQ walking, PSQI and AUDIT-C, ProQOL-5 burnout with SIMPAQ exercise and PSQI and ProQOL-5 traumatic with SIMPAQ walking and PSQI. Mental health nurses meeting PA guidelines reported higher ProQOL-5 compassion satisfaction and lower ProQOL-5 burnout and traumatic stress than those who did not. Those who reported a poor sleep quality reported significantly less ProQOL-5 compassion satisfaction and higher ProQOL-5 burnout than those who did not. Those who reported harmful drinking patterns reported a significantly lower compassion satisfaction versus those who did not.In mental health nurses, a lower professional quality of life is associated with an unhealthy lifestyle. The effectiveness and efficacy of resilience and self-care programs for mental health nurses focusing on unhealthy lifestyle patterns should be explored.

We evaluated the association between the chronic severe back pain with disability and participation, in U.S. Adults using data from the US 2019 National Health Interview Survey. In our sample of 2,925 adults (weighted n: 20,468,134) who reported having chronic severe back pain, 60% reported mobility disability, 60% had work limitations, 34% were limited for social participation and 16% had self-care limitations. Older age (65+) was associated with mobility difficulties (OR 1.99, 95% CI 1.28,6.09) and work limitation (OR 2.21, 95% CI 1.61,3.05). Lower socioeconomic status was associated with increasing odds of disability across the 4 categories. Being obese was only associated with mobility difficulties (OR 1.95, 95% CI 1.41,2.71), while not working in the past week was associated with difficulties in mobility (OR 3.55, 95% CI 2.64,4.75), self-care (OR 3.34, 95% CI 2.20,5.08), and social participation (OR 3.20, 95% CI 2.13,4.80). Comorbidities were highly associated with limitations in all 4 categories. Those deeming their ability to manage their pain ineffective were twice as likely to have limitations in self-care, social and work participation but not mobility. Identifying factors associated with disability and limitation may help target appropriate management for persons with chronic pain at high risk for disability. PERSPECTIVE: We evaluated the association between the chronic severe back pain with disability and participation, in a representative sample of Americans. Identifying factors associated with a likelihood of disability may help target appropriate pain management for persons at high risk for disability due to chronic severe back pain.

Metabolic and bariatric surgery (MBS) in adolescents has been shown to be safe and effective, but current practice patterns are variable and poorly understood. The aim of this study is to assess current MBS practice patterns among pediatric surgeons in the United States.American Pediatric Surgical Association members were surveyed on current bariatric surgery practices.Four hundred and three (40%) surgeons out of a total of 1013 pediatric surgeons responded to the survey. Only 2 respondents had additional training in MBS (0.5%). One hundred thirty-two (32.6%) report that their practice participates in metabolic and bariatric surgery, with 123 (30.4%) having a specific partner specializing in MBS. Most respondents (92%) stated that they believe high volume is associated with better outcomes with regard to MBS. Only 17 (4.2%) surgeons performed a metabolic and bariatric surgery in the last year. All routinely perform sleeve gastrectomy as their primary procedure. Most (82%) perform procedures with an additional surgeon, either another pediatric surgeon (47%) or an adult bariatric surgeon (47%). All pediatric bariatric surgeons responded that they believe high volume led to better outcomes. Adolescent MBS programs most commonly included pediatric nutritionists (94%), pediatric psychologists (94%), clinical nurses (71%), clinical coordinators (59%), pediatric endocrinologists (59%), and exercise physiologists (52%).Only 17 (4.2%) respondents had performed a metabolic and bariatric surgery in the past year, and few of those had additional training in MBS. Future work is necessary to better understand optimal practice patterns for adolescent metabolic and bariatric surgery.Review article.Level III.

With increasing telehealth technology, confirming the validity of non-office administration of questionnaires intended for office use only is important. We studied 3 validated questionnaires: the Urinary Distress Inventory 6-Short Form, the International Incontinence 7-Short Form, and a quality of life survey using a deception model.Following Institutional Review Board approval and power calculations, these 3 questionnaires were prospectively administered in women with and without incontinence by phone and then again in person about 2 weeks later. To avoid recall bias, participants were not informed of the study over the phone. After completing their office visit questionnaire scores, they were told about the study and invited to consent for comparison of their phone and in-person questionnaire scores. Non-English speakers and those with an active urinary tract infection, with impaired mental competency, or on a fluid diet were excluded.From June to September 2021, 86 women, including 40 incontinent (30-85 years old) and 46 control (30-85 years old), with similar demographic parameters met all study criteria. Of the 14 questions studied, only 2, ie, Question 1 on the Urinary Distress Inventory 6-Short Form (The 3 questionnaire scores were overall comparable when obtained over the phone or during office visits. Women with incontinence, who may otherwise be lost to follow-up or only reachable by telehealth calls, can benefit from the remote administration of these 3 questionnaires.

Narcolepsy often begins during adolescence and young adulthood, which are crucial periods for social development. The symptoms of narcolepsy likely impact social interactions, but little research has assessed the effects of narcolepsy on social relationships. The current study investigated the impact of narcolepsy on friendships and romantic and sexual relationships.Young adults (18-39 years) with narcolepsy were recruited through national narcolepsy patient organizations. Participants (n = 254) completed an online survey assessing their friendships and romantic and sexual relationships, including communication about their social relationships with medical providers.All participants (mean age = 28.8 years; 87% female, 92% White/Caucasian) reported that narcolepsy made their social life more challenging. They reported receiving more support from significant others, compared to family or friends (Narcolepsy impacts social functioning in young adults. Many individuals with narcolepsy prioritize single, meaningful, romantic relationships as developing and sustaining new relationships may be challenging. In addition, narcolepsy symptoms impact sexual functioning. Though many participants wanted to discuss their social and sex lives with providers, only a few providers ask. Treatment of narcolepsy in young adulthood should include supporting individuals regarding the impact on social, romantic, and sexual health.Davidson RD, Biddle K, Nassan M, Scammell TE, Zhou ES. The impact of narcolepsy on social relationships in young adults.

Uncontrolled bleeding is a leading cause of preventable death. The "Stop the Bleed" (StB) program trains laypersons in hemorrhage control. This study evaluated the efficacy of video-based StB training.Participants watched two different videos: a didactic video (DdV) and a technical video (TeV) demonstrating proper techniques for StB skills (i.e., direct pressure [DP], wound packing [WP], and tourniquet application [TA]). Then, they completed a standardized skills examination (SE). Participants were surveyed at three different time points (baseline, post-DdV, and post-SE) for comparison. We compared paired categorical and continuous variables with the McNemar-Bowker test and Wilcoxon signed-rank test, respectively. Alpha was set at 0.05.One hundred six participants were enrolled: 52% were female and the median age was 23 y (22, 24). At baseline, 29%, 8%, and 13% reported being somewhat or extremely confident with DP, WP, and TA, respectively. These percentages increased to 92%, 79%, and 76%, respectively, after the DdV (all, P0.0001). After the TeV and SE, percentages increased further to 100%, 96%, and 100% (all, P0.0001). During the SE, 96%, 99%, and 89% of participants were able to perform DP, WP, and TA without prompting. Among participants, 98% agreed that the video course was effective and 79% agreed that the DdV and TeV were engaging.We describe a novel paradigm of video-based StB learning combined with an in-person, standardized SE. Confidence scores in performing the three crucial StB tasks increased significantly during and after course completion. Through remote learning, StB could be disseminated more widely.

A recent study found high levels (43%) of moderate to severe symptoms of depression among patients diagnosed with endometriosis in South Africa (SA) and identified several psychosocial predictors of these symptoms of depression. However, there is limited research on predictors of symptoms of depression in other settings. Considering the contextual differences between SA and the United Kingdom (UK) and their vastly different healthcare settings, we conducted a replication study in the UK and improved on the methodology by adding an established measure of sexual dysfunction to the model and obtaining a larger sample. The study comprised of a secondary analysis of cross-sectional data collected among patients with endometriosis. Study particulars were advertised by a national endometriosis association and data were collected online using Qualtrics. The sample consisted of 598 adults with self-reported endometriosis who completed measures assessing symptoms of depression, physical functioning, menstrual characteristics, sexual functioning, feelings about the medical profession, feelings about infertility, and sexual relationships. Seventy-one percent of participants reported moderate to severe levels of symptoms of depression. In addition, physical functioning, concerns about menstrual characteristics, sexual dysfunction, feelings about infertility and feelings about the medical profession were identified as significant predictors of symptoms of depression. It is important that healthcare professionals recognize that patients with endometriosis may be at risk of depression and that psychological referral should be considered.

There are no recommended treatments for chemotherapy-induced peripheral neuropathy (CIPN) prevention. Recruitment to CIPN prevention clinical trials is challenging because it is difficult to enroll patients between the time of cancer diagnosis and the initiation of neurotoxic chemotherapy. The purpose of this exploratory-sequential mixed-methods study was to determine patients' preferences that could affect the choice to participate in CIPN prevention clinical trials.First, twenty cognitive interviews were conducted with adults who completed less than three neurotoxic chemotherapy infusions to clarify clinical trial attributes and levels thought to be important to patients when deciding whether to enroll in CIPN prevention trials (i.e., type of treatment, clinical tests, reimbursement, survey delivery; length of visits, timing of follow-up, when to begin treatment). Second, another eighty-eight patients completed an adaptive choice-based conjoint analysis survey that incorporated the finalized attributes and levels. Each level was assigned a part-worth utility score using Hierarchical Bayes Estimation. The relative importance of each attribute was calculated.The attributes with the highest relative importance values were type of treatment (27.1%) and length of study visits (20.2%). The preferred levels included non-medicine treatment (53.49%), beginning treatment after experiencing CIPN (60.47%), email surveys (63.95%), assessments that include surveys and clinical exams (39.53%), under 30-min visits (44.19%), $50/week reimbursement (39.53%), and 1-month post-chemotherapy follow-up visits (32.56%).Patients' preferences for participation may be included in the design of future CIPN prevention clinical trials to potentially bolster study enrollment.

The aim of this study was to analyze the prevalence and characteristics of child sexual abuse (CSA) in Andalusia, Spain's most populated region. A sample of 817 adults (281 male

Exercise, like daily walking, may improve overall health and impede progression of chronic kidney disease (CKD); however, no specific walking dose has been recommended for patients with CKD. We aimed to investigate the association between daily walking steps and health-related quality of life (HRQOL) in adults with CKD.The walking steps of patients with CKD were extracted from the We Run mobile application. Their average daily walking steps were calculated and subdivided into the low-, middle-, and high-level groups. HRQOL was assessed using the physical component summary (PCS) and mental component summary (MCS) of the MOS 36 Short Form Health Survey (SF-36).A total of 558 adults (50.5%, men) with an average age of 40.2 (±13.8) years were enrolled. The median daily step count was 7,404 steps. The daily walking step count demonstrated an inverse U-shaped relationship with the SF-36 and subscale scores. Participants with daily walking steps between 7,000 and 12,000 have the highest PCS (68.1 ± 12.2) and MCS scores (70.0 ± 19.5). The multiple linear regression model showed that compared with patients with a daily step count of 7,000 to 12,000, patients with a daily step count12,000 had a significantly lower MCS score (P .001), while patients with a daily step count7,000 had significantly lower PCS (P .001) and MCS scores (P = .034). Moreover, the multivariable logistic regression model showed that patients with a daily step count12,000 had significantly lower mental health-related quality (odds ratio [OR], 2.188; 95% confidence interval [CI], 1.079-1.439 for low MCS), while those with a daily step count7,000 had a significantly lower HRQOL than the 7,000 to 12,000 daily step count group (OR, 2.113; 95% CI, 1.203-3.711 for low PCS; OR, 2.099; 95% CI, 1.210-3.643 for low MCS).These findings suggest that daily walking steps between 7,000 and 12,000 are associated with high HRQOL in adults with CKD.

We aimed to assess the impact of first-person abortion stories on community-level abortion stigma.Between November 2018 and March 2019, we recruited participants and analyzed data from a nationally representative, probability-based online panel of U.S. adults, randomized to watch three first-person abortion video stories (intervention, n = 460) or three nature videos (control, n = 426). We measured community-level abortion stigma using the Community Abortion Attitudes Scale, Reproductive Experiences and Events Scale, and Community Level Abortion Stigma Scale at baseline, immediately after video exposure, and 3 months later. We dichotomized stigma change scores as decreased stigma compared with no change or increased stigma. Bivariate and logistic regression analysis accounted for complex survey methodology and sample weighting.Sample demographics reflected U.S. Census benchmarks (51% female, 68% White, 47% aged 18-44 years). Most participants (83.1%) completed the 3-month follow-up. Viewing the intervention videos was not associated with decreased stigma measured by Community Abortion Attitudes Scale or Community Level Abortion Stigma Scale immediately (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.59-1.09; OR, 1.28; 95% CI, 0.93-1.75) or at the 3-month follow-up (OR, 0.86; 95% CI, 0.62-1.19; OR, 0.98; 95% CI, 0.70-1.37). Intervention exposure was associated with decreased stigma as measured by Reproductive Experiences and Events Scale immediately (OR, 1.74; 95% CI, 1.23-2.46); however, this association was not observed at the 3-month follow-up (OR, 0.98; 95% CI, 0.70-1.37).Exposure to first-person video stories may not decrease community-level abortion stigma among U.S. adults.

Amidst the rapid rise in melatonin supplementation, decreased testosterone levels amongst males in recent decades, and the unclear association between melatonin and the hypogonadal-pituitary-gland (HPG) axis, this study aimed to further examine the association between melatonin use and testosterone levels among men in a nationally representative sample.U.S. men over the age of 18 surveyed from 2011-2016 via the National Health and Nutrition Examination Survey (NHANES) without missing demographic or pertinent health information were included in the analysis. A total testosterone (TT) level of less than 300 ng/dL was considered low. An average daily dose (ADD) was calculated to quantify participants' exposure to melatonin supplementation in the past 30 days.Analysis included 7,656 participants after selection criteria. The median age of participants was 47 [31-63] years old; the median TT level was 389.9 [289 - 513.9] ng/dL. Melatonin intake was reported in 51 (0.7%) individuals with an ADD of 1 [0.4 - 3] mg/day. We found no association between melatonin intake in the past 30 days and low TT levels (OR = 0.958, 95% CI: 0.496 -1.850; P=0.898). As expected, increasing BMI (OR = 1.133, 95% CI: 1.122 - 1.144; P0.001) and older age (OR = 1.019, 95% CI: 1.016 - 1.022; P0.001) were associated with low TT levels.Predominantly low-dose melatonin supplementation was not associated with low TT levels. Future studies are needed to better quantify the relationship between melatonin intake and low TT levels, especially in the setting of supratherapeutic doses and prolonged periods of exposure.

Depressive and obsessive-compulsive (OCD) symptoms often co-occur and a number of possible explanations for this co-occurrence have been explored, including shared biological and psychosocial risk factors. Network approaches have offered a novel hypothesis for the link between depression and OCD: functional inter-relationships across the symptoms of these conditions. The few network studies in this area have relied largely on item, rather than process-level constructs, and have not examined relationships dimensionally.Network analytic methods were applied to data from 463 treatment-seeking adults with OCD. Patients completed self-report measures of OCD and depression. Factor analysis was used to derive processes (i.e., nodes) to include in the network. Networks were computed, and centrality, bridge, and stability statistics examined.Networks showed positive relations among specific OCD and depressive symptoms. Obsessions (particularly repugnant thoughts), negative affectivity, and cognitive-somatic changes (e.g., difficulty concentrating) were central to the network. Unique relations were observed between symmetry OCD symptoms and cognitive-somatic changes. No direct link between harm-related OCD symptoms and depression was observed.Our results bring together prior findings, suggesting that both negative affective and psychomotor changes are important to consider in examining the relationship between OCD and depression. Increased consideration of heterogeneity in the content of OCD symptoms is key to improving clinical conceptualizations, particularly when considering the co-occurrence of OCD with other disorders.

Between 33 and 59% of youth with chronic health conditions experience mental health conditions. Transition readiness, or the acquisition of knowledge and self-management skills, facilitates successful transition to adult care. Transition readiness among youth with co-occurring chronic health and mental health conditions has not been explored.This study used a sample of 201 patients (aged 16-21) with chronic conditions. All patients completed the Transition Readiness Assessment Questionniare (TRAQ) and were grouped into Cohort A: chronic health conditions only (n = 140), and Cohort B: co-occurring chronic health and mental health conditions (n = 61). A quantile regression at the 50th percentile was conducted to examine associations between TRAQ score and mental health comorbidity, age, gender and immigration status.The median TRAQ score for Cohort A was 3.87 (IQR 0.84) versus 4.00 (IQR 0.87) for Cohort B. Our analysis revealed that having a mental health comorbidity (b = 0.402, p = 0.034), being older in age (b = 0.540, p = 0.004) and being female (b = 0.388, p = 0.001) were associated with higher overall TRAQ score.The presence of a mental health comorbidity was associated with greater transition readiness as measured by the TRAQ in our sample. Future research should explore why youth with co-occurring chronic health and mental health conditions exhibit greater transition readiness.Youth with co-occurring chronic health and mental health conditions may develop transition readiness as a result of coping with mental health challenges. Practitioners could invite them to reflect on how their physical and mental health are related and affect their level of preparedness for adult care.

Objective To verify the association between vocal perception and Common Mental Disorders (CMD) suspicion in trans women. Methods Cross-sectional observational study including 24 adult trans women with a minimum time of presentation as a woman of six months. The sampling of the subjects was supported by the “Snowball" technique. Three questionnaires were applied for data collection: sociodemographic and health data, Self-Reporting Questionnaire (SRQ-20) and Trans Woman Voice Questionnaire (TWVQ). The sociodemographic and health data collected were: age, marital status, education, smoking habits, speech therapy, use of hormones, and whether they had undergone Sex Reassignment Surgery (SRG). SRQ-20 was used for suspicion of CMD evaluation, such as depressive and anxiety symptoms. TWVQ is a vocal self-report questionnaire for trans women living the full-time gender role in which they self-identify. TWVQ has a minimum score of 30 points and a maximum of 120 points. Higher scores are associated with perceptions of a higher frequency of voice-related difficulties and psychosocial impacts. For statistical analysis, data were analyzed descriptively and statistically using Fisher's and Mann-Whitney's exact tests, both with a significance level of 5%. Results The average participants’ age in this study was 28.2 years old (SD = 6.5 / minimum = 21 and maximum = 48); 83.3% were single; most (41.7%) were high school graduates; and most (95.83%) had not undergone Sex Reassignment Surgery. All subjects reported using hormones; 37.5% were smokers; 4.2% had undergone speech therapy; and the average number of years of experience in the female role was 8.8 years (SD = 7.2). The average TWVQ score was 55.4 points (SD = 4.3). Through SRQ-20, it was verified the prevalence of suspected CMD in 58.3% of the participants. The study results indicated that communicative dissatisfaction in trans women due to inconsistent voice with the recognized gender is associated with probable CMD such as depression and anxiety (P= 0.001). Conclusion Trans women who reported greater difficulties and voice-related effects in their lives had more symptoms of anxiety and depression. Although more research is needed, results indicate the need for inter-professional preventive and therapeutic actions directed towards assisting trans women. This fact encourages reflection on the care of this population and the role of health professionals, enhancing scientific production, clinical practice and the inclusion of the “transsexuality” theme in Speech Language and Hearing Sciences.

To develop and assess the test-retest reliability of a survey exploring high-performance athletes' perceptions and experiences during and post-pregnancy.Cross-sectional mixed-methods survey.A three-phase approach was employed to develop the Mum-Alete survey. Relevant domains and questions were identified through a review of the literature and gap analysis (Phase 1). The face and content validity were assessed during Phase 2. The survey was modified, and the final survey included 113 questions. The test-retest reliability was assessed during Phase 3. Seven athletes aged ≥18 years who were currently pregnant and/or given birth since 1 July 2016 were recruited. The survey was administered via Qualtrics and completed on two occasions. Intraclass correlation coefficient (ICC) were determined to assess test-retest reliability (excellent, good, moderate, and poor).The average ICC of all items was 0.962 (95% CI 0.957-0.966) demonstrating excellent test-retest reliability. The test-retest reliability was excellent for the demographic and general questions domain (ICC = 0.967 95% CI 0.955-0.977) and good for the exercise (ICC 0.762 95% CI 0.707-0.811), physical health (ICC 0.841 95% CI 0.810-0.868) and well-being (ICC 0.827 95% CI 0.784-0.865) domains.The high test-retest reliability of the survey indicates excellent consistency of measures between the two time-points.

to investigate the effects of a successful KT on EF in male patients with ESRD.A single-center cross-sectional prospective study to assess the erectile dysfunction in male patients one month before and one year after KT. We adopted a validated, self-administered translated International Index of Erectile Function (IIEF-15) questionnaire. A sub-analysis was performed by categorizing the cohort into 2 age groups:50 and ≥50 yr.Between September 2017 and February 2021, 68 ESRD patients underwent kidney transplantation (KT), with a mean age of 48.9 ± 12.9 years. Thirty-one patients were below 50 years (Group I). The median hemodialysis duration was 12 months. Sixty-three patients (92.6%) had ED. The mean total IIEF-15 score before and after was 46.8/75 ±12.7 and 55.5 ±13, respectively (P.001). Forty-six patients (67.6%) reported improved erectile function, 22 (32.4%) did not demonstrate any change, and no patient reported deterioration. Moreover, after KT, sexual desire, orgasm, and overall patient satisfaction improved significantly. Before KT, 83.8% and 100% of groups I and II patients had ED, which dropped to 22.6% and 86.5%, respectively, after KT. IIEF-15 scores improved in both groups. However, the improvement in ED was observed significantly in young patients with mild ED.KT positively impacts sexual function and improves erectile dysfunction, especially among young patients. The duration of dialysis before kidney transplantation had no impact on ED improvement after transplantation. The positive effect of transplantation on ED could encourage ESRD patients to undergo KT.

Many pediatric heart transplant (HT) recipients reach adulthood and may be interested in family planning; there is little data regarding safety of pregnancy post HT and clinicians' opinions differ. Pediatric HT clinicians are instrumental in early counseling. Thus, a better understanding of pediatric HT clinicians' practices regarding family planning and how well aligned these practices are with adult transplant centers is essential.We conducted a confidential, web-based survey of pediatric HT clinicians in fall 2021. We summarized and compared answers using Fisher's exact test.The survey was sent to 53 United States-based HT directors and to the International Society for Heart and Lung Transplantation and Pediatric Heart Transplant Society list serves. There were 69 respondents. The majority (77%) of respondents felt pregnancy was feasible in selected or all female HT recipients. Ten respondents reported that their institution had an established policy regarding pregnancy post HT. A majority (77%) of HT clinicians would either use a shared care model or recommend transition to their adult institution if pregnancy occurred, though 74% of respondents were either unaware of their corresponding adult institution's policy (62%) or had a counterpart adult program with a policy against pregnancy post HT (12%).While many clinicians feel pregnancy is feasible in pediatric HT recipients, there remains significant practice variation. Few pediatric programs have a policy regarding pregnancy post HT. Future efforts to provide consistent messaging between adult and pediatric HT programs regarding the feasibility and care of post HT pregnancy are warranted.

Despite the symptom overlap between allergic rhinitis (AR) and coronavirus disease 2019 (COVID-19), pandemic-time anxiety in people with AR remains an area of limited study.To assess the AR-anxiety relationship in the unique context of the COVID-19 pandemic from a Canadian perspective.The COVID-19 Associated Anxiety in patients with Asthma and AR Experiencing Symptoms survey was distributed on the "Qualtrics XM" platform, with 835 adult participants responding to the first iteration from April to August 2020. Anxiety was assessed on the Generalized Anxiety Disorder Assessment-7 (GAD-7), and AR burden of disease was assessed on the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). All analyses were conducted using IBM SPSS Statistics 27.High levels of anxiety were found, with 28.0% of the AR group and 27.5% of the control group meeting the diagnostic criteria for generalized anxiety disorder. After controlling for covariates, AR status had no significant predictive effect on GAD-7 in a hierarchal multiple regression model (ΔRHigh levels of anxiety exist during the COVID-19 pandemic regardless of AR status, indicating the importance of early anxiety screening in all patients. This study also highlights the importance of non-nose or eye symptoms in AR management.

Background EQ-5D-5L is a standardized health outcomes instrument that can be added to national surveys to measure inequality in health outcomes. The aim of this study was to produce baseline values of health inequality using EQ-5D-5L for five countries in the Caribbean Basin region based on national surveys in 2012-2014. Methods The EQ-5D-5L questionnaire was included in adult population surveys of Barbados, Belize, Colombia, Jamaica and Trinidad and Tobago. EQ-5D-5L measures were calculated for demographic groups using stratifiers from the World Health Organization's PROGRESS-Plus framework, and generalized linear models were used to test for association between EQ-5D-5L and the PROGRESS-Plus variables. Ordered logit models were used to obtain odds ratios for the effect of the PROGRESS-Plus variables on reporting problems on the EQ-5D-5L dimensions. The Kakwani index was calculated for each country. Results Data were obtained for representative samples in each country, giving a combined total of 11,284 respondents. Different patterns of inequality were observed among the five countries. The biggest drivers of inequality were age and gender, and the biggest EQ-5D factors were self-care in Belize and pain/discomfort in the other four countries. Conclusion This study demonstrated that the EQ-5D-5L instrument can easily be added to national surveys. Inequality measures from this study can be used as baseline values for comparisons with future similar surveys in these five countries to infer changes in health inequality as measured by EQ-5D outcomes. These can be used to track the performance of policy initiatives aimed at specific demographic groups.

In Argentina, vaccines included in the national calendar are mandatory, free of charge, and access to vaccination services with social equity for all stages of life are guaranteed by law. However, vaccination coverages are still suboptimal and have shown a constant decrease in the last five years. This study aimed to perform a survey to describe the parent's confidence, risk perception, sources of information and access barriers to vaccines and vaccination in Argentina. A survey was designed for parents in charge of children under 12 years of age to answer. The questionnaire was constructed based on validated questions of the international peer-reviewed literature adapted to our country's characteristics. The survey was performed on 1,202 respondents, covering all regions of Argentina, between 19th May and 18th June 2020. To highlight, 76.6 % were female and the mean age was 40.72 (±9.36 years). 9 % participants reported to assist to the private vaccination center, while 64 % and 23 % referred to take their children to the public vaccination point (primary care center and hospital, respectively). Additionally, respondents agreed that vaccines are safe (92 %), effective (94 %), and important for children to receive them (98 %). 48 % could identify-one or more barriers to vaccination, access and affordability were the most reported ones (74 %) being the lack of vaccine the main reason. In conclusion, this study showed that the great majority of parents trust in vaccines and health care teams but access and affordability reasons emerged as the main barriers to vaccination in our country.

Misophonia is a complex disorder characterized by a heightened reaction to certain sounds and associated stimuli. While there is no uniformly accepted treatment to date, different intervention approaches are being investigated. Individual's perceptions of different misophonia treatment methods may affect compliance and satisfaction with treatment options. We sought to gather data on patient perceptions of currently available misophonia treatments.Using an online survey, we collected data about treatment preferences, treatment usage, and diagnosis history from parents of children with misophonia (N = 141) and adults with misophonia (N = 252).Most respondents were not satisfied with misophonia treatments that they or their children had previously received. Audiologic interventions including active and passive noise cancelling and lifestyle modifications were rated as most appropriate for treatment of misophonia by both parent and adult respondents.Because of the descriptive nature of this study, we chose to use a completer-only approach to ensure the data reflect the true responses of participants, though this did result in a meaningful proportion of missing data. Participants were selected through convenience sampling and responses were self-reported. Individuals with more severe misophonia symptoms may be more likely to participate and complete a research survey.Most interventions are considered inappropriate by parents of youth with misophonia and by adults with misophonia. This should be interpreted in the light of a general lack of misophonia-specific interventions. Findings suggest dissatisfaction with currently available treatments and an opportunity for development of effective treatment strategies corresponding to participants' preferences. Deeper understanding of treatment preferences has the potential to guide future treatment development.

Background Childhood cancer and its treatment can impair survivors’ development throughout life, particularly psychosexual development, which can be affected in complex ways and is crucial for survivors’ well-being. Yet, research is scarce. Aim This study assessed psychosexual development (milestone attainment, age at attainment, perceived timing) in young adult survivors of childhood cancer. It further examined sexual satisfaction and sexual functioning, and whether survivors’ perceived timing of sexual debut was related to satisfaction or functioning. Methods A registry-based nationwide survey was completed by N = 492 German survivors of childhood cancer (age 21–26 years, 6–26 years postdiagnosis). They completed standardized measures of psychosexual milestones (eg, first kiss, sexual debut), sexual satisfaction, and sexual functioning. Psychosexual development was compared to normative data (N = 1,533). Outcomes Psychosexual development, sexual satisfaction, and sexual functioning were the primary outcome measures. Psychosexual development was characterized in three ways: milestone attainment (yes/no), age at attainment, perceived timing (“right” time, too early/late). Results Milestone attainment was comparable to normative data, except for sexual debut: Survivors were less often experienced (82.5% vs 88%; P = .002) and older at sexual debut (17.4 vs 16.2 years; g = 0.55), but most survivors (58.3%) perceived their timing as “right.” Survivors of brain tumors were least likely to have had their sexual debut, but if experienced age at sexual debut was similar to other survivors. Female survivors were somewhat more experienced than males (eg, first kiss, first relationship; Clinical implications Most survivors reported favorable sexual satisfaction and functioning, but a minority of survivors may need supportive services. Strengths & Limitations This project represents one of few large-scale studies on psychosexual development in childhood cancer survivors relative to normative data, and is the first to link development to sexual satisfaction/functioning. Assessing satisfaction/functioning with validated, but brief measures limits detailed insights, but was inclusive of any sexual orientation. Medical background information based on registry data was limited. Conclusion Results showed normative psychosexual development (except for sexual debut) in most survivors. A self-determined attitude toward sexuality (ie, engaging in sexual activities at the “right” time) may generally determine positive sexual experiences.

OBJECTIVE The Young Adult Alcohol Consequences Questionnaire (YAACQ) was designed to measure the various domains of alcohol-related problems experienced by emerging adults (EAs), but has primarily been used in college samples and it remains unclear whether the psychometric properties of the YAACQ function similarly in racially and economically diverse populations. The present study assessed the factor structure and evaluated measurement invariance, latent mean differences, and correlates of the 48-item eight-factor YAACQ across college status, race, and childhood socioeconomic status (SES). METHOD EAs ages 21.5-25 (N = 602; 57.3% female, 47.0% White, 41.5 % Black, 35.4% noncollege EAs) who consumed 3/4 + alcoholic beverages (for women/men) at least twice in the previous month completed measures of alcohol use, alcohol-related consequences and demographics. RESULTS Confirmatory factor analysis (CFA) supported the 48-item eight-factor structure across the entire sample. However, one item related to academic achievement was predictably endorsed by few noncollege EAs and thus, was dropped. Multiple-group CFA demonstrated measurement invariance of a revised 47-item eight-factor YAACQ across college status, race, and childhood SES. Assessment of latent mean differences revealed that noncollege EAs reported more alcohol-related consequences overall, compared to college students, including greater endorsement of severe problem domains. White EAs reported more total alcohol-related consequences relative to Black EAs, and EAs of low childhood SES reported more total alcohol-related consequences compared to those of high childhood SES. Furthermore, all eight alcohol consequence factors demonstrated concurrent associations with weekly alcohol use, binge drinking, and high intensity drinking within each subgroup. CONCLUSIONS Findings suggest that the YAACQ is a psychometrically robust measure of alcohol-related consequences across demographic groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In Belgium, a value set for children and adolescents for a generic health-related quality-of-life measure is not available. To inform drug pricing and make resource allocation decisions for children and adolescents, national tax-payers' preferences for youth health states should be known.We aimed to obtain a value set for EQ-5D-Y-3L in Belgium, following the international youth valuation protocol for data collection.Composite Time Trade-Off interviews were conducted in a sample of 200 adults, either face to face or via video conferencing. Another sample of 1000 adults completed an online discrete choice experiment survey. All adults were asked to take the perspective of a 10-year-old child for both methods. Both samples were representative for Belgium in terms of age, sex and region. A latent class analysis was selected to obtain the relative importance of the five dimensions and their levels based on the discrete choice experiment data, which were anchored with the composite Time Trade-Off censored value for the worst health state (33333).Preferences from Belgian adults revealed a mean censored value for 33333 for children and adolescents of - 0.475. All the estimated coefficients of the model with 4 latent classes were statistically significant and showed higher disutility as severity levels increase. The most important health dimension was pain/discomfort, followed by feeling sad/worried/unhappy.This study presents the Belgian EQ-5D-Y-3L value set, which will be included in the Belgian pharmacoeconomic guidelines. The value set enables the calculation of quality-adjusted life-years in children and adolescents, allowing a cost-effectiveness evaluation of health technologies and their youth-specific price setting.

Few surveys have focused on physician moral distress, burnout, and professional fulfilment. We assessed physician wellness and coping during the COVID-19 pandemic.Cross-sectional survey using four validated instruments.Sixty-two sites in Canada and the United States.Attending physicians (adult, pediatric; intensivist, nonintensivist) who worked in North American ICUs.None.We analysed 431 questionnaires (43.3% response rate) from 25 states and eight provinces. Respondents were predominantly male (229 [55.6%]) and in practice for 11.8 ± 9.8 years. Compared with prepandemic, respondents reported significant intrapandemic increases in days worked/mo, ICU bed occupancy, and self-reported moral distress (240 [56.9%]) and burnout (259 [63.8%]). Of the 10 top-ranked items that incited moral distress, most pertained to regulatory/organizational ( n = 6) or local/institutional ( n = 2) issues or both ( n = 2). Average moral distress (95.6 ± 66.9), professional fulfilment (6.5 ± 2.1), and burnout scores (3.6 ± 2.0) were moderate with 227 physicians (54.6%) meeting burnout criteria. A significant dose-response existed between COVID-19 patient volume and moral distress scores. Physicians who worked more days/mo and more scheduled in-house nightshifts, especially combined with more unscheduled in-house nightshifts, experienced significantly more moral distress. One in five physicians used at least one maladaptive coping strategy. We identified four coping profiles (active/social, avoidant, mixed/ambivalent, infrequent) that were associated with significant differences across all wellness measures.Despite moderate intrapandemic moral distress and burnout, physicians experienced moderate professional fulfilment. However, one in five physicians used at least one maladaptive coping strategy. We highlight potentially modifiable factors at individual, institutional, and regulatory levels to enhance physician wellness.

This study aimed to explore the relationship between gender socialization and psychosocial well-being among young women diagnosed with and treated for breast cancer. A total of 113 women between the ages of 18–49 completed a one-time questionnaire package. Four key measures of gender socialization were included: Gender Role Socialization Scale (GRSS), Objectified Body Consciousness Scale (OBCS), Mental Freedom Scale (MFS), and Silencing the Self Scale (SSS). Two measures of psychosocial well-being were included: Functional Assessment of Cancer Therapy-Breast (FACT-B) and Experience of Embodiment Scale (EES). Correlational and regression analyses were conducted to assess the relationship between gender socialization variables and well-being. In multiple regression models, GRSS and MFS added significant increments to the prediction of variance of the FACT-B (R2 = 23.0%). In contrast, the OBCS and MFS added significant increments to the prediction of variance of the EES (R2 = 47.0%). Findings suggested that women with greater endorsements to proscribed gender socialization were associated with poor well-being scores. Women who endorsed a critical stance, resisting traditional gender-role expectations, objectification pressures, and other social discourses, were associated with greater well-being scores. Future studies are needed to examine the impact of gender socialization on the well-being of young people with breast cancer.

BACKGROUND: Avoidance of activities that trigger dizziness in persons with vestibular disorders may inhibit dynamic vestibular compensation mechanisms. OBJECTIVE: To determine the reliability of the Vestibular Activities Avoidance Instrument (VAAI) 81 and 9 item tool and to compare the VAAI scores in Dutch-speaking healthy adults and in patients with vestibular disorders. METHODS: A prospective cohort study was conducted including 151 healthy participants and 106 participants with dizziness. All participants completed the 81-item VAAI. Within 7 days, the VAAI was completed a second time by 102 healthy adults and 43 persons with dizziness. RESULTS: The average 81-item VAAI scores [54.8(47.1) vs. 228.1(78.3)] and 9-item VAAI scores [2.4(5.9) vs. 28.1(12)] were significantly different between healthy adults and participants with dizziness (p

Background Our study aimed to measure HIV prevalence and associated risk factors among men who have sex with men (MSM) in three regions of Paraguay in 2020. Methods MSM were recruited for cross-sectional surveys in three regions of Paraguay using respondent-driven sampling. Interview were conducted face-to-face to collect demographic characteristics and risk and preventive behaviors. The analysis assessed HIV prevalence and associated risk factors in the three samples of MSM within each region. Results A total of 1,207 MSM were recruited, including 559 in Asunción-Central, 245 in Alto Paraná, and 403 in Caaguazú. HIV prevalence was 24.2% (95% CI 20.6–27.9) in Asunción-Central, 10.2% (95% CI 6.7–14.6) in Alto Paraná, and 3.2% (95% CI 1.7–5.4) in Caaguazú. In Asunción-Central, associations with HIV were age ≥25 years (1.86, 95% CI 1.15–3.00), being employed (1.82, 95% CI 1.07–3.11), self-reporting as homosexual (1.90, 95% CI 1.06–3.43), having sex with a known HIV-positive partner acquisition (4.19, 95% CI 2.37–7.43), self-perceived as being at higher risk for HIV acquisition (4.15, 95% CI 2.54–6.77), and able to access condoms and lubricants (1.82, 95% CI 1.08–3.05). In Alto Paraná, associations with HIV were self-reporting as homosexual (4.33, 95% CI 1.19–15.65) and having higher HIV knowledge (2.53, 95% CI 0.97–6.61). In Caaguazú, associations with HIV were self-reporting as homosexual (7.06, 95% CI 1.53–32.46) and being diagnosed with depression (4.68, 95% CI 0.89–24.43). Conclusions HIV prevalence among MSM in Paraguay varied by region, being highest in the capital and major metropolitan area of Asunción-Central, followed by the border area of Alto Paraná. While being self-identified as homosexual was associated with HIV in all three regions, other associations differed, indicating prevention programs need to be tailored to the locale.