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India has approximately 23 million children without parental care, who need alternative forms of care (MOSPI, 2018). Udayan Care, an NGO, designed an innovative group care model for children and youth in need of care and protection, implementing the indigenously developed LIFE (Living in Family Environment) strategy in 17 Udayan Ghars. (Sunshine Homes). With child participation as a core pillar, Udayan Care developed a Questionnaire to Assess the Needs of Children in Care (QANCC) in 2011, which is to be filled up by children annually, as a longitudinal study. The tool is conceived to ascertain whether children in the Ghars perceived if their rights were being fulfilled and that their needs were being addressed. With "meaningful participation" of children stipulated by the United Nations Convention on the Rights of the Child (UNCRC), the objective was to develop an evidence-based tool to assess the views of children on the services meted out to them, from their standpoint, and inform actual care practices annually. The self-assessment tool consists of questions, assessing the four dimensions of basic/fundamental, emotional, educational, and interpersonal needs, on a four-point Likert rating scale. A convenient purposive sampling is done on children, aged 10 to 18 years, who receive care and protection at the Ghars, and have resided there for a minimum of 6 months. This paper has two objectives, where at one end, the deductions of the previous years' data are made (2011–12 to 2016–17) with demarcating the differences with year 2018–19 data and at the second level, there is an update on the efforts made to establish the reliability and validity of the tool and create a standardized tool that can be implemented by other child care organizations in India. The paper illustrates how listening to direct voices of children and incorporating their inputs into actual care practice, can go a long way in improving the holistic wellness of children living in an alternative care setting. The results indicate that all needs of the majority of the children in Udayan Ghars. [ABSTRACT FROM AUTHOR]

Female genital mutilation (FGM) involves the cutting of the external female genital organs for non-medical purposes. It is a widespread public health problem in Nigeria as it affects the health of women and girls. The views of women about FGM are widely researched and known; however, very little empirical research has been conducted to understand the views of men. Aim: This study therefore sought to examine men's views with regard to the continuation of FGM and its associated factors in a rural Igbo community in Nigeria. Subject and Method: This paper reports the results of a survey of 215 men aged 18 and above living in Isuikwuato Local Government Area, Uturu in Nigeria. Bivariate and binary logistic regression were performed on 215 completed and returned questionnaires (86% response rate) using the Statistical Package for Social Science. This is the first study to investigate Nigerian Igbo men's views of FGM. Results: Descriptive statistics revealed that almost two-thirds of the sample (63.7%) thought FGM should be discontinued. Logistic regression found that owning a television and/or a radio and holding a Christian faith significantly predicted favouring the discontinuation of FGM. Conclusion: This study provides evidence to suggest that some Nigerian Igbo men's attitudes about FGM appear to be generally less than favourable. The major implication of these findings is that policy makers must place greater emphasis on addressing the economic and social development of rural areas in Nigeria if the harmful practice of FGM is to be reduced. [ABSTRACT FROM AUTHOR]

Objectives: Food insecurity (FI) has serious academic, social, and physical health consequences for children. A recent clinical recommendation suggests FI screening during child well visits. While FI screening research has considered clinician feedback, little is known about caregivers' experience of disclosing FI to health care providers. Our paper explores caregivers' barriers and facilitators to FI disclosure. Methods: A survey on factors influencing FI disclosure was completed in a pediatric clinic waiting room in St. Louis, MO. Among households with FI, 15 caregivers participated in a qualitative interview. Caregivers were asked about experiences discussing FI with health care providers. We calculated frequencies for survey responses and analyzed interview data using thematic content analysis. Results: Caregivers highlighted stigma, fear of child being taken away, and shame as barriers to FI disclosure. Caregivers identified strong interpersonal skills, open body language, and empathy as facilitators to disclosure at the interpersonal level. Provider initiated conversations, consideration of FI disclosure in the presence of a child, and normalization of FI discussions within the clinic were described as ways to encourage FI disclosure at the organizational level. In response to FI disclosure, caregivers would like providers to offer resources including referrals to community-based resources extending beyond food. Conclusions for Practice: Our study identifies considerations for FI screening in health care settings, spanning the social-ecological model, from the perspective of caregivers. To successfully screen and address FI, multifaceted health care interventions should address barriers and promote facilitators across multiple levels and in consideration of multiple social needs. [ABSTRACT FROM AUTHOR]

Background: Hip fracture (HF) in older adults is strongly associated with a greater decline in their activities of daily living (ADLs) and health-related (HRQoL). The present study aimed to evaluate the effects of a family-based care transition program (FBCTP) on ADLs, HRQoL and social support in this age group after HF surgery. Methods: A quasi-experimental design was conducted on 100 older adults who had undergone HFS and were selected by convenience sampling and allocated to the IG (n = 50) and the CG (n = 50). Data were collected utilizing the Barthel Index, the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support. The FBCTP was delivered in-hospital education sessions, home visit, and a follow-up and telephone counselling session. The data were collected at three stages, including the baseline, four weeks after discharge, and eight weeks later. The level of statistical significance was set at 0.05. Results: The results of the study indicated that the effects of time and group on the increase in ADLs were 15.2 and 36.69 (p < 0.000), respectively, following the completion of the FBCTP. Furthermore, time and group were found to have a positive effect on HRQoL, with an increase of 2.82 and 5.60 units, respectively (p < 0.000). In this context, time and group also interacted in the IG compared to the CG, with scores increasing by 1.86 units over time (p < 0.000). Although the study results indicated that social support improved by 1.98 units over time (p < 0.000), the effects of group alone and the time × group interaction were not statistically significant. This indicates that the program was not effective in accelerating social support. Conclusion: Consequently, nurses, policymakers, and planners engaged in geriatric healthcare may utilize these results to enhance the health status of this age group following HFS. [ABSTRACT FROM AUTHOR]

This paper provides an overview of the design and cohort characteristics of the Social Spectrum Study: a clinical cohort study that used a two-phase sampling design to identify children at risk for ASD. After screening 1281 children aged 2.5-10 years who had been consecutively referred to one of six mental health services in the Netherlands, children who screened positive for ASD (n = 428) and a random selection of screen negatives (n = 240) were invited to participate in diagnostic assessments and questionnaires regarding the child, family and society. A 1-year follow-up was also conducted. Results from this study may contribute to knowledge of the identification and characterization of children with ASD, family processes, and the impact of ASD on the family and society. [ABSTRACT FROM AUTHOR]

Communities across the United States are increasing efforts to find and count homeless youth. This paper presents findings and lessons learned from a community/academic partnership to count homeless youth and conduct an in depth research survey focused on the health needs of this population. Over a 4 week recruitment period, 632 youth were counted and 420 surveyed. Methodological successes included an extended counting period, broader inclusion criteria to capture those in unstable housing, use of student volunteers in health training programs, recruiting from magnet events for high risk youth, and partnering with community agencies to disseminate findings. Strategies that did not facilitate recruitment included respondent driven sampling, street canvassing beyond known hotspots, and having community agencies lead data collection. Surveying was successful in gathering data on reasons for homelessness, history in public systems of care, mental health history and needs, sexual risk behaviors, health status, and substance use. Youth were successfully surveyed across housing types including shelters or transitional housing (n = 205), those in unstable housing such as doubled up with friends or acquaintances (n = 75), and those who were literally on the streets or living in a place not meant for human habitation (n = 140). Most youth completed the self-report survey and provided detailed information about risk behaviors. Recommendations to combine research data collection with counting are presented. [ABSTRACT FROM AUTHOR]

Background: Knowledge of the prevalence and attributable burden of headache disorders in India is sparse, with only two recent population-based studies from South and East India. These produced conflicting results. A study in North India is needed. We report the methodology of such a study using, and validating, a Hindi translation of the Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation (HARDSHIP) questionnaire developed by Lifting The Burden (LTB). Almost half of the Indian population speak Hindi or one of its dialects. Methods: The study adopted LTB's standardized protocol for population-based studies in a cross-sectional survey using multistage random sampling conducted in urban Delhi and a surrounding rural area. Trained interviewers visited households unannounced, randomly selected one adult member from each and applied the Hindi version of HARDSHIP in face-to-face interviews. The most bothersome headache reported by participants was classified algorithmically into headache on ≥ 15 days/month (H15 +), migraine (including definite and probable) or tension-type headache (including definite and probable). These diagnoses were mutually exclusive. All participants diagnosed with H15 + and a 10% subsample of all others were additionally assessed by headache specialists and classified as above. We estimated the sensitivity and specificity of HARDSHIP diagnoses by comparison with the specialists' diagnoses. Results: From 3,040 eligible households, 2,066 participants were interviewed. The participating proportions were 98.3% in rural areas but 52.9% in urban Delhi. In the validation subsample of 291 participants (149 rural, 142 urban), 61 did not report any headache (seven of those assessed by HARDSHIP, eight by headache specialists and 46 by both) [kappa = 0.83; 95% CI: 0.74-0.91]. In the remaining 230 participants who reported headache in the preceding year, sensitivity, specificity and kappa with (95% CI) were 0.73 (0.65-0.79), 0.80 (0.67-0.90) and 0.43 (0.34-0.58) for migraine; 0.71 (0.56-0.83), 0.80 (0.730.85) and 0.43 (0.37-0.62) for TTH and 0.75 (0.47-0.94), 0.93 (0.89-0.96) and 0.46 (0.34-0.58) for H15 + respectively. Conclusion: This study validates the Hindi version of HARDSHIP, finding its performance similar to those of other versions. It can be used to conduct population surveys in other Hindi-speaking regions of India. [ABSTRACT FROM AUTHOR]

Background: Patient satisfaction is a vital metric for assessing healthcare quality and delivering patient-centered care. It can predict service utilization patterns by determining healthcare users' contentment with their providers. Consequently, evaluating patient satisfaction and its underlying factors is crucial to maintaining the quality of healthcare services. The present study aimed to assess patient satisfaction and its determinants in a tertiary care public hospital in Nepal. In this research, a cross-sectional design was employed to examine patient satisfaction within the Outpatient Department of Mental Hospital Lagankhel, Nepal. The study adopted a systematic random sampling approach for respondent selection, and stringent measures were implemented to uphold the validity and reliability of the collected data. To assess patient satisfaction comprehensively, the Patient Satisfaction Questionnaire-III (PSQ-III), developed by the RAND Corporation, was employed in conjunction with relevant sociodemographic variables. Utilizing mean scores and percentages, we calculated satisfaction levels across various dimensions. Additionally, a multinomial logistic regression analysis was conducted to investigate the relationships between patient satisfaction dimensions and sociodemographic characteristics. Results: This study encompassed perspective of 206 participants, with 57.3% representing patient relatives and 51% being male, median age of 32 years (standard deviation: 12.53). Notably, patients reported higher levels of satisfaction, particularly within the interpersonal relationship dimension, while the technical quality domain received comparatively lower satisfaction ratings. Multinomial logistic regression analysis underscored the significance of sociodemographic factors in shaping patient satisfaction, with age (p = 0.008), type of residence (p = 0.001), occupation (p = 0.0019), income status (p = 0.014), time to reach the healthcare facility (p = 0.013), and insurance enrollment status (p = 0.017) all demonstrating significant associations. These findings illuminate the intricate qualities of patient satisfaction within our healthcare context, offering actionable insights for enhancement and guiding the trajectory of future research endeavors. Conclusions: Overall patient expressed satisfaction with service provided by tertiary care hospital, however continuous improvement remains essential. Conducting large-scale, nationwide studies across hospital tiers is vital. This data-driven approach empowers policymakers to allocate resources effectively, inform decision-making, and enact policies that exceed patient expectations, fostering a healthcare system of unparalleled excellence. [ABSTRACT FROM AUTHOR]

This paper describes the initial development of the Friendships and Social Skills Test (FASST), a clinically oriented 25-item parent report measure of child peer relationships and social skills in a community (N = 423) and clinical sample (N = 159) of elementary school age children. Confirmatory factor analyses supported five factors measuring pro-social skills, negative peer directed behavior, friendship interactions, peer victimization, and the level of concern expressed about a child's social functioning. Internal consistency and test-retest reliability of the FASST factors predominately ranged from moderate to very good. Validity was supported through higher scores in at-risk and clinical groups compared to children in the community and through correlations with an existing measure of social skills and emotional and behavioral functioning. Cross-informant validity was supported by correlations with teacher-report. Moreover, the scales measuring negative social behaviors and pro-social skills predicted changes in peer victimization and concern expressed about the child over a 1-year duration. By assessing positive and negative aspects of peer-directed behaviors and relationships the FASST has the potential to facilitate the identification and treatment of childhood social deficits in mental health settings. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine factors that are associated with tooth loss in older adults living in the San Luis Valley (SLV), Colorado, which is a rural and large geographical area (roughly the size of Connecticut) that has a large population age 60 years or older. Data used in this manuscript were collected as a part of the SLV Community Health Survey. The analyzed sample included 308 adults over the age of 65 years who completed the survey. Basic descriptive statistics and a series of step-wise binary logistic regression analyses were conducted; the dependent variable was the number of permanent teeth removed because of tooth decay or gum disease. Fifty-two percent of the participants were male, Hispanic participants made up 40 % of the sample and 76 % of the participants had at least a high school education. Tooth loss was significantly associated with older age ( OR = 1.09; p = 0.02), lower income ( OR = 0.01; p = 0.00), less than high school education ( OR = 0.32; p = 0.01), being Hispanic ( OR = 2.15; p = 0.05), self-reported fair-poor health status (OR 2.94; p = 0.02), consumption of one or more than one sweet beverage per day ( OR = 4.52 ; p = 0.00), no dental insurance ( OR = 4.70; p = 0.01) and length of time since last dental visit ( OR = 0.21; p = 0.01). The findings of the present study suggest possible causes for tooth loss in rural adults and underscore the need for in-depth research to study the overall oral health of rural older adults living in SLV. [ABSTRACT FROM AUTHOR]

Previous studies show that certain minority and ethnic communities experience low human papillomavirus (HPV) vaccination rates despite a higher cervical cancer burden. HPV is known to be responsible for almost all cervical cancer cases. Hmong Americans, a growing Asian American population, appear to be at increased risk. The cervical cancer incidence rate among Hmong American women is three times higher than other Asian/Pacific Islanders and more than four times higher than Non-Hispanic Whites. Despite such alarming statistics, there is limited research focusing on HPV literacy and its associated factors in the Hmong American community. This study's objectives are to investigate: (1) the level of HPV knowledge among Hmong Americans; (2) HPV vaccination initiation and completion rates of Hmong Americans; and (3) factors associated with HPV literacy in the Hmong American community. Andersen's Behavioral Model of Health Services Use was used as the study's theoretical framework. A self-administered paper and online health survey was completed by192 Hmong Americans living in a major metropolitan area in Minnesota. Results revealed a mean score of 4.76 (SD 1.67) for the 7-item questionnaire measuring HPV knowledge. The HPV vaccination initiation rate was 46.3 % (n = 56), with 32.7 % completing the recommended three doses. Multiple regression analysis found that participants' level of education, number of doctor visits, and cervical cancer screening literacy were significantly associated with HPV knowledge. This study's results indicate the important role of health providers in educating Hmong Americans patients about HPV and cervical cancer prevention to decrease the cervical cancer burden in this high-risk population. [ABSTRACT FROM AUTHOR]

This paper studies the discriminative capacity of CBCL/1½-5 (Manual for the ASEBA Preschool-Age Forms & Profiles, University of Vermont, Research Center for Children, Youth, & Families, Burlington, ) DSM5 scales attention deficit and hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), anxiety and depressive problems for detecting the presence of DSM5 (DSM5 diagnostic and statistical manual of mental disorders, APA, Arlington, ) disorders, ADHD, ODD, Anxiety and Mood disorders, assessed through diagnostic interview, in children aged 3-5. Additionally, we compare the clinical utility of the CBCL/1½-5-DSM5 scales with respect to analogous CBCL/1½-5 syndrome scales. A large community sample of 616 preschool children was longitudinally assessed for the stated age group. Statistical analysis was based on ROC procedures and binary logistic regressions. ADHD and ODD CBCL/1½-5-DSM5 scales achieved good discriminative ability to identify ADHD and ODD interview's diagnoses, at any age. CBCL/1½-5-DSM5 Anxiety scale discriminative capacity was fair for unspecific anxiety disorders in all age groups. CBCL/1½-5-DSM5 depressive problems' scale showed the poorest discriminative capacity for mood disorders (including depressive episode with insufficient symptoms), oscillating into the poor-to-fair range. As a whole, DSM5-oriented scales generally did not provide evidence better for discriminative capacity than syndrome scales in identifying DSM5 diagnoses. CBCL/1½-5 -DSM5 scales discriminate externalizing disorders better than internalizing disorders for ages 3-5. Scores on the ADHD and ODD CBCL/1½-5-DSM5 scales can be used to screen for DSM5 ADHD and ODD disorders in general populations of preschool children. [ABSTRACT FROM AUTHOR]

Background: A common method of pain assessment is the numerical rating scale, where patients are asked to rate their pain on a scale from 0 to 10, where 0 is "no pain" and 10 is "pain as bad as you can imagine". We hypothesize such language is suboptimal as it involves a test of a cognitive skill, imagination, in the assessment of symptom severity. Methods: We used a large-scale online research registry, ResearchMatch, to conduct a randomized controlled trial to compare the distributions of pain scores of two different pain scale anchors. We recruited adults located in the United States who reported a chronic pain problem (> 3 months) and were currently in pain. Participants were randomized in a 1:1 ratio to receive pain assessment based on a modified Brief Pain Inventory (BPI), where the anchor for a score of 10 was either "extremely severe pain", or the original BPI, with the anchor "pain as bad as you can imagine". Participants in both groups also answered additional questions about pain, other symptomatology and creativity. Results: Data were obtained from 405 participants for the modified and 424 for the original BPI. Distribution of responses to pain questions were similar between groups (all p-values ≥ 0.12). We did not see evidence that the relationship between pain score and the anchor text differed based on self-perceived creativity (all interaction p-values ≥ 0.2). However, in the key analysis, correlations between current pain assessments and known correlates (fatigue, anxiety, depression, current pain compared to a typical day, pain compared to other people) were stronger for "extreme" vs. "imaginable" anchor text (p = 0.005). Conclusion: Pain rating scales should utilize the modified anchor text "extremely severe pain" instead of "pain as bad as you can imagine". Further research should explore the effects of anchors for other symptoms. [ABSTRACT FROM AUTHOR]

Unacceptable advertisements and deceptive promotion of formula feeding undermine breastfeeding and threaten infant and maternal health worldwide. The purpose of this study was to estimate the role of healthcare providers and other sources in promoting the use of formula feeding among attendants at healthcare facilities in Mosul, Iraq. This one-year cross-sectional study was conducted at three healthcare facilities in Mosul, Iraq. Mothers of formula-fed infants under the age of one year were surveyed with a prepared questionnaire. Data analysis was performed using descriptive and inferential statistics. Of the 400 women who participated, 73% stated that healthcare professionals encouraged the use of formula feeding without a convenient reason, of which more than 80% were pediatricians and nursery nurses. Only 27% percent of the women chose to formula-feed their infants based on other factors. An extensive analysis of this attitude is warranted. Significance: Health care professionals ought to support breastfeeding by outlining the benefits of breastmilk, yet in this study it was discovered that unwarranted formula feeding recommendations were made. [ABSTRACT FROM AUTHOR]

Will a pastor refer to a mental health center? If they feel qualified to intervene themselves, they may not. Because pastors often provide grief counseling, it is important to understand the decisions they make when intervening with depressed individuals. A random sample of 204 Protestant pastors completed surveys about their treatment practices for depression. Fisher's exact analyses revealed that more pastors with some secular education yet no degree felt that they were the best person to treat depression than pastors who had no secular education or pastors who had at least a secular bachelor's degree. However, the level of theological education did not influence beliefs about the pastor being the best person to treat depression. In addition, neither secular nor theological education level influenced pastors' views on referring people to mental health centers for depression treatment. Based on findings, this paper discusses implications for best practices in training pastors on depression and other mental health topics. [ABSTRACT FROM AUTHOR]

This paper focuses on the importance of family member closeness as a protective factor against domestic abuse. We explore the link between long-lasting relations within the family and intra-familial violence perpetrated against women in Latino households in South Florida. We use data from an Inter-generational Transmission of Drug Use between Latina Mothers and Daughters (ITDMD) study. The study includes data on family relations and domestic abuse. We estimate a series of multivariate regressions to obtain the probability of abuse against women, the types of abuse inflicted and the relationship with the abusers. Our results indicate that among abused women, the effects of long-lasting relations within the family differ depending on the type of relationship between the abuser and the victim and the degree of closeness the victim feels towards other family members. Given these findings, there is a need to further study family relations and abuse in Latino households. [ABSTRACT FROM AUTHOR]

This paper reports on the prevalence of intimate partner violence (IPV) as well as individual, socioeconomic, and family function characteristics associated with IPV among women attending public health services in Marivan County, Iran. Multistage cluster sampling was employed to recruit 770 women to participate in the study. This descriptive, cross-sectional study took place from May to November 2009. The majority of the women (79.7 %) had experienced psychological IPV, followed by physical IPV (60 %) and sexual IPV (32.9 %). There was a positive significant relationship between IPV and education level of women and the level of religious commitment in both women and spouses. Spouse's smoking, addiction to drugs, mental illness, and weakness in religious persuasion were statistically significant predictors of IPV and accounted for 36 % of the variation. This correlational study suggests that educational programs regarding these risk factors and their associations with the outcome of IPV should be designed by healthcare providers and implemented not only in healthcare facilities, but presented from local media. Public health services and healthcare facilities can play an important role in the detection of IPV and improve responses to victims by establishing education centers and informing women of the best ways they can confront this deleterious problem. [ABSTRACT FROM AUTHOR]

Objectives: Pregnancy-Specific Perinatal Anxiety (PSPA) is an understudied mental health condition of pregnancy that may affect maternal-fetal health outcomes. The purpose of this study was to determine the prevalence of PSPA among pregnant women in the province of Nova Scotia, Canada, as well as the factors associated with it. Methods: A sample of 90 pregnant women provided data on PSPA symptomology and demographic co-variables via a self-report online survey. The prevalence of PSPA in the sample was calculated and bivariate statistics and binomial logistic regression were conducted to assess the relationship between the presence of PSPA and the independent variables. Results: The prevalence of PSPA in our sample was 17.8%. Smoking during pregnancy and a pre-pregnancy diagnosis of anxiety were significantly associated with meeting the criteria for PSPA (p = 0.008 and p = 0.013, respectively) and strongly predicted the presence of PSPA (odds ratio 8.54 and 3.44, respectively). Conclusions for Practice: A significant proportion of participants in our sample experienced symptoms consistent with a diagnosis of PSPA. This underscores the importance of further research on PSPA as a unique phenomenon in pregnant women, and the impact it may have on fetal and maternal health outcomes. A greater clinical emphasis should be placed on screening for and treating mental health conditions of pregnancy, including PSPA. Significance: Anxiety in pregnancy affects maternal, fetal, and child health outcomes. A distinction – in terms of definition and diagnostic criteria – exists between generalized anxiety disorder (GAD) affecting pregnant women and pregnancy-specific perinatal anxiety (PSPA). The latter is a condition that has been identified as affecting pregnant women uniquely and with distinct clinical impact, but few studies have made effort to distinguish it from GAD when studying its prevalence and impact on health. This study examines the prevalence of PSPA exclusively and the variables associated with it to provide insight on the importance of this distinct clinical phenomena. [ABSTRACT FROM AUTHOR]

Purpose Pain and stress-related ill-health are major causes of long-term disability and sick leave. This study evaluated the effects of a brief psychosocial program, which previously has been tested for an at-risk population of employees. Methods The Effective Communication within the Organization (ECO) program, where supervisors and employees were trained in communication and problem solving, was compared to an active control consisting of psychoeducative lectures (PE) about pain and stress in a cluster randomized controlled trial. First-line supervisors were randomized to ECO or PE, and a total of 191 mainly female employees with self-reported pain and/or stress-related ill-health were included. The hybrid format programs consisted of 2–3 group sessions. Sick leave data was collected from social insurance registers, before and 6-months after the program. Secondary outcomes (work ability, work limitations, pain-disability risk, exhaustion symptoms, perceived stress, perceived health, quality of life, perceived communication and support from supervisors) were assessed at baseline, post intervention, and at 6-months follow-up. Results No effects were observed on primary or secondary outcome variables. Pain symptoms were common (89%), however a lower proportion (30%) were identified as at risk for long-term pain disability, which might explain the lack of evident effects. The Covid-19 pandemic affected participation rates and delivery of intervention. Conclusion In this study, preventive effects of the ECO program were not supported. Altogether, the findings point at the importance of selecting participants for prevention based on screening of psychosocial risk. Further research on workplace communication and support, and impact on employee health is warranted. [ABSTRACT FROM AUTHOR]

This study was undertaken to test the validity of the Spirituality and Spiritual Care Rating Scale (SSCRS) by McSherry et al. (IJNS 39:723–734, 2002) in an Indian context. The study was conducted in a tertiary care teaching hospital with a convenience sample of 200 nurses. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were completed to assess the reliability and validity of the tool. The results of the present study were similar to but differed from the McSherry et al's (IJNS 39:723–734, 2002) study which identified 17 items on the scale. Only 15 items loaded on three factors. [ABSTRACT FROM AUTHOR]

Background: Use of numerical and spatial language, also known as math talk, is critical to the development of foundational number and spatial skills in early childhood. However, caregivers and children of low socioeconomic status (SES) tend to use less math talk than their higher-SES peers. Objective: The current efficacy study tested the hypothesis that quantity of math talk among low-SES caregivers and children is increased via a caregiver education curriculum aimed at improving caregivers' language input to children. Methods: Caregiver-child dyads (n = 37; children aged 17 to 36 months) participated in either the language input or a control intervention. Math talk (operationalized as number and spatial word tokens) was coded from video recordings of each dyad engaging in free play at three time points: baseline, post-intervention, and follow-up. Results: The language input curriculum significantly increased caregivers' amount of spatial talk and cildren's amount of number and spatial talk for up to 4 months after the intervention. Conclusions: A caregiver education intervention increased caregivers' use of math talk, which resulted in higher math talk usage by their children. Further verification is needed through an adequately powered longitudinal randomized controlled trial. [ABSTRACT FROM AUTHOR]

The article presents a study which analyses efficacy of facial emotion training program for children and adolescents with autism spectrum disorder (ASD). Topics discussed include co-morbid anxiety and mood disorders in individuals with ASD, computer-based programs to teach facial emotion recognition skills to ASD patients, and coach-assisted MiX training.

Background: Reliable information on headache characteristics, including frequency and intensity, headache-associated impairment, and use of analgesic medications, may depend on the assessment method used. This study analyzed the correlations between headache characteristics determined in structured interviews and those determined in prospective diary recordings kept by adolescents in the general population. Methods: In this cross-sectional school-based study, a representative sample of 488 adolescents aged 12-18 years were interviewed about headaches experienced during the previous year. Headache diaries for a three-week period were kept by 393 participants: 244 girls (62 %) and 149 (38 %) boys. Results: Most adolescents (88 %) who reported headaches during their interview also recorded headaches in their diary. In contrast, 51 % of those who reported being headache-free during the last year recorded headaches in their diary. In the interviews, frequent headaches (at least 50 % of days during the last year) were reported by 2.9 % of participants, while 25.5 % reported this headache frequency in their diary. Overall, the ratings of headache frequency were significantly higher in diaries than in interviews ( p < 0.001). Significant but low correlations were observed between intensity levels reported retrospectively and prospectively (rho = 0.28; p < 0.001) and between average scores of headache-related impairment reported retrospectively and prospectively (rho = 0.35; p < 0.001). The use of medications by those who reported one or more current headache disorder during their interview was significantly lower in prospective recordings than in the retrospective interview estimates ( p < 0.001). Conclusions: There is inconsistency in the estimates of headache characteristics between retrospective reports and diary recordings. A comprehensive picture of headache complaints among adolescents may be better obtained through a combination of prospective diary recordings and interviews by school health and clinical services. [ABSTRACT FROM AUTHOR]

Background: Although gun owners overwhelmingly support violence prevention policies, they are hesitant to speak up publicly to advocate for these policies. We tested a series of communication messages on gun owners' level of support for various firearm violence prevention policies and on their willingness to engage in gun violence prevention advocacy. Methods: We conducted three consecutive experiments, testing a total of thirteen messages on a sample of gun owners over 18 years old who live in the U.S. The first was a random experiment, the second a quasi-experiment, and the third a randomized control trial. The goal of having these varied methods was to develop messages applicable to different contexts with different levels of information about the audience. Results: The most effective message was a script showing respect for gun owners' decisions to purchase a firearm and proposing a balanced policy roadmap to end gun violence, which led to an increase in gun owner's willingness to engage in eight different advocacy activities. We also found a value-based message conveying loyalty to increase support for domestic violence related prohibitions and willingness to engage in advocacy for gun violence prevention policies. Conclusions: Public health professionals need to develop communication strategies that are aligned with gun owners' values and that affirm respect for gun culture and for gun owners' decisions to own a gun. [ABSTRACT FROM AUTHOR]

Introduction: The Brief Coping Orientation to Problems Experienced (Brief-COPE) measures individuals' coping strategies. There is limited evidence on the psychometric properties of this measure in a perinatal population. The aim of this study is to explore the psychometric properties of the Brief COPE in pregnant and postpartum women. Methods: The Dutch/Flemish version of the Brief-COPE was administrated in a sample of 754 antenatal (n = 432) and postpartum (n = 322) women living in Belgium. Exploratory factor analyses assessed the factor structure of the Brief-COPE and its convergent validity in an antenatal and postpartum sample. Cronbach's alpha was calculated for internal consistency reliability of the Brief-COPE items. Results: Exploratory factor analysis showed a five-factor antenatal model, presented by the subscales: (1) Active coping (α = 0.86), (2) Self-blame and Disengagement (α = 0.70), (3) Alcohol use (α = 0.96), (4) Humour (α = 0.79), and (5) Spirituality (α = 0.81). For the postpartum sample, a three-factor model emerged, presented by the subscales: (1) Active coping (α = 0.85), (2) Self-blame (α = 0.85) and (3) Spirituality (α = 0.74). Conclusions: We observed differences and similarities in coping strategies between antenatal and postpartum women – information to be of merit for clinical practice and research. The Brief-COPE is a promising tool for the use of identifying women's coping strategies during pregnancy and the postpartum period, specifically for women in a similar cultural context as the women in this study, mainly in terms of antenatal alcohol use. [ABSTRACT FROM AUTHOR]

The lack of effective, scalable solutions for lifestyle treatment is a global clinical problem, causing severe morbidity and mortality. We developed a method for lifestyle treatment that promotes self-reflection and iterative behavioral change, provided as a digital tool, and evaluated its effect in 370 patients with type 2 diabetes (ClinicalTrials.gov identifier: NCT04691973). Users of the tool had reduced blood glucose, both compared with randomized and matched controls (involving 158 and 204 users, respectively), as well as improved systolic blood pressure, body weight and insulin resistance. The improvement was sustained during the entire follow-up (average 730 days). A pathophysiological subgroup of obese insulin-resistant individuals had a pronounced glycemic response, enabling identification of those who would benefit in particular from lifestyle treatment. Natural language processing showed that the metabolic improvement was coupled with the self-reflective element of the tool. The treatment is cost-saving because of improved risk factor control for cardiovascular complications. The findings open an avenue for self-managed lifestyle treatment with long-term metabolic efficacy that is cost-saving and can reach large numbers of people. [ABSTRACT FROM AUTHOR]

Background: Smoking is an avoidable behavioral cause of premature morbidity and mortality. The initiation, continuation, and dependence of smoking is associated with multiple personal, environmental, and sociocultural factors, which vary between age groups and geographical regions. Objective: To investigate the pattern of smoking cessation and the extent of the smoking dependence among smokers in urban and rural societies in Egypt. Methods: A cross-sectional study was conducted targeting a convenience sample of 552 adult smokers aged 11–75 years. All participants were inquired about their demographic features, lifestyle and behaviors, motives for smoking cessation, and quitting attempts using a predesigned interview questionnaire. Nicotine dependence was assessed using the Fagerström Test for Nicotine Dependence (FTND). Results: About 28.1% of the participants reported a motivation to quit smoking and about 61.1% had made at least one attempt. The longest duration of quitting was ≥5 years, as reported by 4.0% of the smokers. The drive to quit smoking was prompted by the advice of a family member (39.9%) or a doctor (30.1%), concerns about smoking hazards (19.7%), or due to financial limitations (12.7%). The most frequently used methods to quit smoking were cold turkey (23.4%), gradual reduction (15.9%), and the use of nicotine replacement therapy (12.5%). Moderate and high nicotine dependence was found in 46.7% and 24.6% of respondents, respectively. Male sex was the single predictor of smoking dependence. Motivation to stop smoking was associated with the presence of social support and having a low dependence score. Conclusion: Nicotine dependence was significant at younger ages. Therefore, smoking cessation programs should be a top priority and targeted to prevent smoking in adolescence. Appropriate interventions addressing individuals' motives and considering pharmacotherapeutic management are needed to encourage successful quit attempts. [ABSTRACT FROM AUTHOR]

Aims: Students are significantly present in virtual social networks and spend a considerable amount of time in this space. An increase in the number of users of virtual social networks has led to the emergence of a new lifestyle, known as the virtual lifestyle, which can affect the daily activities of students, especially their health behaviors. Therefore, this study is aimed to determine the relationship of virtual social networks with health-promoting behaviors among the medical students of Qazvin University of Medical Sciences. Method: In this descriptive-analytic study, 318 medical students were included using the stratified random sampling technique. By means of a 52-item health-promoting behavior scale (Walker et al.) and a researcher-made questionnaire, the use of virtual social networks was studied. The data were analyzed in SPSS (V.22) software by Kruskal-Wallis, Mann-Whitney, Pearson's and Spearman correlation coefficients, independent t-test and one-way ANOVA at a significance level of 0.05. Results: The use of virtual social networks was high (66%), and the mean score of health-promoting behaviors of students was moderate (135.32 ± 19.35). The data analysis showed a significant relationship between the aspects of responsibility for health, nutrition status and interpersonal relationships and the use of virtual social networks (P < 0.05). A meaningful correlation was also found between the use of virtual social networks and demographic characteristics of students including marital status, age, employment status and residence (P < 0.05). However, no significant relationship was obtained with other demographic variables, and no statistically meaningful association was observed between health-promoting lifestyle and any of the demographic variables. Conclusion: According to the findings of the study, it seems that the presence of students in virtual social networks can be an opportunity and, through creating special student groups under the supervision of professors working in the field of health promotion, it is possible to publish scientific content in these networks to take a step toward promoting the health of students. [ABSTRACT FROM AUTHOR]

Background: The disabilities of the arm, shoulder and hand (DASH) is a commonly used region-specific patient-reported outcome measure (PROM) that quantify upper extremity function (activity limitation) and symptoms. Current evidence suggests that measurement properties of the adapted versions of the DASH are not sufficiently examined. The Arabic DASH has evidence supporting its internal consistency, test–retest reliability, construct validity and responsiveness. On the other hand, the validity of the assumed unidimensionality of the Arabic DASH has not been examined previously. The aim of this study was to examine the structural validity of the Arabic DASH in patients with upper extremity musculoskeletal disorders using Rasch measurement model. Methods: Patients with upper extremity musculoskeletal disorders were recruited and were asked to complete the Arabic DASH at their initial visit to physical therapy departments. The overall fit of the Arabic DASH to the requirement of the Rasch measurement model was examined using chi-square statistics for item-trait interaction, mean item and person fit residuals. The fit of individual items, thresholds ordering, local dependency, differential item functioning (DIF), and unidimensionality using the t-test approach were also examined. Results: The Arabic DASH did not fit the Rasch measurement model initially (χ2 = 179.04, p < 0.001) with major breach of local item independence and a pattern of high residual correlations among the activity-related items and among the impairment-related items. Combining items into activity-limitation and impairment testlets accommodated the local dependency and led to satisfactory fit of the Arabic DASH to the requirement of the Rasch measurement model (χ2 = 3.99, p = 0.41). Conclusions: Rasch measurement model supports the structural validity of the Arabic DASH as a unidimensional measure after the accommodation of local dependency. [ABSTRACT FROM AUTHOR]

Aims: Students' research self-efficacy represents their confidence in their own ability to conduct various research activities. Hence, the present study aimed to investigate the components of research self-efficacy in postgraduate students at Kermanshah University of Medical Sciences in 2016. Methods: In this descriptive-analytical study, the statistical population consisted of 200 postgraduate students at Kermanshah University of Medical Sciences who were selected and studied through simple random sampling. For data collection, a two-part questionnaire was used: a demographic questionnaire and the Lawrence Newman's research self-efficacy questionnaire. For data analysis, the t-test and analysis of variance (ANOVA) were used in the SPSS Statistics Software Version 16.0. Results: The results of the study demonstrated that the total mean score of research self-efficacy measured 3.23 ± 0.61 out of 5.0. The dimensions of method and implementation and conceptualization had the highest mean scores, while writing reports and research ethics had the lowest mean scores. In addition, the results of comparing the total score of research self-efficacy with demographic characteristics showed that there were significant differences between research self-efficacy and each of gender and marital status (p > 0.05). Conclusion: The results of the study revealed that the total score of the majority of students' research self-efficacy scale was above average, and PhD students had more positive attitudes towards research self-efficacy than Masters students. [ABSTRACT FROM AUTHOR]

African American and Hispanic women report less physical activity (PA) than non-Hispanic White women. As such, a digitally-enhanced 16-week social support pilot intervention was conducted to promote PA among African American and Hispanic women dyads. This study quantitatively and qualitatively examined the engagement and satisfaction of participants (N = 30; 15 dyads) assigned to the intervention. Intervention participants received telephone counseling calls based on motivational interviewing and a Jawbone UP activity monitor. Intervention engagement and satisfaction data were collected from the Jawbone UP, call logs, self-report questionnaires conducted at the 16-week follow-up, and two post-intervention focus groups. Nonparametric tests assessed group differences across engagement and satisfaction measures, and a manually-driven coding scheme was used to evaluate emerging themes from qualitative text. Participants demonstrated high engagement in the telephone counseling sessions and moderate engagement with the Jawbone UP. Friend/co-worker dyads and participants who were 45 years and older were more likely to use the device. Qualitative results emphasized participants' appreciation for the counseling calls, the Jawbone UP, and the overall dyadic framework of the study to collectively nurture social support and accountability for PA. Overall, the intervention group reacted positively to study components. Additional research is needed to understand the role of technology in facilitating long-lasting PA change via social support in minority populations. [ABSTRACT FROM AUTHOR]

Religion can lead to the creation of meaning. Therefore, religion gives meaning to the life and death of humans. Spirituality is far higher than religion and entails all concepts of human dimensions such as spiritual health, peace resulting from belief and spiritual adaptation as well as one's experiences in a unique and dynamic process (which is reflecting the belief in God and infinite power), connection (to someone, others, nature or God) and coalition. Regardless of considering the role of spirituality in the health section, what is worldly paid attention today, is the "spirituality" and "sublime values" in medical science education specially life skills and spiritual life skills education and the people of the society. This research sought to investigate the effect of religious and spiritual education on the mental health of girl students (2018–2019) of Technical and Vocational University in the architecture major of Tehran province. The methodology of the study was quasi-experimental having pretest and posttest and control group. The sample size included 152 individuals using Morgan table who were selected through multi-stage sampling. The statistical population was randomly divided into two experimental and control groups. Experimental group received educational–religious classes for 15 sessions. To analyze the data, Goldberg health questionnaire was utilized, and also descriptive as well as inferential statistics such as covariance analysis and LSD test were used in this regard. The results indicated that religious and spiritual effects were influential on the increase in mental health and social and physical performances as well as the decrease in students' depression. [ABSTRACT FROM AUTHOR]

Research has shown that postnatal depression (PND) is higher in low- and middle-income countries as compared to higher-income countries. Despite this, little is known about practical interventions in these poorly resourced countries. This research investigated the effectiveness of a brief, prophylactic and therapeutic psychoeducational intervention in a low-resourced community in Nairobi. Two closely similar Maternal and Child Health (MCH) clinics in urban slums in Nairobi were identified and randomly selected. A total of 567 mothers formed the study population. The experimental group (284) mothers received the intervention, which included psychoeducation on PND, coping skills, healthy way of mother/child interaction and infant stimulation in addition to routine treatment, while the control group (283) mothers received treatment as usual. Data was collected using a social-demographic questionnaire and the English version of Becks Depression Inventory (BDI) at baseline. At 6 months, we reassessed both groups using BDI only. Within group comparison, the percentage reduction of depression was 35.6% among the experimental as compared to 2.3% in the control group. Between group comparison, the mean BDI depression score was significantly low in the experimental arm compared to the control arm at endline (p = 0.025). When all variables were adjusted, using a generalized linear model, BDI depression score reduction among the participants was significantly associated with the intervention (p = 0.040). A brief, psychoeducational intervention that targets the mother and her infant may reduce PND even in poorly resourced environments. Therefore, it can be integrated into existing MCH services. [ABSTRACT FROM AUTHOR]

Sexual performance refers to activities served by sexual capacity and motivation. As a culturally sensitive issue, to date the scalar invariance of sexual performance has not been examined for Iranians with spinal cord injuries (SCIs). Aim: To develop and assess properties of an instrument evaluating sexual performance of an Iranian population with SCIs., in Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Using multi-modal methods, we developed and assessed the Sexual Performance Questionnaire (SPQ). This included collecting expert opinions; engaging with patients with SCI referred to BASIR; pilot testing to assess the scale; and a formal investigation. Participants (men = 156, women = 58) completed the SPQ. Internal consistency and reliability were measured using Cronbach's α coefficient. Content and face validity were examined by academic experts. Construct validity was assessed by examining convergent and discriminant validity. Finally, exploratory factor analysis was used to extract the factor structure of the questionnaire. The Cronbach's α coefficient was 0.77. There was a significant (p = 0.04) correlation (r = − 0.23) between the SPQ score and age. Those with a partner scored higher (p = 0.001). We found three components: Spouse as initiator, self-initiation, and genital-oriented sex which accounted for 59% of the observed variance. The face and content validity was approved by an expert committee. The development and application of the 13-item SPQ provides a thorough understanding of sexual performance amongst persons with SCI. It facilitates the development of efficient sexual rehabilitation interventions and SCI-specific sexuality education programs. [ABSTRACT FROM AUTHOR]

Background: Adaptation of a patient-reported outcomes survey into a new language requires careful translation procedures as well as qualitative and quantitative psychometric testing. This study aimed to evaluate the basic psychometric properties of the new Saudi Arabian SF-36v2 and establish norm data for Saudi Arabia. Methods: Translation and adaptation of the SF-36v2 used standard methodology. Psychometric validation included two stages: 1) A qualitative study (n = 100) explored the components of health and health-related quality of life considered important in Saudi Arabia and evaluated the content validity of the SF-36v2 in Saudi Arabia, and 2) A quantitative study (n = 6166) evaluated the basic psychometric properties of the Saudi SF-36v2 and established norm data for Saudi Arabia. Comparison with US general population data (n = 4040) evaluated differential item function (DIF) and cross-national differences. Results: The qualitative study supported the content validity of the Saudi SF-36v2. Cognitive debriefing identified only few and minor problems. Psychometric analyses supported item convergence within scales and differentiation across scales of the SF-36v2. Scale level exploratory factor analyses did not support the typical distinction between physical health and mental health components. Internal consistency reliability was satisfactory for all scales except the social function scale (alpha = 0.67). Cross-national DIF was identified for 9 items. In the Saudi general population, the average vitality score was lower for women (− 2.71 points) compared to men. For men, older age groups scored lower on the physical function scale (− 3.31) and the physical health component (− 3.06). For women, older age groups scored lower on the role physical (− 3.72), bodily pain (− 3.66), and vitality (− 2.32) scales as well as the physical health component (− 3.52). Compared to the 2009 United States general population, and after adjusting for age, gender, and differential item function, persons in Saudi Arabia had lower average scores for the physical function (− 3.10), role physical (− 4.75), social function (− 4.23), role emotional (− 5.67), and mental health (− 4.82) scales, as well as the mental health component (− 4.57). Conclusion: This Saudi normative study of patient reported outcomes supported the validity and reliability of the new Saudi SF-36v2 and found cross-national differences with the USA. [ABSTRACT FROM AUTHOR]

Purpose Musculoskeletal disorders (MSDs) are often associated with long-term sick leave, productivity loss, and reduced work functioning. However, measures that assess work-related functioning are sparse. Objective To assess the psychometric properties of the Work Rehabilitation Questionnaire (WORQ)-German version in patients with MSDs in an outpatient physical therapy practice. Methods Psychometric study including patients with MSDs with restricted work participation. Data was collected in a single physical therapy outpatient clinic. For construct validity, we developed a priori hypotheses on the correlation between the functioning part of WORQ (40 items) and other questionnaires with similar concepts. For test–retest reliability, WORQ was administered twice, 7 days apart. We examined internal consistency (Cronbach's Alpha) and Minimal Detectable Change (MDC). Feasibility of WORQ was examined using feedback from patients and physical therapists. Results There were 51 study participants. Test–retest of WORQ sum score was 0.80 (p < 0.01) (Spearman's rho). Internal consistency was 0.94 and MDC established at 9.2%. WORQ correlated with general health (r = − 0.49), with HADS (r = 0.55), and with quality of life (WHOQOL) (r = − 0.47). WORQ had the highest correlation with WHODAS 2.0 (r = 0.81). Patients rated WORQ as easy to answer and meaningful to their experience. Conclusions When evaluating self-reported work-related functioning, the WORQ-German version was demonstrated to be a valid, reliable, and easy to administer questionnaire for our sample of patients with MSDs in an outpatient PT clinic. [ABSTRACT FROM AUTHOR]

Aim: There is a well-established association between tobacco consumption with asthma and chronic bronchitis (CB). This study aimed at estimating the prevalence of tobacco consumption and its association with asthma and CB in Kanpur, Uttar Pradesh, India. Subjects and methods: A cross-sectional household survey of 573 males was conducted during January–June 2015 in the Jajmau area of Kanpur, Uttar Pradesh, India. The questionnaire was designed to collect information on self-reported symptoms pertaining to asthma and CB, which were considered as response variables for the study. Results: More than one-third of the respondents (36%) smoked tobacco and 44% consumed smokeless tobacco. Men who were aged 35 years and above were more prone to CB, with odds ratios (ORs) of 2.08 in model 1 and 1.84 in model 2. The prevalence of CB is higher among those from the Scheduled Castes and Scheduled Tribes (12.4%). People consuming any form of tobacco are more likely to get CB (OR = 5.22) than their counterparts who do not consume tobacco. The chances of getting asthma was higher among those who consumed any form of smokeless tobacco (OR = 1.34) and those who consume any form of tobacco (OR = 2.30) in model 2. Conclusions: Our study found a significant association between tobacco consumption (smoking and use of smokeless tobacco) with asthma and CB and the predictors that affect the pattern of tobacco consumption, such as respondents' age, education level, caste, level of exposure to the media, and standard of living index. [ABSTRACT FROM AUTHOR]

Introduction: Knowledge gaps exist among providers and pregnant women about the importance and safety of oral health care around pregnancy. This article describes the current state of perinatal oral health and healthcare among underserved women in North Carolina (NC) and provides policy recommendations to improve their access to and utilization of dental services. Methods: A descriptive analysis is provided using (a) 2016 oral health surveillance data of a convenience sample of 459 pregnant women across NC, (b) 2014–2016 Medicaid dental provider and dental services utilization data for the Medicaid for Pregnant Women (MPW) program, and (c) 2017 Medicaid dental benefits policy. Surveillance data was not linked to Medicaid dental services utilization data. Results: Less than 20% of pregnant women surveyed reported having a dental visit during pregnancy and oral screenings revealed 33% had untreated caries. Medicaid data showed a steady decline since 2014 in percentage of MPW beneficiaries utilizing any dental service—less than 10% as of 2016. MPW dental benefits lapse at delivery because dental care is not considered pregnancy-related in NC policy. Only 20% of practicing NC dentists provided care to MPW beneficiaries in 2015. Discussion: Inadequacies in oral health knowledge, beliefs and practices exist among pregnant women, health care professionals and policymakers. Statewide efforts are needed to promote a standard of perinatal care that emphasizes collaborative practice and addresses existing barriers at the patient, provider and policy levels. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the relationship between spiritual intelligence and aggression among elite wrestlers of adolescent age group. The present study was descriptive of correlation type in terms of method and applied in terms of purpose. The population of this research was the elite wrestlers of adolescents age group aged 14–17 (mean and SD of 15.27 ± 1.33) using the convenient sampling method for adolescent wrestling teams of Hamedan clubs selected as samples. To measure variables, King's spiritual intelligence scale and Bass and Perry aggression questionnaire were used. Pearson correlation coefficient and simple regression method were used for data analysis. Results showed a significant negative relationship between spiritual intelligence and aggression. The spiritual intelligence scores also have a significant effect on aggression. The findings show that the higher the spiritual intelligence, the less likely the aggression of the elite wrestlers in different competitions and they can have a better performance than others. [ABSTRACT FROM AUTHOR]

Assessment tools for measuring cyberchondria, a process of increased anxiety over one's health as a result of excessive online searching, are still in the early stages of development. The goals of the present study were to develop a short cyberchondria scale and to evaluate its structure, reliability and validity among participants from a community sample. The analyses conducted in this study were based on data from three samples (N1 = 540; N2 = 379; N3 = 594) that were recruited online via a snowball method. Participants provided demographic information and completed the Short Cyberchondria Scale (SCS) as well as three comparison measures (Cyberchondria Severity Scale, Anxiety Sensitivity Index and Health Anxiety Questionnaire) via an online survey tool. Extensive analyses were performed in order to inspect various aspects of the validity of the new SCS scale, including its factor structure, measurement invariance and convergent validity. The findings of the present study suggest that the SCS is a satisfactory instrument for measuring cyberchondria. [ABSTRACT FROM AUTHOR]

Purpose The Work Rehabilitation Questionnaire (WORQ) was developed to evaluate work functioning in vocational rehabilitation, but was not yet available in Dutch. The goal of this study is twofold: a description of the cross-cultural adaptation process (part 1) of the WORQ to be used in Flanders (The Dutch speaking part of Belgium, WORQ-VL) and a presentation of the first psychometric testing of the WORQ-VL (part 2). Methods For part 1, the guidelines for cross-cultural adaptation of self-report measures by Beaton et al. were used to structure the cross-cultural adaptation. For part 2, a cross-sectional study was conducted in patients with musculoskeletal disorders [sample A: hand and wrist rehabilitation (n = 21) and sample B: fibromyalgia patients (n = 93)] who completed the WORQ-VL. Internal consistency and factor structure were examined in the total sample, whereas convergent and discriminant validity of the WORQ-VL were researched in sample A. Results First results on the convergent validity and discriminant validity (small sample size) and internal consistency of the WORQ-VL are promising. The exploratory factor analysis revealed seven factors which were labeled as 'cognition', 'physical', 'mood', 'activities of daily living', 'sensory', 'emotional' and 'social'. The best evidence was found for the 'physical' subscale of the WORQ-VL: strong correlations were found with the 'physical functioning' and 'role limitations—physical' subscales of the Short-Form Health Survey, respectively r = −.84 and r = −.59, p <.01. As expected, predominantly weak correlations were found with hand grip strength, kinesiophobia, hand-related aesthetics and satisfaction (ranging between r = −.38 and r =.34, p >.05). Conclusions The WORQ-VL is a user-friendly and valuable ICF-based self-report questionnaire to evaluate work functioning. Future studies are highly needed to examine the value of the WORQ within different patient populations and settings in order to examine further the added value of this self-report measure. [ABSTRACT FROM AUTHOR]

Various drug camps have been introduced in Thailand since the 2000s. This study explored the effects of drug camps in Thailand. Four provinces were selected to represent different region throughout Thailand. Assessments of 2679 drug users were carried out longitudinally, age ranging from 11 to 67 years old; assessments occurred before camp, after camps, and after a 1 year follow-up. Two hundred twenty-six camps organizers, community leaders, and lay people were selected as key informants. Twenty communities were observed prospectively and 400 lay people were studied. Self-administered questionnaires were utilized as well as interview guidelines and documents. It emerged that the effectiveness of drug camp was 51.3% (intention-to-treat), whilst poly drug use increased significantly from before camp and 3 months after camp (repeated ANOVA p < 0.001) particularly among users aged 15 years old and over. Drug camps could be considered as an alternative measure for drug users; however, negative impacts should be considered. [ABSTRACT FROM AUTHOR]

Firearm violence remains a significant problem in the US (with 2787 adolescents killed in 2015). However, the research on school firearm violence prevention practices and policies is scant. Parents are major stakeholders in relation to firearm violence by youths and school safety in general. The purpose of this study was to examine what parents thought schools should be doing to reduce the risk of firearm violence in schools. A valid and reliable questionnaire was mailed to a national random sample of 600 parents who had at least one child enrolled in a public secondary school (response rate = 47%). Parents perceived inadequate parental monitoring/rearing practices (73%), peer harassment and/or bullying (58%), inadequate mental health care services for youth (54%), and easy access to guns (51%) as major causes of firearm violence in schools. The school policies perceived to be most effective in reducing firearm violence were installing an alert system in schools (70%), working with law enforcement to design an emergency response plan (70%), creating a comprehensive security plan (68%), requiring criminal background checks for all school personnel prior to hiring (67%), and implementing an anonymous system for students to report peer concerns regarding potential violence (67%). Parents seem to have a limited grasp of potentially effective interventions to reduce firearm violence. [ABSTRACT FROM AUTHOR]

In Puerto Rico, colorectal cancer (CRC) incidence and mortality rates are increasing. Moreover, adherence rates to CRC screening (52.2%) are still below the goals (70.5%) established by Healthy People 2020. Lack of knowledge is described as a significant barrier to adherence to CRC screening. The aim of this study was to assess CRC knowledge and screening rates among Puerto Rican Hispanics. Participants aged 40-85 years were recruited from the internal medicine outpatient clinics at the University of Puerto Rico. Demographic characteristics and knowledge about CRC, including risk factors and CRC screening tests, were obtained through face-to-face interviews. A mean CRC knowledge score was calculated based on correct responses to 13 validated questions. Mean knowledge scores were evaluated according to demographic characteristics using the Wilcoxon-Mann-Whitney test. A total of 101 participants were recruited with mean age of 63 (±10.6) years. Fifty-eight (58%) of participants were females, 59% reported ≥12 years of education, and 71% reported ever screening for CRC. The mean CRC knowledge score was significantly lower (p < 0.05) among participants with lower annual family income, those who had never received a recommendation for CRC screening by a healthcare provider, and those who had no history of CRC screening. Knowledge about CRC must be improved in Puerto Rico. Efforts must be made to promote and develop culturally appropriate CRC educational strategies. Future studies should focus on identifying other barriers and factors that may limit CRC screening in the Puerto Rican Hispanic population. [ABSTRACT FROM AUTHOR]

U.S. Hispanics disproportionately show health burdens that may be decreased by discussing physical activity (PA) and healthy eating with their healthcare providers (HCPs). We examined the perceptions of both HCPs and low-income Hispanic patients regarding the dynamics of these communications. We surveyed 295 low-income Hispanic patients and interviewed 14 HCPs at three community health clinics. Patients were asked about their comfort level with HCPs, how often their HCP discussed PA and healthy eating, and the likelihood of following advice on PA and healthy eating. HCPs were asked about their delivery (frequency/duration) and perceived effectiveness in providing such advice. Patients reported feeling 'most comfortable' with their physicians (57%) with a lower proportion (19%) feeling 'most comfortable' with nurses. Nearly all patients (95%) reported being very likely to follow the advice of their physician. On average, HCPs (physicians and nurses) reported discussing PA and healthy eating with 85% and 80% of their patients, respectively. In contrast, a fewer proportion of patients (65.8%) reported that their physician discussed PA and healthy eating 'some' or 'a lot' of the time. Overall, physicians reported discussing PA and healthy eating for an average of 5 and 6 min, respectively; whereas nurses reported discussing PA and healthy eating for an average of 12 and 19 min, respectively. Further study on the content and delivery of conversations between HCPs and their low-income Hispanic patients regarding PA and healthy eating could be vital to optimally impact health behaviors. [ABSTRACT FROM AUTHOR]

Given the shortage of medical providers and the need for medical decisions to be responsive to community needs, including lay health providers in health teams has been recommended as essential for the successful management of global health care systems. Brazil's Unified Health System (UHS) is a model for delivering community-based care through Family Health Strategy (FHS) interdisciplinary teams comprised of medical and lay health providers-Community Health Agents (CHAs), nurses, and physicians. This study aims to understand how medical and lay health providers' perceptions and attitudes could impact the delivery of community-based care. The study compares perceptions and attitudes of 168 CHAs, 62 nurses, and 32 physicians across their job context, professional capacities, professional skills, and work environment. Descriptive and bivariate analysis were performed. CHAs reported being the most efficacious amongst the providers. Physicians reported incorporating consumer-input to a lesser degree than nurses and CHAs. CHAs reported using a lesser variety of skills than physicians. A significant proportion of physicians compared to CHAs and nurses reported that they had decision-making autonomy. Providers did not report differences that lack of resources and poor work conditions interfered with their ability to meet consumer needs. This study offers technocratic perspectives of medical and lay health providers who as an inter-professional team provide community-based primary health care. Implications of the study include proposing training priorities and identifying strategies to integrate lay health providers into medical teams for Brazil's Unified Health System and other health systems that aim to deliver community-based care through inter-professional health teams. [ABSTRACT FROM AUTHOR]

The enactment of the Affordable Care Act increased the emphasis on health promotion and disease prevention by making preventive care accessible for many Americans, especially young adults, who could remain on their parents or legal guardians' health insurance until the age of 26. Yet, many Americans receive only half of the recommended preventive care services, which highlight the need for the improvement of health promotion and prevention services. The aim of this study was to assess the relationship among access to health care insurance, perceptions about health insurance, and use of preventive care services among young adults. Nine hundred and forty-six participants ages 19-34 completed a 40 question web-based survey. Data analysis suggested that while the majority of participants had health insurance, there were significant differences in opinions about the ACA, health insurance, and use of preventive services by gender, education level, and health insurance status. Overall, participants with health insurance were more likely to have received at least three of the basic preventive care services; however, most of them were not getting the preventive care as recommended. Results reaffirm the need for further studies on the impact of health insurance among young adults and the need for the emphasis on health promotion to educate young adults about the importance of disease prevention and preventive services. [ABSTRACT FROM AUTHOR]

The main aim was to assess Nepali adults' knowledge, health beliefs, and health promoting behaviors regarding cardiovascular diseases (CVDs). A descriptive, cross sectional study was conducted in five wards of Lalitpur Sub-Metropolitan City. A random sample of 300 Nepali individuals aged 20-65 years completed the heart disease knowledge questionnaire and health beliefs related to cardiovascular diseases. The health belief model related to CVDs was used. Sociodemographic and personal information was collected. Of the adults 45.3% were aged 20-40 years, and 50.7% were male. The male participants smoked and consumed alcohol more than the female participants (p < 0.05). The mean score on the heart disease knowledge questionnaire was 11.8 ± 4.6. Adults between 20 and 40 years age, non smokers, and daily exercisers had greater knowledge on CVDs. The mean score on the four subscales of the health beliefs related to cardiovascular disease scale were as follows: perceived susceptibility (11.5 ± 2.5), perceived severity (12.1 ± 3.5), perceived benefits (20.1 ± 2.9) and perceived barriers (19.4 ± 3.3). Adults performing health promoting activities had better knowledge and greater perceived susceptibility. A simple regression showed knowledge and education were predictors of health promoting activities. Adults who were performing more than two activities for health promotion had better knowledge of CVDs and perceived more susceptibility. Identifying the health needs, understanding cultural beliefs and misconceptions, and adopting health-promoting actions might help to improve the health behavior of Nepali adults. [ABSTRACT FROM AUTHOR]

Michigan has the 17th highest adult obesity rate in the United States. Among college-aged adults between 18 and 25 years old, the rate of obesity was 11.6%. Obesity is a key precedent for the development of metabolic syndrome. Accordingly, the purpose of this study was to examine the prevalence of metabolic syndrome and its individual components among a sample of students at Central Michigan University. A cross-sectional survey was conducted among 462 students, aged 18-25 years, in Spring 2015 and Fall/Spring 2016 semesters. Students were recruited throughout the campus via flyers, in-class, and Blackboard announcements. Biochemical, anthropometric, and blood pressure measurements were taken for all students. Prevalence of metabolic syndrome was estimated based on the National Cholesterol Education Program's Adult Treatment Panel III guidelines. Multivariable analysis was used to assess the prevalence of metabolic risk components. To explore the association between metabolic risk factors and lifestyle behaviors, students filled out a validated online questionnaire related to their eating habits, physical activity, and sleep patterns. Metabolic syndrome was not prevalent in our sample. However, about one-third of the students had at least one metabolic abnormality, and 6.0% had two metabolic abnormalities. The most common metabolic abnormalities were low HDL-cholesterol levels (22.0%) and high waist circumference (12.6%), and elevated serum triglyceride (5.8%). Adjusting for other factors, excess adiposity and high visceral fat scores were associated with increased risk of metabolic risk factors, whereas healthy lifestyle practices such as daily breakfast consumption, eating three meals a day, being active, and not smoking were associated with lower risks for MetS. Given the adverse consequences of undiagnosed metabolic abnormalities, efforts to identify and manage MetS among asymptomatic college students, particularly women, is essential and warrants further research. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the level of sun safe behaviors, as well as to measure knowledge and attitudes toward being tan in a sample of college students. The sample was comprised of 315 college students attending a personal health course. During Fall of 2016, a survey was distributed to assess knowledge, attitudes, and behaviors of university students regarding skin cancer related behaviors. Students with a friend or family member with skin cancer more often reported thinking that they were at risk for developing skin cancer (48.6 vs. 21.2%, p < 0.001). Despite this opinion, they more often sunbathed (p = 0.008) and had a sunburn (p < 0.001) in the past year. Being in a health-related major did not significantly impact attitudes or behaviors. Future studies can focus further on raising awareness about skin cancer, specifically in college aged populations. [ABSTRACT FROM AUTHOR]