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Background: Depressive symptoms among nurses have been a significant public health concern. Although many studies have demonstrated the potential relationship between interpersonal conflict at work and depressive symptoms, the mechanisms underlying this relationship among nurses remain unclear. Based on the theoretical and empirical research, this study aimed to investigate the multiple mediating effects of negative emotion at work and meaning in life on the relationship between interpersonal conflict at work and depressive symptoms among nurses. Methods: An online multicenter cross-sectional study was conducted in 15 hospitals from different geographical areas of Hunan Province, China, from December 2021 to February 2022. A total of 1754 nurses completed validated self-reported questionnaires, including their sociodemographic information, interpersonal conflict at work, negative emotions at work, meaning in life, and depressive symptoms. Descriptive statistics analysis, Spearman's correlation analysis, multiple linear regression analysis, and chain mediation analysis were performed using IBM SPSS software (version 29) and Mplus software (version 8). Results: There were significant correlations between interpersonal conflict at work, negative emotions at work, meaning in life, and depressive symptoms (r = -0.206 ~ 0.518, all p < 0.01). Interpersonal conflict at work had a statistically significantly direct effect on depressive symptoms (β = 0.061; 95% confidence interval, CI: 0.011 ~ 0.126, p = 0.039). Analysis of mediating effects revealed that interpersonal conflict at work also influenced depressive symptoms through two statistically significantly indirect pathways: (a) the mediating effect of negative emotions at work (β = 0.167; 95% CI: 0.138 ~ 0.195, p < 0.001) and (b) the chain mediating effect between negative emotions at work and meaning in life (β = 0.008; 95% CI: 0.003 ~ 0.013, p = 0.005). Conclusion: Interpersonal conflict at work has a direct positive effect on depressive symptoms among nurses. Meanwhile, interpersonal conflict at work can influence depressive symptoms among nurses through the mediating effect of negative emotions at work and the chain mediating effect between negative emotions at work and meaning in life. [ABSTRACT FROM AUTHOR]

Background: Teachers are recognized as 'key agents' for the delivery of physical activity programs and policies in schools. The aim of our study was to develop and evaluate a tool to assess teachers' capability, opportunity, and motivation to deliver school-based physical activity interventions. Methods: The development and evaluation of the Capability, Opportunity, and Motivation to deliver Physical Activity in School Scale (COM-PASS) involved three phases. In Phase 1, we invited academic experts to participate in a Delphi study to rate, provide recommendations, and achieve consensus on questionnaire items that were based on the Capability, Opportunity, and Motivation Behavior (COM-B) model. Each item was ranked on the degree to which it matched the content of the COM-B model, using a 5-point scale ranging from '1 = Poor match' to '5 = Excellent match'. In Phase 2, we interviewed primary and secondary school teachers using a 'think-aloud' approach to assess their understanding of the items. In Phase 3, teachers (n = 196) completed the COM-PASS to assess structural validity using confirmatory factor analysis (CFA). Results: Thirty-eight academic experts from 14 countries completed three rounds of the Delphi study. In the first round, items had an average rating score of 4.04, in the second round 4.51, and in the third (final) round 4.78. The final tool included 14 items, which related to the six constructs of the COM-B model: physical capability, psychological capability, physical opportunity, social opportunity, reflective motivation, and automatic motivation. In Phase 2, ten teachers shared their interpretation of COM-PASS via a 20-min interview, which resulted in minor changes. In Phase 3, CFA of the 3-factor model (i.e., capability, opportunity, and motivation) revealed an adequate fit to the data (χ2 = 122.6, p <.001, CFI =.945, TLI =.924, RMSEA =.066). The internal consistencies of the three subscale scores were acceptable (i.e., capability: α =.75, opportunity: α =.75, motivation: α =.81). Conclusion: COM-PASS is a valid and reliable tool for assessing teachers' capability, opportunity, and motivation to deliver physical activity interventions in schools. Further studies examining additional psychometric properties of the COM-PASS are warranted. [ABSTRACT FROM AUTHOR]

Background: Multimorbidity is common in elderly people, and one of the major consequences of multimorbidity is low health-related quality of life (HRQoL). The aim of this study was to investigate the frequency of comorbid diseases in patients with Parkinson's disease (PD) and to analyze their relative importance in HRQoL. The aim was also to examine agreement between the generic 15D questionnaire and the PD-specific Parkinson's Disease Questionnaire (PDQ-8) to further validate 15D in the evaluation of HRQoL in patients with PD. Methods: Patients with PD (N = 551) filled a questionnaire on comorbid diseases, and the 15D questionnaire yielding a 15-dimensional health profile and a score representing the overall HRQoL. Self-organizing map was used for an unsupervised pattern recognition of the health profiles. Relative importance analysis was used to evaluate the contribution of 16 comorbid diseases to the 15D score. The agreement between 15D and PDQ-8 questionnaires was studied in a subset of 81 patients that were examined clinically. Results: 533 patients (96.7%) reported comorbid diseases. The most affected dimensions in the 15D questionnaire were secretion, usual activities, discomfort and symptoms, and sexual activity. Self-organizing map identified three patterns of health profiles that included patients with high, low or transition HRQoL. The transition subgroup was similar to low HRQoL subgroup in non-motor dimensions. Sixteen comorbid diseases explained 33.7% of the variance in the 15D score. Memory deficit, depression, heart failure, and atrial fibrillation had the highest relative importance. The intraclass correlation coefficient between the generic 15D and the PD-specific PDQ-8 was 0.642 suggesting moderate reliability. Conclusions: The most marked differences in HRQoL were in the dimensions of secretion, usual activities, and sexual activity. Pattern detection of 15D health dimensions enabled the detection of a subgroup with disproportionately poor HRQoL in non-motor dimensions. The comorbid diseases affecting most to HRQoL were memory deficit and depression. The generic 15D questionnaire can be used in the evaluation of HRQoL in PD patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: A major industrial fire accident occurred in a tire manufacturing factory in Daejeon, Korea, on 12 March 2023 and lasted for 3 d, generating air pollutant emissions. Although evidence regarding the health effects of urban fires is limited, residents near tire factory may have experienced health hazards due to smoke exposure from fire plumes. OBJECTIVES: Capitalizing on the timing of this fire incident as a natural experiment, we estimated the attributable excess air pollution exposure and associated disease development among residents living near the tire factory. METHODS: We used the generalized synthetic control method to estimate air pollution exposure and health burden attributable to the accident among residents living in smoke-exposed districts. Based on satellite images and air pollution monitoring results, three administrative districts (within 1.2 km from the factory) were defined as smoke-exposed, and the other 79 districts of Daejeon were defined as controls. Among the 11 monitoring stations in Daejeon, the station located 500 m from the factory was used to estimate excess air pollution exposure (PM10, PM2.5, NO2, O3, SO2, and CO) for residents in the exposed districts. The number of daily district-level disease-specific incidence cases were acquired from the National Health Insurance Database and used to estimate excess health burden resulting from the fire. RESULTS: During the first week following the factory fire, residents of exposed districts had an estimated excess exposure to 125.2 [95% confidence interval (CI): 44.9, 156.7] μg/m³ of PM10, 50.4 (95% CI: 12.7, 99.8) ppb of NO2, and 32.0 (95% CI: 21.0, 35.9) ppb of SO2. We also found an average increase in the incidence cases of other diseases of upper respiratory tract [20.6 persons (95% CI: 6.2, 37.4)], lung disease due to external agents [2.5 persons (95% CI: 2.1, 3.3)], urticaria and erythema [5.9 persons (95% CI: -0:6, 11.2)], and episodic and paroxysmal disorders [8.5 persons (95% CI: 3.7, 13.4)] in exposed districts. DISCUSSION: Excessive air pollution exposure and disease incidence were identified among residents living close to the tire factory. Preventive measures, such as a warning system, to avoid health impacts to people breathing fire-related pollution may be beneficial for communities impacted by such events. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this retrospective study is to further the limited body of evidence regarding the effects of a group-based boxing intervention for those with Parkinson's disease (PD). Design: A retrospective cohort study was performed analyzing data collected on outcome measures at 6-month intervals up to 2 years. Individuals participated in the standardized "Rock Steady Boxing" (RSB) program for up to 24 months. Every 6 months, measures were taken of balance (Fullerton Advanced Balance [FAB] Scale), functional mobility (Timed-Up and Go [TUG]), lower extremity strength (30-second Chair Stand [30CST]), and gait speed (10 Meter Walk Test [10MWT]). Methods: Statistical significance (P <.05) was determined by a two-tailed t test. Data were collected from RSB-affiliated programs at 4 locations across the southeastern United States. Current and/or past participants in RSB with baseline and at least one subsequent outcome measure were included, resulting in 68 participants (54 male, 14 female, and mean age of 71.2 years ± 8.56 standard deviation). Results: Statistically significant improvements in FAB scale, TUG, and 30CST over time were found at both 6- and 12-month time points. Significant changes continued through 18 months for FAB and 30CST. No significant changes in 10MWT were observed; however, a moderate effect size was observed at the 1-year point. Conclusions: Participants with PD were able to achieve statistically significant improvements in standard measures of functional mobility, balance, and strength within the timeline of this study. Limitations include the retrospective nature, an inability to monitor adherence, and lack of control over pharmaceutical or other interventions. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Investigación e Innovación en Ciencias de la Salud (RIICS) is the property of Fundacion Universitaria Maria Cano and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Wearable sensors are increasingly popular in concussion research because of their objective quantification of subtle balance deficits. However, normative data and minimal detectable change (MDC) values are necessary to serve as references for diagnostic use and tracking longitudinal recovery. To identify normative and MDC values for instrumented static- and reactive-balance tests, an instrumented static mediolateral (ML) root mean square (RMS) sway standing balance assessment and the instrumented, modified push and release (I-mP&R), respectively. Cross-sectional study. Clinical setting. Normative static ML RMS sway and I-mP&R data were collected on 377 (n = 184 female) healthy National Collegiate Athletic Association Division I athletes at the beginning of their competitive seasons. Test-retest data were collected in 36 healthy control athletes based on standard recovery timelines after concussion. Descriptive statistics, intraclass correlation coefficients (ICCs), and MDC values were calculated for primary outcomes of ML RMS sway in a static double-limb stance on firm ground and a foam block, and time to stability and latency from the I-mP&R in single- and dual-task conditions. Normative outcomes across static ML RMS sway and I-mP&R were sensitive to sex and type of footwear. Mediolateral RMS sway demonstrated moderate reliability in the firm condition (ICC = 0.73; MDC = 2.7 cm/s2) but poor reliability in the foam condition (ICC = 0.43; MDC = 11.1 cm/s2). Single- and dual-task times to stability from the I-mP&R exhibited good reliability (ICC = 0.84 and 0.80, respectively; MDC = 0.25 and 0.29 seconds, respectively). Latency from the I-mP&R had poor to moderate reliability (ICC = 0.38 and 0.55; MDC = 107 and 105 milliseconds). Sex-matched references should be used for instrumented static- and reactive-balance assessments. Footwear may explain variability in static ML RMS sway and time to stability of the I-mP&R. Moderate-to-good reliability suggests time to stability from the I-mP&R and ML RMS static sway on firm ground can be used for longitudinal assessments. [ABSTRACT FROM AUTHOR]

Background & Objective: This research aimed to study the role of the meaning of life in death anxiety and suicidal thoughts in women with cancer. Materials & Methods: The method of this research is correlation. The statistical population of the study included all women with cancer referred to Tawheed Hospital in Sanandaj City in 1400-1401. The sample size consists of one hundred people selected by purposive sampling. To collect data, Steger's Meaning in Life (MLQ), Templer's Death (DAS), and Beck's Suicidal Thoughts (BSSI) questionnaires were used. SPSS software was used in this research. Results: The information was analyzed using correlation tests and regression analysis. The regression conclusions showed that the meaning of life has an inverse relationship with suicidal thoughts, and death anxiety has a direct relationship with suicidal thoughts. The Pearson correlation results showed that the meaning of life predicts death anxiety and suicidal thoughts. Conclusion: In general, it can be concluded that the meaning of life plays an instrumental role in the death anxiety and suicidal thoughts of women with cancer. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine the relationship between postural sway performance during commonly utilized postural control assessments following a concussion, including the modified Balance Error Scoring System (mBESS), concussion balance test (COBALT), and sensory organization test (SOT) in healthy young adults. Approach: Twenty participants completed all balance testing. The mBESS conditions included double limb stance, single limb stance, and tandem stance. The COBALT was comprised of yaw plane head shake (HS) and vestibular ocular reflex cancellation conditions performed on firm and foam surfaces. Subjects performed 6 conditions of the SOT (C1-C6), which systematically perturbed sensory inputs. Postural sway performance was measured using a single force plate and quantified as a sway score for the mBESS and COBALT, and an equilibrium score for the SOT. Spearman rank correlations were used to examine the relationship between postural sway performance for each test. Main Results: There was a moderate positive correlation between mBESS-tandem stance and the HS on foam COBALT condition (r = .643, P = .002). There was a moderate negative correlation between mBESS-double limb stance and SOT-C6 (r = -.512, P = .021), and between mBESS-single limb stance and SOT-C6 (r = -.523, P = .018). The COBALT and SOT demonstrated numerous moderate to good negative correlations (r = -.448 to -.708, P ≤ .05), including a good negative correlation between HS on foam and SOT-C1 (r = -.725, P = .0003). Significance: Performance on the mBESS had minimal relationship to performance on the COBALT and SOT, suggesting that the clinical standard may not challenge sensory integration at the same capacity as other tests. All COBALT conditions had fair to good associations to at least 2 SOT conditions, suggesting both assessments are representative of sensory integration. Further investigation of the current clinical approach is warranted as the COBALT may be a clinically feasible test of sensory integration. [ABSTRACT FROM AUTHOR]

Objective The aim of this study was to establish the test–retest reliability of metrics obtained from wearable inertial sensors that reflect turning performance during tasks designed to imitate various turns in daily activity. Methods Seventy-one adults who were healthy completed 3 turning tasks: a 1-minute walk along a 6-m walkway, a modified Illinois Agility Test (mIAT), and a complex turning course (CTC). Peak axial turning and rotational velocity (yaw angular velocity) were extracted from wearable inertial sensors on the head, trunk, and lumbar spine. Intraclass correlation coefficients (ICCs) were established to assess the test–retest reliability of average peak turning speed for each task. Lap time was collected for reliability analysis as well. Results Turning speed across all tasks demonstrated good to excellent reliability, with the highest reliability noted for the CTC (45-degree turns: ICC = 0.73–0.81; 90-degree turns: ICC = 0.71–0.83; and 135-degree turns: ICC = 0.72–0.80). The reliability of turning speed during 180-degree turns from the 1-minute walk was consistent across all body segments (ICC = 0.74–0.76). mIAT reliability ranged from fair to excellent (end turns: ICC = 0.52–0.72; mid turns: ICC = 0.50–0.56; and slalom turns: ICC = 0.66–0.84). The CTC average lap time demonstrated good test–retest reliability (ICC = 0.69), and the mIAT average lap time test–retest reliability was excellent (ICC = 0.91). Conclusion Turning speed measured by inertial sensors is a reliable outcome across a variety of ecologically valid turning tasks that can be easily tested in a clinical environment. Impact Turning performance is a reliable and important measure that should be included in clinical assessments and clinical trials. [ABSTRACT FROM AUTHOR]

This study examined the relationships between positive/negative spirituality and meaning in life at two religious sites in Japan. Participants reported greater sadness and less meaning in life at Koyasan Okunoin, a temple with graves surrounded by nature, than at Nachi Kumano Taisha, a shrine with a waterfall. However, greater feelings of happiness protected meaning in life in the presence of sadness at Koyasan. Additionally, participants who felt a sense of awe reported greater meaning in life through self-liberation, regardless of the sites. The results provide new insights into meaning in life from the two sides of spirituality. [ABSTRACT FROM AUTHOR]

Background: Access to palliative care is often limited for challenging and vulnerable groups, including persons with substance use disorders. However, with optimized healthcare options and liberal substitution policies, this patient group is likely to increase over the upcoming years, and comorbidities will also influence the need for palliative support. Here, we aim at analyzing characteristics and specific challenges associated with substance use disorders (SUD) in palliative care. Methods: We retrospectively reviewed all patients diagnosed with substance use disorder that were treated at our Competence Center Palliative Care within the University Hospital Zurich, Switzerland between 2015 and 2021. Patient characteristics, including age, gender, duration of hospitalization, as well as specific metrics like body mass index, distinct palliative care assessment scores, and in-hospital opioid consumption were retrieved from the electronic patient files. Demographics and clinical data were analyzed by descriptive statistics, and compared to those of a control group of palliative care patients without SUD. An opioid calculator was used to standardize opioid intake based on morphine equivalents for meaningful comparisons. Results: The primary characteristics revealed that the majority of individuals were single (56%), had no children (83%), lived alone (39%), and were either unemployed or recipients of a disability pension (in total 50%). Nicotine (89%), opioids (67%), and alcohol (67%) were the most used substances. We identified various comorbidities including psychiatric illnesses alongside SUD (56%), hepatitis A, B, or C (33%), and HIV infection (17%). Patients with SUD were significantly younger (p < 0.5), predominantly male (p < 0.05), and reported a higher prevalence of pain (p < 0.5) compared to the standard cohort of palliative patients. Regarding the challenges most frequently reported by healthcare practitioners, non-compliance, multimorbidity, challenging communication, biographical trauma, lack of social support, and unstable housing situations played a key role. Conclusion: Patients with SUD represent a complex and vulnerable group dealing with multiple comorbidities that profoundly affect both their physical and psychological well-being. Understanding their unique characteristics is pivotal in providing precise and suitable palliative care. [ABSTRACT FROM AUTHOR]

Current clinical concussion evaluations assess balance deficits using static or dynamic balance tasks while largely ignoring reactive balance. Including a reactive balance assessment might provide a more comprehensive concussion evaluation. To identify redundancy in current clinical baseline assessments of concussion and determine whether reactive balance adds unique information to these evaluations. Cross-sectional study. Clinical assessment. A total of 279 healthy National Collegiate Athletic Association Division I athletes. Two cohorts of data were collected at the beginning of the athletic season. For cohort 1 (n = 191), the Immediate Post-Concussion Assessment and Cognitive Tool, instrumented modified push and release (I-mP&R), and Balance Error Scoring System (BESS) were administered. For cohort 2 (n = 88), the I-mP&R, BESS, timed tandem gait, walking with eyes closed, and clinical reaction time were administered. The strengths of the relationships between the Immediate Post-Concussion Assessment and Cognitive Tool cognitive indices, mP&R clinical score, instrumented measures (BESS sway; I-mP&R time to stability, latency, and step length), BESS score, timed tandem gait, walking time to completion, and clinical reaction time were characterized. The strongest interinstrument correlation value was between single-task time to stability from the I-mP&R and clinical reaction time but was considered weak (r = 0.35, P =.001). The mP&R and I-mP&R clinical scores were weakly associated with the other assessments. Weak correlations between interassessment variables indicated that little redundancy was present in the current clinical evaluations. Furthermore, reactive balance represents a unique domain of function that may improve the comprehensiveness of clinical assessments. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health & Life Sciences / Sağlık ve Yaşam Bilimleri Dergisi is the property of Istanbul Kultur University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Studies have examined floor-to-stand performance in varied adult populations both quantitatively and qualitatively. Despite an elevated risk of falls and inability to independently return to stand after a fall, few have examined the ability to stand from the floor in patients recovering from stroke. There were 2 objectives of the study: to identify the relationships between floor-to-stand performance using a timed supine-to-stand test (TSS) and physical performance measures of gait, balance, and balance confidence among persons in the subacute phase after stroke; and to analyze descriptive strategies used in the completion of the TSS. Methods A cross-sectional design was implemented. Fifty-eight adults (mean age = 59.2 [standard deviation (SD) = 13.9] years; 34 [58.6%] men) who were in the subacute phase after ischemic or hemorrhagic stroke and who could stand from the floor with no more than supervision completed the TSS and physical performance assessments. Results The median time to complete the TSS in our sample was 13.0 (interquartile range = 15.5) seconds. TSS time was significantly correlated with physical performance tests, including the Timed "Up & Go" Test (ρ = 0.70), gait speed (ρ = −0.67), Dynamic Gait Index (ρ = −0.52), and Activities-Specific Balance Confidence Scale (ρ = −0.43). Thirty-two percent of the variance in TSS time was attributed to Timed "Up & Go" Test time and the use of the quadruped position to transition to standing. Participants who used a gait device were more likely to use a chair during rise to stand. Conclusion The TSS demonstrates concurrent validity with physical performance measures. Impact Findings serve to improve functional mobility examination after stroke and to formulate effective treatment interventions to improve floor-to-stand performance. [ABSTRACT FROM AUTHOR]

As a severe public health concern directly endangering life safety, adolescent suicide has been extensively investigated in variable-centered studies. However, gaps remain in the knowledge of heterogeneous suicide risk patterns and their developmental nature. Additionally, little is known about protective factors associated with suicide risk patterns and changes. This study applied person-centered approaches to explore suicide risk profiles and transitions over time in early Chinese adolescents, along with their protective factors. A total of 1518 junior high school students (49.6% girls, Mage = 13.57, SD = 0.75) participated in two surveys within a 12-month interval. Latent Profile Analysis and Latent Transition Analysis were used to model the profiles and transitions of suicide risk. Three risk profiles were identified at both time points: low risk profile (73.9, 78.3%), medium risk-high threat profile (16.2, 10.2%), and high risk profile (9.9, 10.2%). Low risk profile was stable, while medium risk-high threat and high risk profiles showed great transitions over 12 months. Sense of control, meaning in life, and regulatory emotional self-efficacy served as protective factors against suicide risk profiles and transitions. Findings underscore the importance of comprehensively illustrating suicide risk states from multiple aspects, as well as understanding the fluid nature of transitions between different risk states. Prevention and intervention strategies aimed at enhancing resilience, such as increasing sense of control, perceived meaningfulness, and belief in emotional regulation, may contribute to reducing the risk of suicide among adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Engaging in meaningful activities contributes to health and well-being. Therefore, it is important to measure this with reliable and valid evaluation tools. The Engagement in Meaningful Activities Survey (EMAS-VL) has been cross-culturally validated in Flemish and the psychometric properties determined. Method: The adaptation process followed the guidelines 'Translation and Adaptation of Instruments' and 'Cross-Cultural Adaptation of Self Report'. A forward and backward translation was performed. Three authors of the original EMAS were in close contact. Pretesting and cognitive interviews were performed on a sample of 10 chronically ill individuals. Psychometric analysis of survey data, collected during the COVID-19 lockdown (N = 1938 Belgian adults, Flemish speaking), was performed. Internal consistency, factorial validity and construct validity were examined. Results: The adaptation process involved an accurate analysis of the items of the EMAS by the expert panel and EMAS authors. The EMAS-VL showed high reliability (Cronbach's α = 0.91). Exploratory factor analysis discerned an interpretable two-factorial structure of the EMAS-VL. As hypothesized, moderate associations were found between GHQ-12 (r = −0.57) and CD-RISC (r = 0.50) so the EMAS-VL possesses satisfactory construct validity as well. Conclusion: EMAS-VL is shown to be a reliable and valid instrument for evaluating meaning in activities in Flanders. [ABSTRACT FROM AUTHOR]

Introduction: Posttraumatic Stress Disorder (PTSD) has been found to be positively related to victimization of emotional abuse from an intimate partner. However, as PTSD has also been demonstrated to be associated with perpetration of emotional abuse, there may be confounding factors between perpetration and victimization of emotional abuse as many couples present with bi-directional abusive behavior. The current study examined the unique variance of PTSD symptom severity among trauma exposed women explained by victimization and perpetration of emotional abuse, as well as to explore whether these factors interact. Method: Couples with trauma exposed women (N = 141) completed measures of physical and emotional abuse in their current relationship and women reported on their own PTSD symptom severity. Results: Victimization of the Restrictive Engulfment, Hostile Withdrawal, and Denigration forms of emotional abuse were positively associated with PTSD symptom severity. For Hostile Withdrawal and Denigration, the associations between victimization and PTSD symptom severity were only significant among women who were not also engaging in emotional abuse perpetration. Victimization of Dominance/Intimidation emotional abuse was not related to PTSD symptoms. Rather, perpetration of Dominance/Intimidation emotional abuse was associated with heightened PTSD symptom severity. Conclusion: Findings suggest specific dimensions of emotionally abusive behaviors, both victimization and perpetration, place trauma exposed women at risk for heightened symptom severity. [ABSTRACT FROM AUTHOR]

To summarize the effects of rehabilitation interventions to reduce freezing of gait (FOG) in people with Parkinson's disease. A systematic review with meta-analyses of randomized trials of rehabilitation interventions that reported a FOG outcome was conducted. Quality of included studies and certainty of FOG outcome were assessed using the PEDro scale and GRADE framework. Sixty-five studies were eligible, with 62 trialing physical therapy/exercise, and five trialing cognitive and/or behavioral therapies. All meta-analyses produced very low-certainty evidence. Physical therapy/exercise had a small effect on reducing FOG post-intervention compared to control (Hedges' g= −0.26, 95% CI= −0.38 to −0.14, 95% prediction interval (PI)= −0.38 to −0.14). We are uncertain of the effects on FOG post-intervention when comparing: exercise with cueing to without cueing (Hedges' g= −0.58, 95% CI= −0.86 to −0.29, 95% PI= −1.23 to 0.08); action observation training plus movement strategy practice to practice alone (Hedges' g= −0.56, 95% CI= −1.16 to 0.05); and dance to multimodal exercises (Hedges' g= −0.64, 95% CI= −1.53 to 0.25). We are uncertain if physical therapy/exercise, cognitive or behavioral therapies, are effective at reducing FOG. FOG leads to impaired mobility and falls, but the effect of rehabilitation interventions (including physical therapy/exercise and cognitive/behavioral therapies) on FOG is small and uncertain. Until more robust evidence is generated, clinicians should assess FOG using both self-report and physical measures, as well as other related impairments such as cognition, anxiety, and fear of falling. Interventions for FOG should be personalized based on the individual's triggers and form part of a broader exercise program addressing gait, balance, and falls prevention. Interventions should continue over the long term and be closely monitored and adjusted as individual circumstances change. [ABSTRACT FROM AUTHOR]

Recent studies implicate the use of psychedelic substances in the treatment of psychiatric conditions. However, this literature also suggests that the psychedelics may have utility in the promotion of positive adult development. Accordingly, this paper outlines a study exploring this premise. An online sample (n = 684) of psychedelic users and non-users (age range: 18–24 to 75–84; median = 25–34) was recruited. Conditional process analysis was used to assess whether the relationship between psychedelic use and two facets of adult development, adjustment and growth, would be mediated by openness to experience, awe-proneness, and mystical experiences, and whether these relationships would be moderated by drug-use reflection/integration. Results show that the direct relationship between psychedelic use and growth was moderated by drug-use reflection/integration. In addition, the indirect relationship between psychedelic use and adjustment was mediated through awe-proneness, while the indirect relationships between psychedelic use and growth were mediated via awe-proneness and openness to experience; drug-use reflection/integration moderated these mediated relationships. In addition, drug-use reflection/integration directly predicted openness, awe-proneness, and growth. These findings suggest that, when used with self-expansive intentions and actively reflected upon and integrated post use, psychedelics may augment positive adult development. [ABSTRACT FROM AUTHOR]

Background and Objectives: Spiritual health, along with mental, physical, and emotional health, is one of the four dimensions of health, which can increase the level of adaptation of teachers to life events. The present study investigates the mediating role of meaning in life in relationships of responsibility and spiritual health with prospective personalities of competent teachers. Methods: This study used a structural equation model method, and the statistical population consisted of all competent teachers in Ahvaz City, Iran, in 2023. A total of 264 participants were selected via multi-stage cluster sampling. Prospective personality, responsibility, spiritual health, and meaning in life questionnaires were used to collect the data. The data were analyzed through descriptive and inferential statistics, the Pearson correlation coefficient, and structural equation modeling. Results: Spiritual health had positive, significant relationships with prospective personality and meaning in life in competent teachers (P<0.01). Responsibility was significantly related to prospective personality and meaning in life (P<0.01). Furthermore, the relationship between meaning in life and perspective personality in teachers was significant (P<0.001). The indirect paths to perspective personality were found to become significant through meaning in life (P<0.01). Conclusion: The proposed model had a good fit and is a major step toward identifying factors affecting prospective personality in teachers. [ABSTRACT FROM AUTHOR]

Existential nihilism is a worldview characterized by the belief that the totality of existence is meaningless and any attempt to change or rectify this, with the goal of establishing meaning, is futile. Despite the rich but often ambiguous philosophical and cultural history of existential nihilism, its impact on mental health and society remains largely unknown due to a gap in the scientific measurement literature. To address this gap, an 8-item scale measuring the proposed construct was rigorously developed and tested in accordance with psychometric theory and scale development guidelines. Two identical studies were conducted with an undergraduate sample (N = 329) and a community sample (N = 307) to evaluate the scale's item quality, reliability, internal structure, convergent validity, concurrent validity, discriminant validity, and incremental validity. Evaluation of the Existential Nihilism Scale (ENS) provided evidence of strong psychometric properties. This new measure promises to contribute to future research examining the impact of existential nihilism on mental health, wellbeing, and social outcomes. [ABSTRACT FROM AUTHOR]

Background COVID-19 has had a detrimental impact on access to hip and knee arthroplasty surgery. We set out to examine whether this had a subsequent impact on preoperative opioid prescribing rates for those awaiting surgery. Methods Data regarding patient demographics and opioid utilisation were collected from the electronic health records of included patients at a large university teaching hospital. Patients on the outpatient waiting list for primary hip and knee arthroplasty as of September 2020 (COVID-19 group) were compared with historical controls (Controls) who had previously undergone surgery. A sample size calculation indicated 452 patients were required to detect a 15% difference in opioid prescription rates between groups. Results A total of 548 patients (58.2% female) were included, 260 in the COVID-19 group and 288 in the Controls. Baseline demographics were similar between the groups. For those with data available, the proportion of patients on any opioid at follow-up in the COVID-19 group was significantly higher: 55.0% (143/260) compared with 41.2% (112/272) in the Controls (p=0.002). This remained significant when adjusted for confounding (age, gender, Scottish Index of Multiple Deprivation, procedure and wait time). The proportion of patients on a strong opioid was similar (4.2% (11/260) vs 4.8% (13/272)) for COVID-19 and Controls, respectively. The median waiting time from referral to follow-up was significantly longer in the COVID-19 group compared with the Controls (455 days vs 365 days; p<0.0001). Conclusion The work provides evidence of potential for an emerging opioid problem associated with the influence of COVID-19 on elective arthroplasty services. Viable alternatives to opioid analgesia for those with end-stage arthritis should be explored, and prolonged waiting times for surgery ought to be avoided in the recovery from COVID-19 to prevent more widespread opioid use. [ABSTRACT FROM AUTHOR]

Background and Aims: The addictive potential of electronic cigarettes (e‐cigarettes) remains to be fully understood. We identified patterns and correlates of perceived addiction to e‐cigarettes and perceived addictiveness of e‐cigarettes relative to tobacco cigarettes (relative addictiveness) in dual users as well as exclusive e‐cigarette users. Design, Setting and Participants: Observational study using cross‐sectional survey data from England (2016) from the International Tobacco Control Project (ITC) Four Country Smoking and Vaping (4CV) survey. The study comprised 832 current e‐cigarette users who had been vaping for at least 4 months. Measurements: Perceived addiction to e‐cigarettes and relative addictiveness of e‐cigarettes were examined. Socio‐demographic factors were age, gender and education; markers of addiction included urge to vape, time to first vape after waking and nicotine strength used; vaping and smoking characteristics included frequency and duration of e‐cigarette use, intention to quit, adjustable power or temperature, enjoyment, satisfaction relative to tobacco cigarettes and tobacco cigarette smoking status. Findings A total of 17% of participants reported feeling very addicted to e‐cigarettes, while 40% considered e‐cigarettes equally/more addictive than tobacco cigarettes. Those who felt very addicted had higher odds of regarding e‐cigarettes as more addictive than tobacco cigarettes (odds ratio 3.4, 95% confidence interval 2.3–5.1). All markers of addiction, daily use and enjoyment were associated with higher perceived addiction, whereas time to first vape after waking, daily vaping and perceiving vaping as less satisfying than smoking were associated with relative addictiveness. Conclusions: Markers of addiction to e‐cigarettes appear to correspond with perceived addiction to e‐cigarettes, suggesting that self‐reported perceived addiction might serve as an indicator of addiction. Prevalence both of markers of addiction and perceived addiction were comparatively low overall, suggesting a limited but relevant addictive potential of e‐cigarettes. Additionally, positive and negative reinforcement, reflected here by enjoyment and relative satisfaction, might play a role in e‐cigarette addiction. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to evaluate sex differences in health and fitness outcomes among United States Military Academy (USMA) graduates (class years 1980-2011). Subjects (n = 701 men, 641 women, age: 45.7 ± 9.3 years) were surveyed as a part of a larger investigation on risk and resiliency factors among USMA graduates. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) short form and calculation of weekly metabolic equivalents (METs). Overweight and obesity status were assessed by body mass index (BMI). Significance for the study was set at p ≤ 0.05. Obesity rates for men (30.1%) were significantly higher than for women (16.6%). Men reported significantly higher (p = 0.01) vigorous METs·wk-1 (1,214.6 ± 1,171.6) than women (1,046.8 ± 1,133.2) despite significantly higher (p = 0.00) BMI values (28.75 ± 4.53 kg·m-2) than women (25.90 ± 5.48 kg·m-2). Women were 89% more likely to have ever been on a diet and reported higher (15.2%) Army Body Composition Program enrollment rates than men (6.3%). Obesity rates among men reflect trends seen in the broader military, Veteran, and U.S. adult populations, whereas obesity rates among women were lower. Men may be at a greater risk for obesity later in life despite higher self-reported physical activity; however, lean body mass and self-report bias should be considered. Because lifetime obesity may be influenced by factors other than physical activity, health initiatives should use a comprehensive approach early in the career of military officers. [ABSTRACT FROM AUTHOR]

This paper reflects on the value of diary methods in the context of a qualitative, longitudinal narrative inquiry exploring the higher education decision-making of further education students in England. Event-based diaries were used alongside interviews and focus groups over a 14-month period to gain in-depth insights into the reasons and influences informing their decision-making trajectories. I explore the challenges, successful approaches and advantages of employing diary methods with young people in this context. Challenges consisted of maintaining participant engagement, which was overcome by combining methods and incorporating a reactive co-participatory element. Yet, a number of advantages emerged from participants' engagement with diary keeping which enhanced the richness of the data; this inspired deeper reflections on decision-making and influences and provided a private space for participants to disclose personal difficulties that could not be obtained via interviews. [ABSTRACT FROM AUTHOR]

Previous research has shown that depression is associated with adverse recovery outcomes following work-related musculoskeletal injury. Treatment outcome expectancies have also been shown to predict recovery trajectories following musculoskeletal injury. The present study examined the role of positive and negative treatment outcome expectancies as mediators of the relation between depressive symptoms and treatment outcome for individuals receiving physical therapy for a musculoskeletal injury. The study sample consisted of 153 individuals who had sustained a work-related musculoskeletal injury to the back or neck within 6 months of enrolment. Participants completed self-report measures of depressive symptom severity, pain severity, and treatment outcome expectancies prior to treatment; pain severity was assessed again after 4 weeks of treatment. The results of this study were consistent with previous research showing significant relations between depressive symptom severity, pain severity and treatment outcome expectancies. Bootstrapping mediation analyses separately assessed the mediating roles of positive and negative treatment outcome expectancies on the relation between depressive symptoms and pain severity. Findings revealed that positive treatment outcome expectancies mediated the relation between depressive symptoms and pain severity, whereas negative treatment outcome expectancies did not. Discussion addresses potential pathways through which positive treatment outcome expectancies might influence pain outcomes. The findings suggest that intervention techniques aimed at increasing positive treatment outcome expectancies, rather than decreasing negative treatment outcome expectancies, might contribute to better recovery outcomes for individuals experiencing pain and depressive symptoms following a work-related musculoskeletal injury. [ABSTRACT FROM AUTHOR]

Background : This study investigated the ways in which adults reflect on their psychological experiences amid a recent marital separation and how these patterns of thought, manifest in language, are associated with self-reported negative affect and actigraphy-assessed sleep disturbance. Methods: In a sample of 138 recently separated adults assessed three times over five months, we examined within- and between-person associations among psychological overinvolvement (operationalized using verbal immediacy derived as a function of the language participants used to discuss their relationship history and divorce experience), continued attachment to an ex-partner, negative affect, and sleep efficiency. Results: The association between psychological overinvolvement and negative affect operated at the within-person level, whereas the associations between psychological overinvolvement and sleep disturbance, as well as negative affect and sleep disturbance, operated at the between-person level. Conclusions: These findings shed light on the intraindividual processes that may explain why some people are more susceptible to poor outcomes after separation/divorce than others. Our findings suggest that individuals who express their divorce-related thoughts and feelings in a psychologically overinvolved manner may be at greatest risk for sleep disturbances after marital separation/divorce. [ABSTRACT FROM AUTHOR]

Objectives. Workplace safety problems are often catastrophic. There are both external and internal factors that influence employee safety performance. Strengthening internal factors is crucial to enhancing safety performance. Methods. Through a sense-making perspective, in the present study the impact of spiritual leadership on employees' career callings and safety performance was investigated, along with the moderating function of future work self-salience. A total of 339 paired leader–employee data were obtained. Results. Spiritual leadership significantly improved employee safety performance. Career callings served a mediating role between spiritual leadership and employee safety performance. The moderating effect of future work self-salience was significant. When future work self-salience was high, the influence of career callings on employees' safety performance was greater. Conclusion. The present results indicated that spiritual leadership sense-giving influences the development of employees' career sense and improves employees' safety performance in regard to spiritual motivation and pursuing career callings. In the present article, a theoretical and practical basis is provided for the safe development of organizations and society. [ABSTRACT FROM AUTHOR]

Objective: Concussion is a common ED complaint, but diagnosis is challenging as there are no validated objective measures. Use of concussion tools derived from sports medicine is common, but these tools are not well validated in ED settings. The aim of this study was to assess the ability of the Sport Concussion Assessment Tool 5th Edition (SCAT5) to identify concussion in ED patients presenting following head injury. Methods: We conducted a prospective observational study of head‐injured adult patients presenting to ED between March and July 2021. ED diagnosis of concussion was used as the diagnostic standard, and we assessed the diagnostic performance of the SCAT5 test and its three subsections (Standardised Assessment of Concussion (SAC), Post‐Concussion Symptom Scale (PCSS) and Modified Balance Error Scoring System (mBESS)) against this. Results: Thirty‐two head‐injured participants were enrolled, 19 of whom had a discharge diagnosis of concussion, alongside 17 controls. Median time for SCAT5 testing was 21 (interquartile range 16–27) min. Fifteen (30.6%) participants were interrupted during testing. Area under the curve (AUC) (95% confidence interval) for the SAC, PCSS and mBESS were 0.51 (0.34–0.68), 0.92 (0.84–0.99) and 0.66 (0.47–0.85), respectively. Sensitivity and specificity of sections were as follows: entire SCAT5 (100.0%, 20.0%), SAC (48.1%, 60.0%), PCSS (89.7%, 85.0%) and mBESS (83.3%, 58.8%). Using PCSS alone would have identified 17 of 19 concussions. Conclusion: The SCAT5 test had a low specificity, was long and was frequently interrupted. We suggest it is not an ideal assessment to use in ED. The PCSS score performed well and was easy to complete. It may be useful as a standalone tool to simplify ED concussion identification. [ABSTRACT FROM AUTHOR]

Individuals with persistent post-concussive symptoms (PPCS) may present with a myriad of physical symptoms. There is limited research available comparing the presence of examination findings among individuals with PPCS from different age groups. Retrospective case-control chart review of 481 patients with PPCS and 271 non-trauma controls. Physical assessments were categorized as ocular, cervical, and vestibular/balance. Differences in presentation were compared between PPCS and controls as well as between individuals with PPCS in three age groups: adolescents, young adults, and older adults. All three PPCS groups had more abnormal oculomotor findings than their age-matched counterparts. When comparing PPCS patients from different age groups, no differences were seen in prevalence of abnormal smooth pursuits or saccades; however, adolescents with PPCS had more abnormal cervical findings and a lower prevalence of abnormal NPC, vestibular and balance findings. Patients with PPCS presented with a different constellation of clinical findings based on their age. Adolescents were more likely to demonstrate evidence of cervical injury compared to younger and older adults, and adults were more likely to present with vestibular findings and impaired NPC. Adults with PPCS were more likely to present with abnormal oculomotor findings compared to adults with non-traumatic causes of dizziness. [ABSTRACT FROM AUTHOR]

Aims: to investigate the effects of Pilates exercise on the anticipatory activation of selected lower limb muscles and balance in elderly women who had previous history of falling. Methods: In this randomized clinical trial study, 22 elderly women were divided into the control (n = 10) and the experimental (n = 12) groups. The Berg balance scale and Timed Up and Go Test and electrical activity of selected lower-limb muscles were collected before and after the intervention period. The experimental group performed the Pilates exercises for eight weeks (three sessions of one hour per week). Results: Pilates exercises had a significant effect on the Berg balance scale (p = 0.001), the timed up and go test (p < 0.001), the onset time of the tibialis anterior (p < 0.001), vastus lateralis (p = 0.004), vastus medialis (p = 0.033), and biceps femoris (p = 0.001). Conclusion: Pilates exercises can improve anticipatory activation of lower extremity muscles, balance and performance in elderly women with falling history. [ABSTRACT FROM AUTHOR]

Freezing of gait (FOG) is a disabling phenomenon defined by the periodic absence or reduction of forward progression of the feet despite the intention to walk. We sought to understand whether Google Glass (GG), a lightweight wearable device that provides simultaneous visual-auditory cues, might improve FOG in parkinsonism. Patients with parkinsonism and FOG utilized GG custom-made auditory-visual cue applications: "Walk With Me" and "Unfreeze Me" in a single session intervention. We recorded ambulation time with and without GG under multiple conditions including 25 feet straight walk, dual task of performing serial 7's while straight walking, 180 degree turn after walking 25 feet, and walking through a doorway. FOG and patient experience questionnaires were administered. Using the GG "Walk With Me" program, improvements were noted in the following: average 25 feet straight walk by 0.32 s (SD 2.12); average dual task of serial 7's and 25 feet straight walk by 1.79 s (SD 2.91); and average walk through doorway by 0.59 s (SD 0.81). Average 180 degree turn after 25 feet walk worsened by 1.89 s (SD 10.66). Using the "Unfreeze Me" program, only the average dual task of serial 7's and 25 feet straight walk improved (better by 0.82 s (SD 3.08 sec). All other tasks had worse performance in terms of speed of completion. This feasibility study provides preliminary data suggesting that some walking tasks may improve with GG, which uses various musical dance programs to provide visual and auditory cueing for patients with FOG. Freezing of gait in parkinsonian syndromes is a disabling motor block described by patients as having their feet stuck to the floor leading to difficulty in initiation of gait and increased risk for falls. Wearable assistive devices such as Google Glass™ use visual and auditory cueing that may improve gait pattern in patients with freezing of gait. Augmented reality programs using wearable assistive devices are a home-based therapy, with the potential for reinforcing physical therapy techniques; this is especially meaningful during the COVID-19 pandemic when access to both medical and rehabilitative care has been curtailed. [ABSTRACT FROM AUTHOR]

Freezing of gait (FoG) is a common target of rehabilitative interventions for people with Parkinson disease (PD). Virtual reality (VR) holds potential for advancing research and clinical management of FoG through flexible creation of FoG-provoking environments that are not easily or safely replicated in the clinic. The aim of this study was to investigate whether VR environments that replicate FoG-provoking situations would exacerbate gait impairments associated with FoG compared to unobstructed VR and physical laboratory environments. Gait characteristics (pace, rhythm, variability, asymmetry, and postural control domains) and festination were measured using motion capture while people with PD walked in VR environments based on FoG-provoking situations (doorway, hallway, and crowd environments) compared to unobstructed VR and physical laboratory environments. The effect of VR environments was assessed using one-way repeated measures ANOVAs with planned contrasts. Ten participants (mean age 74.1 years, 3 females, Hoehn and Yahr stage 2–3) with PD who self-reported FoG participated. Gait speed and step length were reduced in all VR environments compared to the physical laboratory. Step width was wider, step length was more variable, and festination was more common for some of the VR environments compared to the physical laboratory environment. Compared to the unobstructed virtual laboratory environment, step length was more variable in VR crowd and doorway environments. The exacerbation of gait impairments that are characteristic precursors of FoG in FoG-provoking VR environments supports the potential utility of VR technology in the assessment and treatment of gait impairments in PD. Freezing increases fall risk and reduces quality of life in Parkinson disease (PD). Virtual reality (VR) can simulate visuospatial environments that provoke freezing. Immersive VR doorway, hallway, and crowd environments were developed. Gait speed slowed when people with PD walked overground in all VR environments. Step variability and festination increased in freeze-provoking environments. [ABSTRACT FROM AUTHOR]

Pre-migration trauma, a psychological risk factor for refugees, is often measured using cumulative indices. However, recent research suggests that trauma subtypes, rather than cumulative trauma, may better predict psychological outcomes. This study investigated the predictive utility of trauma subtypes in the assessment of refugee mental health. Multiple regression was used to determine whether cumulative trauma or trauma subtypes explained more variance in depression, anxiety, and post-traumatic stress disorder (PTSD) symptom scores in 70 Syrian and Iraqi refugees. Subtype models performed better than cumulative trauma models for PTSD (cumulative R2 = 0.138; subtype R2 = 0.32), anxiety (cumulative R2 = 0.061; subtype R2 = 0.246), and depression (cumulative R2 = 0.041; subtype R2 = 0.184). Victimization was the only subtype significantly associated with PTSD (p < 0.001; r2 = 0.210), anxiety (p < 0.001; r2 = 0.162), and depression (p = 0.002; r2 = 0.140). Cumulative trauma was predictive of PTSD symptoms only (p = 0.003; r2 = 0.125). Trauma subtypes were more informative than cumulative trauma, indicating their utility for improving predictive efforts in research and clinical contexts. [ABSTRACT FROM AUTHOR]

Background: Australia has one of the highest rates of overweight and obesity in the developed world, and this increasing prevalence and associated chronic disease morbidity reinforces the importance of understanding the attitudes, views, and experiences of patients and health providers towards weight management interventions and programs. The purpose of this study was to investigate patients, family practitioners and family practice nurses' perceptions and views regarding the receipt or delivery of weight management within the context of the HeLP-GP intervention. Methods: A nested qualitative study design including semi-structured interviews with family practitioners (n = 8), family practice nurses (n = 4), and patients (n = 25) attending family practices in New South Wales (n = 2) and South Australia (n = 2). The patient interviews sought specific feedback about each aspect of the intervention and the provider interviews sought to elicit their understanding and opinions of the strategies underpinning the intervention as well as general perceptions about providing weight management to their patients. Interviews were recorded and transcribed verbatim, and coding and management conducted using NVivo 12 Pro. We analysed the interview data using thematic analysis. Results: Our study identified three key themes: long-term trusting and supportive relationships (being 'in it for the long haul'); initiating conversations and understanding motivations; and ensuring access to multi-modal weight management options that acknowledge differing levels of health literacy. The three themes infer that weight management in family practice with patients who are overweight or obese is challenged by the complexity of the task and the perceived motivation of patients. It needs to be facilitated by positive open communication and programs tailored to patient needs, preferences, and health literacy to be successful. Conclusions: Providing positive weight management in family practice requires ongoing commitment and an open and trusting therapeutic relationship between providers and patients. Behaviour change can be achieved through timely and considered interactions that target individual preferences, are tailored to health literacy, and are consistent and positive in their messaging. Ongoing support of family practices is required through funding and policy changes and additional avenues for referral and adjunctive interventions are required to provide comprehensive weight management within this setting. [ABSTRACT FROM AUTHOR]

To investigate: (1) the interrater, and test–retest reliability of the figure-of-eight walk test (F8WT) in people with Parkinson's disease (PwPD); (2) the minimum detectable change in the F8WT times; (3) the concurrent and known-groups validity of the F8WT times; and (4) the cut-off times that best discriminate PwPD from healthy people and fallers from non-fallers with PD. This was a cross-sectional study. Forty-three PwPD and 34 healthy people were recruited. The F8WT was performed along with the timed up and go test, 10 m walk test, Berg Balance Scale, Activities-Specific Balance Confidence Scale, Unified Parkinson's disease Rating Scale, and Hoehn and Yahr Scale. The F8WT showed good interrater and test–retest reliability (ICC = 0.964–0.978 and ICC = 0.905–0.920, respectively). The MDC was 2.77 s. The F8WT was correlated with other outcome measures. Significant differences in the F8WT times were found between PwPD and healthy people and between fallers and non-fallers with PD (p < 0.001 and p < 0.001, respectively). The cut-off times of 8.43 s best discriminated PwPD from healthy people, while 11.19 s best discriminated fallers from non-fallers with PD. The F8WT is a reliable, valid, and easy-to-administer tool in assessing the walking skill of PwPD. The figure-of-eight walk test (F8WT) is a reliable, valid, and clinically available tool for assessing walking skill in Parkinson's disease (PD). The minimal detectable change of the F8WT is 2.77 s, which may help to determine any real change in walking skill after any intervention. The F8WT correlated with functional mobility, gait speed, balance, balance confidence, and severity and stage of PD. The F8WT times may detect impaired walking skill between people with PD and healthy people, and between fallers and non-fallers with PD. [ABSTRACT FROM AUTHOR]

Background: Apathy remains a common and problematic neuropsychiatric feature associated with Parkinson's disease resulting in reductions in health-related quality of life, and effective treatments remain elusive. Meaning in life (MIL) has been implicated in a variety of positive health outcomes, and this study assesses the relationship between apathy and MIL while hoping to identify a potential new interventional target. Methods: A cross-sectional sample of 237 PwPD completed surveys to evaluate MIL and a variety of non-motor symptoms (NMS), and a hierarchical regression analysis was conducted to evaluate relationships of interest. Results: Correlational analysis indicated the presence of meaning in life was statistically negatively and moderately to strongly correlated with apathy (r = − 0.60, p <.001). Hierarchical regression analysis results showed that presence of meaning in life explained a total of 48% of variance in apathy. More specifically, the presence of meaning in life (β = − 0.43, p <.001) was associated with apathy after controlling for sociodemographic and other potentially confounding variables. Conclusions: This study demonstrates the significant negative relationship between MIL and apathy. Considering the lack of effective treatments for apathy, which is one of the most disabling symptoms affecting PwPD, identifying a potential target for intervention is exciting. MIL has the potential to offer clinicians a novel intervention to provide a much-needed treatment option to improve both apathy and HRQoL. [ABSTRACT FROM AUTHOR]

Perceived personal wellbeing tends to be lower in individuals with autism spectrum disorders (ASD), especially in the case of women. To develop the present study, the Personal Wellbeing Index (PWI-A) was administered to a Spanish-speaking sample of women with ASD (N = 401) and self-diagnosed ASD (N = 343), women without ASD (N = 373) and men with ASD (N = 65) to compare their self-perceptions. Women with ASD showed significantly lower wellbeing rates than women in the control group for the total PWI-A and across all the domains, and there were no significant differences when compared with self-diagnosed women with ASD and men with ASD. Autism explained between 24 and 26% of the decline in the PWI-A total score, with life achievement, future security, safety and relationships being the domains most highly correlated with the total. These findings are an effective contribution to improving diagnosis and professional intervention in women with ASD. [ABSTRACT FROM AUTHOR]

Studies show the importance of the personal experience of meaning in life for older adults, but adults with dementia have been largely excluded from this research. The current study examined the longitudinal predictive effect of meaning in life for the psychological and cognitive functioning of older adults with Alzheimer's disease and whether cognitive decline predicted presence of meaning in life. On three yearly measurement occasions, presence of meaning in life, depressive symptoms, life satisfaction, and cognitive functioning were assessed in structured interviews with a convenience sample of 140 older adults with Alzheimer's disease from nine nursing homes in Belgium. Cross-lagged panel and latent growth curve models were used to analyze the longitudinal relationships between the variables. Over the three measurement waves, participants with higher presence of meaning reported lower depressive symptoms one year later. Presence of meaning and life satisfaction predicted each other over time, but only between the first and second wave. The analyses showed no strong evidence for a longitudinal association between meaning in life and cognitive functioning in either direction. The findings emphasize the importance of the experience of meaning in life for the psychological functioning of older adults with Alzheimer's disease. The lack of evidence for associations between meaning and cognitive functioning questions the prevailing view that intact cognitive abilities are a necessity for experiencing meaning. More attention to the potential of meaning interventions for persons with dementia is warranted. [ABSTRACT FROM AUTHOR]

Aims: To estimate the prevalence of family members affected by addictive disorders (FMA) with regard to various types of addictive disorders, and self‐rated health and depression in the general population. Design: Cross‐sectional general population survey. Setting: The German Health Update study (GEDA) 2014/2015, a nationally representative panel of German residents aged 15 years or older. Participants: A total of 24 824 residents aged 15 years or older. Measurements Participants were asked if they had a family member with current or past addictive disorder, the type of addiction and the relationship status. In addition, self‐rated health and depression were assessed using standardized questionnaires. Findings Of the respondents, 9.5% [95% confidence interval (CI) = 9.0–10.0] reported being affected by a current addictive disorder of a relative (cFMA), with a further 4.5% (95% CI = 4.2–4.9) reported having been affected by the addictive disorders of a relative in the past but not within the last 12 months (pFMA). Most FMAs reported having been affected by disorders due to alcohol, followed by cannabis and other drugs. Compared with life‐time non‐FMAs, FMAs reported significantly (P < 0.001) higher odds ratios for depression (cFM = 2.437; 95% CI = 2.082–2.853; pFMA = 1.850; 95% CI = 1.519–2.253) and ill‐health (cFMA = 1.574; 95% CI = 1.374–1.805; pFMA = 1.297; 95% CI = 1.082–1.555). Conclusions: In Germany, family members affected by addictive disorder are a substantial group within the general population. This group is characterized by ill‐health and has not yet been adequately addressed by the addiction treatment system. [ABSTRACT FROM AUTHOR]

For decades predictors of alcohol use disorder (AUD) relapse have been studied, and around 40 different clinical and demographic relapse determinants have been identified. This paper aims to investigate the relationship of two of these AUD relapse factors, namely craving and meaning in life (MiL). We hypothesized that greater meaning in life would be associated with lower cravings and lower relapse rates. An AUD subsample of 81 patients within a clinical population that participated in ongoing exploratory research on religious/spiritual factors related to substance use disorders was followed up to 1 year. Craving (as measured with the Penn Alcohol Craving Scale) and meaning in life (as measured with the Meaning in Life Questionnaire- presence subscale) measures were assessed at baseline and relapse was assessed at 6- and 12-month follow up. Main effects and the interaction between craving and meaning in life in predicting alcohol relapse (with relapse defined as 'any alcohol use' and ≥ 3 consecutive days of drinking) were calculated/subject of analyses. We also investigated the relationship between relapse and alcohol dependence severity as measured with the Leeds Dependence Questionnaire. Baseline craving and dependence severity were related to relapse, but there were no associations between meaning in life and levels of craving or alcohol relapse. Our findings suggest a need for additional research on characterizing the Meaning in Life concept. [ABSTRACT FROM AUTHOR]

Background Reports indicate that the proportion of adults using drugs of abuse has been increasing in recent years in Europe. Although there are various indicators of increased drug use in Sweden over time, few studies could demonstrate an increase in the proportion of adults using drugs. To investigate changes in drug use prevalence over time, drug testing at the workplace has been used for a 25-year period. Methods The urine samples of employees sent by occupational health services from all over Sweden during a 25-year period were analyzed. The analyzing capacity increased over time (from 3411 in 1994 to 60 315 samples analyzed in 2019), and the majority of the samples was analyzed for the following drugs: cannabis (tetrahydrocannabinol), amphetamine, opiates, cocaine, and benzodiazepines. Results There was an overall increase in the proportion of samples that tested positive for illicit drugs over a 25-year period. This increase seemed to take place step-wise, with phases of linear increases and plateaus that over time became shorter. About 1.3% of samples tested positive for drugs in 1994, whereas 5.6% tested positive in 2019. Since 2007, the rate of positive samples has increased for cannabis and decreased for benzodiazepines. Although the rate of samples tested positive for opiates had remained relatively stable over the last 20 years, this rate had increased for amphetamine and cocaine between 2013 and 2019. Conclusion The results indicate that the use of illicit drugs among employees at Swedish workplaces has increased during a 25-year period. [ABSTRACT FROM AUTHOR]

Background: Many pregnant and postpartum Veterans have experienced multiple lifetime traumas, including military sexual trauma, intimate partner violence, and combat trauma. These women may be particularly vulnerable to increased post-traumatic stress disorder and other mental health problems following additional trauma exposures or stressful events, such as Coronavirus disease 2019 (COVID-19). This study sought to examine the impact of prior trauma exposures on the lived experience of pregnant and postpartum Veterans during the COVID-19 pandemic. Materials and Methods: Pregnant Veterans at 15 VA medical centers were surveyed at 20 weeks of pregnancy and 3 months postpartum asked about their COVID-19-related perinatal and mental health experiences, as well as the stressors that impacted them as a result of the COVID-19 pandemic. Results: Overall, 111 women Veterans completed both the pregnancy and postpartum surveys that included COVID-19 items. Sixty percent of our sample had experienced at least one potentially traumatic lifetime event, with 22% of our sample experiencing two or more of the included exposures. Women with a trauma history had 3.5 times increased odds of reporting their mental health as "much worse" compared to before the COVID-19 pandemic (95% confidence interval [CI]: 1.06–11.75) and were more likely to report that COVID-19 negatively affected their mental or emotional health "a lot" compared with women without a trauma history (odds ratio: 8.5; 95% CI: 1.93–37.48). Conclusions: COVID-19 has had a significant impact on pregnant and postpartum Veterans' mental health. Obstetricians should consider strategies to ensure women have access to mental health care during pregnancy, especially as the COVID-19 pandemic continues. Hospitals should also consider the importance of labor support companions during the COVID-19 pandemic and examine adjusting policies to allow for at least one labor support companion during labor and delivery. [ABSTRACT FROM AUTHOR]

Purpose: Benzodiazepines (BZD), Z-drugs (ZD), and opioids share a high risk of abuse. This study assessed and characterised adverse events (AEs) related to BDZ, ZD, and opioids leading to emergency department (ED) visits in the Italian setting. Methods: ED accesses related to BDZ, ZD, and/or opioids were analysed from the MEREAFaPS database. Information on AEs, suspected and concomitant medications was retrieved. Multivariate logistic regression was used to estimate the reporting odds ratios (RORs) of hospitalisation according to the different treatments. Results: A total of 5,970 pharmacovigilance reports involving BZD/ZD (n = 3,106), opioids (n = 2,767), or their combination (n = 97) were analysed. Compared to opioids, patients with BZD/ZD-related AEs were often younger (51 vs 64 years), more frequently presented 2+ suspected medications (13 vs 3%), and often had a history of abuse (4%). Twenty-three percent of BZD/ZD-related AEs were related to drug abuse (vs 2% of opioid-related ones) and frequently required patient hospitalisation (52% vs 24%), despite the significantly lower clinical complexity of these patients as compared to those on opioids. An increased risk of hospitalisation was found for flurazepam (ROR 1.62; 95% CI, 1.18–2.22), prazepam (2.66; 1.05–6.70), lorazepam (1.26; 1.07–1.49), and morphine (1.76; 1.11–2.79). Conclusions: These results indicate that, in Italy, the inappropriate use of BZD/ZD is a relevant heath issue, often leading to serious AEs requiring patients' ED visits and hospitalisation, especially in young women and patients with a history of substance abuse. [ABSTRACT FROM AUTHOR]

The purpose of this study was to employ the theoretical domains framework (TDF) to identify behaviour change factors related to leisure-time physical activity (LTPA) in spinal cord injury (SCI) ambulators. A cross-sectional design was employed. Among 43 SCI ambulators, the TDF behaviour change factors were assessed, along with the duration, types, and intensities of LTPA performed over the previous week. The TDF behaviour change factors identified as barriers to LTPA included: knowledge, beliefs about capabilities, coping planning, and goal conflict. Approximately 71.81 mins/day (SD = 75.41) was spent doing LTPA. Participants reported aerobic and resistance training activities, along with several other types of LTPA (e.g., rock climbing). Coping planning, action planning, goal conflict, and skills explained significant variance in time spent on LTPA (R2adjusted = 0.259, p < 0.01), but only action planning uniquely predicted LTPA. Greater use of coping and action planning, lower levels of goal conflict and stronger skills were associated with greater participation in LTPA. These factors will be targeted for a future LTPA-enhancing intervention for SCI ambulators, informed by behaviour change theory. SCI ambulators participate in a surprisingly wide range of LTPA. Rehabilitation specialists can use this list to suggest activities for patients with SCI who ambulate. Barriers to leisure-time physical activity for individuals with spinal cord injury (SCI) who ambulate include lack of knowledge, weak beliefs about capabilities, lack of coping planning, and high goal conflict. Physical activity interventions for individuals with SCI who ambulate should include action and coping planning, goal conflict, and skills. Physical activity interventions should be created systematically using behaviour change theory and involvement of stakeholders throughout the development process. Practitioners can promote skills training in adapted activities like gardening, cycling, and rock-climbing for ambulators with SCI. [ABSTRACT FROM AUTHOR]

Promoting well-being is a key aim of rehabilitation. The intentional design of interventions to address well-being requires an understanding of the factors that affect this complex phenomenon. A growing body of qualitative literature has identified determinants that people with SCI report affect their well-being. It is unclear whether or how rehabilitation interventions can influence these well-being determinants. This study sought to explore the experience and perspective of people with SCI about interventions that target their well-being. Systematic search of seven databases. Deductive analysis to categorize findings related to well-being determinants, and further inductive coding to identify sub-themes, relationships and additional findings. Twenty studies were selected, involving a wide range of interventions. Each intervention influenced a number of well-being determinants, which were inter-related. People with SCI reported improvements in both subjective and psychological well-being. However, well-being was not always well defined in the studies and people with SCI reported lack of priority for, and opportunity to engage in, well-being interventions in the current rehabilitation system. Rehabilitation interventions can influence well-being determinants. These determinants form a useful framework for the intentional design of well-being interventions, which should be informed by a broad understanding of well-being. Well-being can be influenced by rehabilitation interventions, and a more explicit focus on well-being in intervention design and evaluation is recommended. Conceptual frameworks used to define and measure well-being should adopt a broad understanding of well-being. Well-being interventions should address the determinants identified by people with SCI (engaging in occupation, responsibility, values and perspectives, self-worth, self-continuity, relationships and the environment). People with SCI want a greater priority placed on well-being interventions, and more opportunities to engage in these interventions, especially in the community. [ABSTRACT FROM AUTHOR]

Background: Sexual assault affects one in three U.S. women and may have lifelong consequences for women's health, including potential barriers to completing cervical cancer screening and more than twofold higher cervical cancer risk. The objective of this study was to determine whether a history of sexual assault is associated with reduced cervical cancer screening completion among women Veterans. Materials and Methods: We analyzed data from a 2015 survey of women Veterans who use primary care or women's health services at 12 Veterans Health Administration facilities (VA's) in nine states. We linked survey responses with VA electronic health record data and used logistic regression to examine the association of lifetime sexual assault with cervical cancer screening completion within a guideline-concordant interval. Results: The sample included 1049 women, of whom 616 (58.7%) reported lifetime sexual assault. Women with a history of sexual assault were more likely to report a high level of distress related to pelvic examinations, and to report ever delaying a gynecologic examination due to distress. However, in the final adjusted model, lifetime sexual assault was not significantly associated with reduced odds of cervical cancer screening completion (OR 1.35, 95% CI 0.93–1.97). Conclusions: Contrary to our expectations, sexual assault was not significantly associated with gaps in cervical cancer screening completion. Three- to five-year screening intervals may provide sufficient time to complete screening, despite barriers. Trauma-sensitive care practices promoted in the VA may allow women to overcome the distress and discomfort of pelvic examinations to complete needed screening. ClinicalTrials.gov (#NCT02039856). [ABSTRACT FROM AUTHOR]