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Translation and Validation of the Arabic International Adjustment Disorder Questionnaire Among Patients with Physical Illness and Their Families in Iraq
Get PDFBackground: The populations of middle- and low-income countries are exposed to many stressors, and these are associated with worse mental health. The ICD-11 includes a section “Disorders specifically associated with stress” and there are many validated measures for the assessment of stress-related disorders. However, there is no self-reported measure of ICD-11 adjustment disorder available for use in Arabic-speaking populations. This study aimed to translate and validate the Arabic version of the self-reported International Adjustment Disorder Questionnaire. Methods: Data was collected from Iraqi patients with physical illness and their families from October 6 to October 14, 2024, through a cross-sectional study conducted at Baghdad's Teaching Hospital and the Oncology Teaching Hospital. The R Environment for Statistical Programming was utilized for analysis. Results: Findings from confirmatory factor analysis were consistent with previous studies by identifying two strongly correlated factors (r = 0.72), representing the ‘preoccupation’ and ‘failure to adapt’ symptom clusters. These factors showed reliable scores (α = 0.695 and 0.814) and significant relations to depression and anxiety. To avoid multicollinearity, a total symptom scale can be used, based on similarly positive relations to psychological states and high reliability (α = 0.798). Conclusion: The Arabic translation demonstrates good psychometric properties and can be utilized in clinical and research settings
Confidence, Barriers, and Role Identity of General Practice Independent Pharmacist Prescribers in Northern Ireland
Get PDFBackground: The role of General Practice Independent Pharmacist Prescribers (GPIPPs) has expanded significantly in primary care, with increasing responsibilities in medicines optimisation and chronic disease management. However, gaps remain in understanding their confidence in clinical decision-making, the barriers they face, and their professional identity within multidisciplinary teams. This study aimed to explore GPIPPs’ confidence, identify barriers to their prescribing autonomy, and assess the clarity of their role and their support within primary care settings in Northern Ireland. Methods: A cross-sectional study design was employed, combining quantitative and qualitative approaches. Data were collected via a Jisc online questionnaire distributed to GPIPPs working in general practices across Northern Ireland. The questionnaire assessed their demographic information, confidence in clinical decision-making, barriers to prescribing, and professional identity. Qualitative data from open-ended responses were analysed using thematic analysis. Results: Quantitative findings indicated that most GPIPPs viewed clinical decision-making as integral to their role, yet only a few felt adequately prepared by their independent prescribing courses. Qualitative analysis revealed themes such indemnity concerns, insufficient training, role ambiguity, and variability in GP support. Conclusions: The study highlights that while GPIPPs are confident in their prescribing roles, significant barriers such as indemnity concerns, training gaps, and role ambiguity hinder their full potential. Policy-level changes, including clearer indemnity policies, enhanced training programs, and standardised mentorship, are essential to optimise GPIPPs’ integration and effectiveness in primary care. Addressing these challenges will ensure that GPIPPs can fully contribute to patient care as autonomous prescribers
Pediatric chest X-ray diagnosis using neuromorphic models
Get PDFThis research presents an innovative neuromorphic method utilizing Spiking Neural Networks (SNNs) to analyze pediatric chest X-rays (PediCXR) to identify prevalent thoracic illnesses. We incorporate spiking-based machine learning models such as Spiking Convolutional Neural Networks (SCNN), Spiking Residual Networks (S-ResNet), and Hierarchical Spiking Neural Networks (HSNN), for pediatric chest radiographic analysis utilizing the publically available benchmark PediCXR dataset. These models employ spatiotemporal feature extraction, residual connections, and event-driven processing to improve diagnostic precision. The HSNN model surpasses benchmark approaches from the literature, with a classification accuracy of 96% across six thoracic illness categories, with an F1-score of 0.95 and a specificity of 1.0 in pneumonia detection. Our research demonstrates that neuromorphic computing is a feasible and biologically inspired approach to real-time medical imaging diagnostics, significantly improving performance
Tensile Strength, Cellular Content and Degradation properties in three generations of concentrated growth factors
Get PDFConcentrated growth factors (CGF) is a biomaterial with regenerative potential, enriched with platelets, leukocytes, growth factors, and fibrin, but it degrades within 2-3 weeks. Albumin extends CGF stability, while silver nanoparticles (SNP) improve its mechanical and antibacterial properties. This in vitro and ex vivo study investigates the impact of albumin (Alb-CGF) and albumin with SNP (Alb-CGF-SNP) on CGF's mechanical properties, degradation rate, and cellular bioactivity. Blood samples were collected from 15 healthy volunteers who met specific inclusion criteria, with the sample size determined using G*Power software for power calculation. Three groups were prepared: control CGF, experimental Alb-CGF, and Alb-CGF-SNP. Membranes were produced using a Medifuge MF200 centrifuge and activated plasma albumin gel (APAG) device following standard settings. In experimental groups, the superficial 2.5 ml of plasma layer was heated at 75 °C for 10 min before combining with the buffy coat layer of CGF. Mechanical properties were tested using a texture analyzer, degradation rates were measured by weight loss percentage, and cellular bioactivity was evaluated with a Sysmex hematology analyzer. Data analysis was conducted using GraphPad Prism 8.0. Group differences were assessed via one-way ANOVA and Welch ANOVA, with Tukey's HSD test for post hoc paired group comparisons. The control (CGF) showed the highest mechanical properties, with Ultimate Tensile Strength (UTS) (95.6 kPa), Modulus of Toughness (55.55 kJ/m ), and Young's Modulus (75.73 kPa; (P 0.90). Alb-CGF-SNP displayed superior degradation resistance, with 45.2% weight loss at day 60 versus 84.2% in CGF (P
Loneliness in advanced life-threatening illness: an integrative review
Get PDFCONTEXT: To inform supportive interventions, experiences of loneliness must be understood specifically from the perspective of those with advanced life-threatening illness and their caregivers.OBJECTIVES: To identify the causes, experiences, and impacts of loneliness among adults with advanced life-threatening illnesses and caregivers, and which modifiable factors might mitigate loneliness.METHODS: Systematic searching of six databases (CINHAL, Web of science, Cochrane central, Medline, HMIC and Proquest) was supplemented by backward citation searching from Jan 2014-Jan2024. This was followed by screening and selection based on the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. Studies were imported into NVivo version 1.6 for data management. An inductive approach was used to facilitate the synthesis. Quality assessment with diverse studies (QuADS) was used. The review protocol was registered with Prospero, ID: CRD42023493999.RESULTS: Ninteen observational studies and 6 intervention studies were included in this review. Evidence confirms that the causes, impacts and outcomes of loneliness are multifaceted and interact dynamically. Risk factors on a micro level include psychological and existential factors such as emotional distress and fear of death; potentially modifiable factors include efforts to enhance communication and befriending programs. On meso level physical and social factors are risk factors such as symptom burden and social withdrawal, potentially modifiable factors include utilizing technology to make home an accessible place to maintain social connections. On a macro level environmental and societal risk factors include mobility restrictions and stigma; potentially modifiable factors include increasing societal engagement through community programs CONCLUSION: This integrative review will help healthcare providers, policymakers and the public understand the causes, experiences and impact of loneliness in adults with advanced life-threatening illnesses and their caregivers. The evidence suggests that an integrated approach that combines personal, social, and systemic efforts is needed which includes enhanced communication, targeted interventions, robust support systems, and community engagement. Rigorous research studies are required which include patient and public involvement from inception to completion to ensure that the study designs and methodologies are purposeful for those they intend to serve.</p
Mental health disorders, childhood adversities, and recent stressors as risk factors for non-suicidal self-injury, and suicidality among LGBTQA+ higher education students
Get PDFBackground: Prevalence rates of mental health disorders, non-suicidal self-injury and suicidality among Lesbian, Gay, Bisexual, Transgender, Queer and Asexual (LGBTQA+) higher education students are consistently higher than rates for heterosexual students. Nevertheless, in the United Kingdom, there remains limited prevalence data and evidence on the risk factors that confer increased risk of suicide among this population. The purpose of the present study was to investigate mental health disorders, childhood adversities, and recent stressors as risk factors for non-suicidal self-injury, and suicidality among LGBTQA+ students.Methods: The Student Psychological Interventional Trial (SPIT) was conducted as part of the World Mental Health International College Student Initiative (WMH-ICS). First year undergraduate students aged 18-24 years were recruited (n=1525), including LGBTQA+ students (n=190). Chi-squared test of independence was used to identify significant differences in lifetime prevalence rates between heterosexual and LGBTQA+ students. Bivariate and multivariate logistic regression analyses examined the associations between mental health disorders, childhood adversities, recent stressors, non-suicidal self-injury, and suicidality among LGBTQA+ students. Results: LGBTQA+ students were significantly more likely to have experienced mental health difficulties, childhood adversities, recent stressors, non-suicidal self-injury, and suicidality than their heterosexual counterparts. One in four LGBTQA+ students reported experiencing major depressive episode, and non-suicidal self-injury in their lifetime. LGBTQA+ students also reported earlier onset of mental health disorders and suicidality, with much higher rates of interpersonal conflict, and probable post-traumatic stress disorder. Among LGBTQA+ students, major depressive disorder, probable post-traumatic stress disorder, and non-suicidal self-injury were significantly associated with an increased likelihood of suicidal ideation and suicide plan. Childhood adversities, and recent stressors such as bullying were significantly associated with an increased likelihood of suicide attempt. Conclusions: Our findings highlight the existing mental health disparities, childhood adversities, and recent stressors which may contribute to higher prevalence rates of non-suicidal self-injury, and suicidality among LGBTQA+ students. The results emphasise the importance of early intervention, prevention, and treatment, focused on reducing the impact of childhood adversities and recent stressors such as bullying. In addressing these risk factors, educational settings may offer unique opportunities for the practice of inclusion, preventative care, and harm reduction for LGBTQA+ students.<br/
Estudio De La Vida Bajo Estres: methodological overview and baseline data analysis of a case-control investigation of risk and resiliency factors for traumatic stress in Colombia
Get PDFThe Estudio de la Vida Bajo Estres (My Life Under Stress [MI-VIDA] Study) aims to investigate risk and resilience factors associated with the development of PTSD in a trauma-exposed sample of more than 500 Colombian residents exposed to this country’s armed conflict. The study utilised a longitudinal case-control design capturing psychosocial data over 18 months, in addition to baseline DNA samples for a parallel genomic analysis. This paper specifically provides an overview of the design and methodology of the wider investigation, and reports baseline characteristics including sociodemographic information and mental health outcome prevalences from this hard-to-reach and under-researched population. Results of baseline analysis suggested that one third (34.88%) of this trauma-exposed sample screened positively for PTSD. Participants endorsed high numbers of potentially traumatic experiences including Forced Displacement (88.61%), Exposure to Severe Human Suffering (53.91%), Combat Exposure (53.02%), and Physical Assault (51.78%). Participants also reported relatively high levels of mental ill-health including depression (29.90%) and anxiety (27.56%). The number of traumas experienced, and the reported comorbid difficulties were generally higher among those who screened positive for PTSD. These preliminary analyses detail the baseline characteristics, and the relative burden of mental ill-health in this trauma-exposed sample. The wider study comprising longitudinal measurement of these conditions has the potential to make a significant contribution to the understanding of risk and resiliency factors for posttraumatic stress in this unique Latin American context
The International Trauma Interview (ITI): development of a semi-structured diagnostic interview and evaluation in a UK sample
Get PDFBackground: The International Trauma Interview (ITI) is a structured clinician-administered measure developed to assess posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined in the 11th version of the International Classification of Diseases (ICD-11). This study aimed to investigate a psychometric evaluation of the ITI and to finalise the English language version. Method: The latent structure, internal consistency, interrater agreement, and convergent and discriminant validity were evaluated with data from a convenience sample, drawn from an existing research cohort, of 131 trauma exposed participants from the United Kingdom reporting past diagnosis for PTSD or who had screened positively for traumatic stress symptoms. A range of self-report measures evaluating depression, panic, insomnia, dissociation, emotion dysregulation, negative cognitions about self, interpersonal functioning and general wellbeing were completed. Results: Confirmatory factor analysis supported an adjusted second-order two-factor model of PTSD and disturbances in self-organisation (DSO) symptoms, allowing affect dysregulation to also load onto the PTSD factor, over alternative models. The ITI scores showed acceptable internal consistency, and interrater reliability was strong. Findings for convergent and discriminant validity were mostly as predicted for PTSD and DSO domains. Correlations with the ITQ were good but coefficients for the level of agreement of PTSD diagnosis and CPTSD diagnosis between the ITI and the ITQ were weaker, and item level agreement was variable. Conclusion: Results provide support for the reliability and validity of the ITI as a measure of ICD-11 PTSD and CPTSD. Final revisions of the ITI are described
Mental Health Literacy in Nursing Students: Insights From a Cross-sectional Analysis
Get PDFMental health literacy is crucial for nursing students to deliver effective patient care; however, its development throughout their academic journey remains underexplored. This study aimed to assess mental health literacy among nursing students in the UAE and examine factors influencing their literacy levels. A quantitative cross-sectional study was conducted from February 2024 to August 2024 using convenience sampling. A total of 295 undergraduate nursing students participated in the study. Data were collected using the Mental Health Literacy Questionnaire (MHLq) and analyzed using SPSS software (version 24). Descriptive and inferential analyses were conducted to calculate means, standard deviations, percentages, and measures of association using t-tests for students’ sociodemographic variables, dimensions, and global scores, with a significance level of 0.05 for the tests. The findings indicated that participants (all female, with a mean age of 20.7 ± 1.85 years) had a mean MHLq score of 108.19 ± 10.53. Fourth-year students scored higher (110.78 ± 9.79) than lower-year students (106.85 ± 10.68). Students with family or friends who were affected had higher scores (48.00 ± 6.16) than those without (45.97 ± 6.16). The highest-scoring domain was knowledge of mental health problems (46.59 ± 6.40), while self-help strategies scored lowest (16.99 ± 2.61). Students with a personal history of mental illness had lower scores. The study also indicated a statistically significant association between students’ marital status, their level of study, and their first-aid skills and help-seeking behavior. The study highlights the importance of integrating mental health literacy into undergraduate nursing curricula to enhance student’s ability to provide patient-centered care for individuals with mental health disorders. Implementing targeted educational strategies focusing on awareness, recognition, and communication may strengthen students’ competency and preparedness for mental health care practice
Comparative effectiveness of health literacy intervention on reducing sugar or sugar-sweetened beverage consumption in Asian populations: A systematic review
Get PDFObjectiveThis study evaluated the effectiveness of health literacy interventions aimed at reducing sugar and sugar-sweetened beverage (SSB) intake among Asian populations and identified the common characteristics of effective interventions through a systematic review of randomised and non-randomised studies.Study designSystematic review of randomised and non-randomised trials.MethodsA systematic search of five databases identified randomised and non-randomised studies on health literacy interventions aimed at reducing sugar and SSB intake among Asian populations. Screening followed predefined criteria, and data extraction captured the intervention type, delivery, duration, and outcomes. Quality was assessed using the Cochrane Risk of Bias-2 and ROBINS-I tools for bias, and the findings were synthesised to identify effective intervention traits and research gaps.ResultsOf the eight included studies, three were face-to-face educational, one behavioural, one online, one mobile text messaging, and two front-of-pack (FOP) labelling interventions. Six out of eight studies measured sugar intake, with four assessing SSB intake. Seven studies reported significant dietary improvements. Overall, bias risk was present, with three rated high. Significant inconsistencies in the two studies were further explored.ConclusionThe effectiveness of health literacy interventions in reducing sugar or sugar-sweetened beverage intake was positive, particularly for face-to-face interventions and FOP labels. Available evidence may inform policymaking for the implementation of health promotion for disease prevention and complement standards of care practices for disease management