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Fostering resilience and well-being in emerging adults with adverse childhood experiences: study protocol for a randomized controlled trial to evaluate the FACE self-help app.
Get PDFBACKGROUND
Adverse childhood experiences (ACE) are linked to an increased risk of psychological disorders and lower psychosocial functioning throughout life. This study aims to evaluate the FACE self-help app, designed to promote resilience and well-being in emerging adults with a history of ACE. The app is based on cognitive-behavioural principles and consists of two thematic components: (1) self- and emotion regulation (SER) and (2) social skills and biases in social information processing (SSIP).
METHODS
The efficacy of the app will be tested through a single-centre, two-arm randomized controlled trial, comparing an active intervention group against a waiting list control group. The active group is divided into two subgroups, in which the two components are delivered in a different order to investigate differential effects in a crossover design. Up to 250 emerging adults aged 18 to 25 years with a history of ACE from a general population cohort study will be recruited. The primary objective is to test the efficacy of the app in improving resilience (primary outcome) and well-being (co-primary outcome) compared to a waiting list control group and to examine the stability of these effects. The secondary objectives include testing the efficacy of the app in improving the secondary outcomes, i.e., self-efficacy in managing emotions, problem solving, fear of evaluation, social avoidance, and self-esteem; examining the differential effects of the two components; and assessing the effect of the app on real-life data on resilience, affective states, distress in social interactions and coping strategies. Furthermore, the study will investigate potential moderators (e.g. ACE severity) and mediators of intervention outcomes (e.g. self-efficacy in managing emotions).
DISCUSSION
The results will provide insights into the efficacy of the self-help intervention as well as mediators and moderators of outcomes. Furthermore, results will extend the existing knowledge by testing the differential effects of the SER and SSIP component on the outcomes. Findings can inform improvements to the FACE app and the development of other interventions for this target group and assess its potential as a scalable, low-threshold intervention to support emerging adults with a history of ACE in their transition to adulthood.
TRIAL REGISTRATION NUMBER
NCT05824182
Consent
No full textConsent affected medieval women’s lives and engagement with literary culture in a variety of ways. Consent was invoked within the contexts of marriage and sex, whether upheld as crucial for a valid marriage or violated through rape or abduction. The significance of consent varied depending upon regional, temporal, and cultural factors. Whether as writers or readers, medieval women engaged with the idea of consent through literary representations as well as in legal contexts and their own experiences. Literature offered a means through which women could articulate desire and volition, voice dissent to patriarchal representations of violent sexuality, or express rage at sexual assault. This entry surveys the representation of consent in marriage and rape law within Christian, Islamic, and Jewish contexts and explores how medieval women’s literary culture engaged with these ideas. Finally, it includes two case studies of consent and coercion in medieval women’s writing from Japan and Korea
FDG imaging with long-axial field-of-view PET/CT in patients with high blood glucose-a matched pair analysis.
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High blood glucose (hBG) in patients undergoing [18F]FDG PET/CT scans often results in rescheduling the examination, which may lead to clinical delay for the patient and decrease productivity for the department. The aim of this study was to evaluate whether long-axial field-of-view (LAFOV) PET/CT can minimize the effect of altered bio-distribution in hBG patients and is able to provide diagnostic image quality in hBG situations.
MATERIALS AND METHODS
Oncologic patients with elevated blood glucose (≥ 8.0 mmol/l) and normal blood glucose ( 11 mmol/l). Tracer uptake in the liver, muscle, and tumor was evaluated. Furthermore, image quality was compared between long acquisitions (ultra-high sensitivity mode, 360 s) on a LAFOV PET/CT and routine acquisitions equivalent to a short-axial field-of-view scanner (simulated (sSAFOV), obtained with high sensitivity mode, 120 s). Tumor-to-background ratio (TBR) and contrast-to-noise ratio (CNR) were used as the main image quality criteria.
RESULTS
Thirty-one hBG patients met the inclusion criteria and were matched with 31 nBG patients. Overall, liver uptake was significantly higher in hBG patients (SUVmean, 3.07 ± 0.41 vs. 2.37 ± 0.33; p = 0.03), and brain uptake was significantly lower (SUVmax, 7.58 ± 0.74 vs. 13.38 ± 3.94; p 11 mmol/l) patients examined with LAFOV PET/CT showed no statistical significant difference in CNR (19.84 ± 8.40 vs. 17.79 ± 9.3, p = 0.08).
CONCLUSION
While elevated blood glucose (> 11 mmol) negatively affected TBR and CNR in our cohort, the images from a LAFOV PET-scanner had comparable CNR to PET-images acquired from nBG patients using sSAFOV PET/CT. Therefore, we argue that oncologic patients with increased blood sugar levels might be imaged safely with LAFOV PET/CT when rescheduling is not feasible
Reproductive Justice and Incarceration: Experiences and Governance of Mothers in a Swiss Women's Prison
Get PDFMen’s access to outpatient psychosocial cancer counseling
No full textHintergrund: Männer nehmen seltener als Frauen ambulante Krebsberatung in Anspruch, auch wenn sie davon profitieren könnten.
Methode: In einer cluster-randomisierten Studie (registriert unter DRKS00032181) wurde geprüft, ob durch Maßnahmen auf verschiedenen Ebenen (Informierung von Zuweisenden, Öffentlichkeitsarbeit, strukturelle Veränderungen, männerspezifische Angebote) in einem Zeitraum von 12 Monaten der Anteil männlicher Ratsuchender in Krebsberatungsstellen erhöht werden kann (primärer Endpunkt: Erstkontakte, sekundärer Endpunkt: alle Kontakte). Der Interventionseffekt wurde durch Anpassen verallgemeinerter linearer gemischter Modelle als Odds Ratio ermittelt, welches für die Cluster-Struktur und den Anteil von Erst- beziehungsweise allen Kontakten während der 12 Monate vor Beginn der Intervention adjustiert ist.
Ergebnisse: In 12 Regionen Deutschlands (je 6 im Interventions- beziehungsweise Kontrollarm) wurden 11 986 Personen erstmals beraten (Erstkontakte), davon 6 004 während der Interventionsphase. Der Männeranteil lag in diesem Zeitraum bei 30,7 % im Interventions- und 25,7 % im Kontrollarm. Das entspricht einem nicht signifikanten modellbasierten adjustierten Odds Ratio (OR) von 1,2 (95-%-Konfidenzintervall: [1,0; 1,4] p = 0,08) für den primären Endpunkt. Insgesamt 51 842 Beratungen (Erst- und Folgekontakte zusammen) wurden durchgeführt, 26 651 davon in der Interventionsphase. Der Männeranteil lag bei 27,6 % im Interventionsarm und 22,2 % im Kontrollarm. Das adjustierte OR für den sekundären Endpunkt ist 1,3 [1,1; 1,6] p = 0,01).
Schlussfolgerung: Durch gezielte Umsetzung männerspezifischer Maßnahmen auf verschiedenen Ebenen kann der Männeranteil von Ratsuchenden in Krebsberatungsstellen leicht erhöht werden
Systematic review of the association between short chain fatty acids and allergic diseases.
Get PDFWe performed a systematic review to investigate the current evidence on the association between allergic diseases and short chain fatty acids (SCFAs), which are microbially produced and suggested as one mechanism on how gut microbiome affects the risk of allergic diseases. Medline, Embase and Web of Science were searched from data inception until September 2022. We identified 37 papers, of which 17 investigated prenatal or early childhood SCFAs and the development of allergic diseases in childhood, and 20 assessed SCFAs in patients with pre-existing allergic diseases. Study design, study populations, outcome definition, analysis method and reporting of the results varied between papers. Overall, there was some evidence showing that the three main SCFAs (acetate, propionate and butyrate) in the first few years of life had a protective effect against allergic diseases, especially for atopic dermatitis, wheeze or asthma and IgE-mediated food allergy in childhood. The association between each SCFA and allergic disease appeared to be different by disease and the age of assessment. Further research that can determine the potentially timing specific effect of each SCFA will be useful to investigate how SCFAs can be used in treatment or in prevention against allergic diseases
Sex-Related Outcomes of Transcatheter Aortic Valve Implantation with Self-Expanding or Balloon-Expandable Valves: Insights from the OPERA-TAVI Registry.
No full textEvidence regarding sex-related differences in response to transcatheter aortic valve implantation according to the valve type is lacking. This study sought to evaluate the impact of sex on the treatment effect of Evolut-PRO/PRO+ (PRO) or Sapien 3 Ultra (ULTRA) devices on clinical outcomes. Comparative Analysis of Evolut PRO vs Sapien 3 Ultra Valves for Transfemoral Transcatheter Aortic Valve Implantation (OPERA-TAVI) is a multicenter multinational registry including patients undergoing latest-iteration PRO or ULTRA implantation. Overall, 1174 out of 1897 patients were matched based on valve type and compared according to sex, while 470 males and 630 females were matched and compared according to valve type. Thirty-day and 1-year outcomes were evaluated. In both PRO and ULTRA group, males had a higher comorbidity burden, while females had smaller aortic root. Both 30-day (device success [DS], early safety outcome, permanent pacemaker implantation [PPI], patient-prosthesis mismatch [PPM], paravalvular regurgitation [PVR], bleedings, vascular complications, and all-cause death) and 1-year outcomes (all-cause death, stroke and heart failure hospitalization) did not differ according to sex in both valve groups. However, male sex decreased the likelihood of 30-day DS with ULTRA versus PRO (p for interaction 0.047). A higher risk of 30-day PPI and 1-year stroke, and a lower risk of PPM was observed in PRO versus ULTRA, regardless of sex. In conclusion, sex did not modify the treatment effect of PRO versus ULTRA on clinical outcomes, with the exception of 30-day DS that was decreased in males (versus females) receiving ULTRA (versus PRO)
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