Influencing factors of kinesiophobia among stroke patients with hemiplegia: A mixed methods study.

OBJECTIVES: There is a scarcity of data regarding the effects of kinesiophobia on stroke patients with hemiplegia. Therefore, this paper aims to evaluate the level of kinesiophobia experienced by stroke patients with hemiplegia in China, examine the elements that influence it, and investigate the unique psychological experience of kinesiophobia combined with a qualitative study. METHODS: This mixed study was conducted in two steps. Four approved scales were used to evaluate a total of 163 patients: (i) Tampa Scale of Kinesiophobia, (ii) Pain Catastrophizing Scale, (iii) Self-Efficacy for Exercise Scale, and (iv) Hospital Anxiety and Depression Scale. A multivariate linear regression model was used to evaluate the predictors of kinesiophobia in stroke patients with hemiplegia. Subsequently, semi-structured interviews with 15 stroke patients with hemiplegia were conducted using an objective sampling method, and the Colaizzi 7-step analysis process was utilized to analyze the interview data. RESULTS: A total of 163 stroke patients with hemiplegia were included in this study, of them, 47.9% reported kinesiophobia. Multiple linear regression revealed that the influencing factors of kinesiophobia in stroke patients with hemiplegia were a history of falls, exaggeration, helplessness, anxiety, depression, and low exercise self-efficacy (P<0.05). The qualitative research focuses on two main topics: personal adoption of negative coping styles and insufficient external support. CONCLUSION: Our study showed that the kinesiophobia in stroke patients with hemiplegia was high, with several factors influencing their kinesiophobia. Some of these factors are modifiable and should be considered when formulating kinesiophobia intervention strategies for stroke patients with hemiplegia.

Relations Between Posttraumatic Growth and Fear of Progression Among Young and Middle-Aged Primary Brain Tumor Patients: The Parallel Mediating Role of Perceived Social Support and Illness Uncertainty.

OBJECTIVE: This study aimed to investigate the mediating role of perceived social support and illness uncertainty in posttraumatic growth (PTG) and fear of progression (FoP) among young and middle-aged primary brain tumor (PBT) patients. METHODS: A total of 252 young and middle-aged benign PBT patients were investigated. Data were collected by using self-designed general and disease-related data questionnaires, PTG Inventory, FoP Questinaire-Short Form, Mischel Uncertainty in Illness Scale, and Perceived Social Support Scale. Parallel mediation effect models were used to explore the relationship between PTG and FoP mediation effects. Bootstrap analysis was conducted to examine the mediation effect of PTG on FoP. RESULTS: The total FoP and PTG scores were 35.15 ± 4.85 and 55.04 ± 7.86. Furthermore, mediation effect analyses revealed that perceived social support and illness uncertainty were partially associated with the mediated relationship between PTG and FoP. (std.ß = -0.026, P-value = 0.001, std. ß = -0.393, P value ＜0.001, respectively). CONCLUSIONS: Illness uncertainty and perceived social support were identified as partially parallel mediators between PTG and FoP. Thus, we should ensure adequate social support and improve the enthusiasm and input of family members for better patient recovery. Strengthening the nursing support, reducing the uncertainty of young and middle-aged PBT patients, and improving the patients' PTG can help reduce the fear of disease progression.

Status and Influencing Factors of Body Image Disturbance in Patients With Hemifacial Spasm: A Quantitative and Qualitative Study.

OBJECTIVE: Patients diagnosed with hemifacial spasm (HFS) often experience significant facial changes that affect their body image and potentially have a negative impact on their physical and psychological well-being. This study therefore seeks to identify the current state of body image of Chinese patients with HFS, analyze the factors that influence it, and further explore their experiences based on their level of body image disturbance (BID) using a mixed methods approach. METHODS: A mixed-methods study was conducted between January 2021 and June 2023. Phase I encompassed the completion of questionnaires by 124 participants. Subsequently, in Phase II, in-depth interviews were conducted with 15 individuals selected from Phase I to gain deeper insights into their specific experiences with BID. RESULTS: Patients afflicted with HFS achieved Body Image Scale scores 9.00 (0.00, 12.00). Age, anxiety, depression, and fear of negative evaluation were identified as predictors of exacerbated BID (P < 0.05). Qualitative research predominantly centered on 2 primary themes: the experiences and outward manifestations of BID in HFS patients. These individuals expressed dissatisfaction with their appearance, apprehensions about being the focus of attention, and instances of social avoidance. CONCLUSIONS: Owing to varying degrees of anxiety, depression, and apprehension about external evaluation, individuals grappling with HFS are susceptible to experiencing BID. Consequently, when devising interventions, it is imperative to conduct a comprehensive assessment of the patient's condition and implement targeted measures aimed at ameliorating body image, ultimately enhancing the overall quality of life for the patient.

Plastic bottles for chilled carbonated beverages as a source of microplastics and nanoplastics.

Carbonated beverages are characterized by low temperatures, multiple microbubbles, high pressure, and an acidic environment, creating ideal conditions for releasing contaminants from plastic bottles. However, the release patterns of microplastics (MPs) and nanoplastics (NPs) are poorly understood. We investigated the effects of plastic type, CO2 filling volume, temperature, sugar content, and additive on the leakage of MPs/NPs and heavy metals. Our results showed that polypropylene bottles released greater MPs (234±9.66 particles/L) and NPs (9.21±0.73 × 107 particles/L) than polyethylene and polyethylene terephthalate bottles. However, subjecting the plastic bottles to 3 repeated inflation treatments resulted in 91.65-93.18% removal of MPs/NPs. The release of MPs/NPs increased with increasing CO2 filling volume, driven by the synergistic effect of CO2 bubbles and pressure. After 4 freeze-thaw cycles, the release of MPs and NPs significantly increased, reaching 450±38.65 MPs and 2.91±0.10 × 108 NPs per liter, respectively. The presence of sugar leads to an elevation in MPs release compared to sucrose-free carbonated water, while the addition of additives to carbonated water exhibits negligible effects on MPs release. Interestingly, actual carbonated beverages demonstrated higher MPs concentrations (260.52±27.18-281.38±61.33 particles/L) than those observed in our well-controlled experimental setup. Our study highlights the non-negligible risk of MPs/NPs in carbonated beverages at low temperatures and suggests strategies to mitigate human ingestion of MPs/NPs, such as selecting appropriate plastic materials, high-pressure carbonated water pretreatment, and minimizing freeze-thaw cycles. Our findings provide insights for further study of the release patterns of the contaminants in natural environments with bubbles, pressure, low temperature, and freeze-thaw conditions.