Spirituality, Intolerance and Fear of COVID-19: Psychological Distress Among Older Adults in Pakistan.

The present study aimed to investigate the role of spirituality, intolerance of uncertainty (IU), and fear of COVID-19 as correlates and predictors of psychological distress among older adults in Pakistan and also assess the gender differences among research variables. Using a quantitative correlational survey research design, a sample of 150 (75 = Men, 75 = Women) older adults aged 55 years and above from different cities of Pakistan were approached through a non-probability purposive sampling strategy. Participants completed the Daily Spiritual Experience Scale, Intolerance of Uncertainty Scale IUS-12, Fear of COVID-19, and Kessler Psychological Distress Scale-K10. Spirituality has a significant negative relationship with psychological distress. Whereas, IU (Inhibitory anxiety and prospective anxiety) and fear of COVID-19 have a significant positive relationship with psychological distress. Results also showed that spirituality, IU dimensions, and fear of COVID-19 emerged as significant predictors of psychological distress among older adults after controlling for the effect of covariates. In addition, elderly females significantly showed more spirituality, less IU, and fear of COVID-19 as compared to elderly males. It is proposed that mental health care plays an important role in treating the psychological needs of older adults in pandemic situations and that further study is needed to develop effective solutions for older persons in stressful situations such as pandemics.

Personality, Religiosity and Satisfaction with Life in Young Muslim and Christian Women in Pakistan.

This study investigated the relationship between personality traits, religiosity and satisfaction with life in young Muslim and Christian women. The current research involved a convenience sample (N = 200; Mage = 21.26) that was drawn from Kinnaird College for Women University Lahore, and Youhanabad Town Lahore, Pakistan. The Big Five Inventory, Centrality of Religiosity Scale, and the Satisfaction with Life Scale were administered. Results of correlation analysis demonstrated a significant positive relationship between 'conscientiousness' and 'religious ideology' among Muslim women, whereas 'openness' and 'agreeableness' were strongly associated with all the dimensions of religiosity in Christian women. Findings of hierarchical linear regression analyses indicated that extraversion and agreeableness significantly predicted life satisfaction among Muslim and Christian participants respectively. Religiosity did not contribute to life satisfaction among both groups. Results of independent sample t-test showed that Christian women reported significantly higher degrees of extraversion and life satisfaction as compared to Muslim women who in contrast reported significantly higher level of agreeableness, neuroticism, and public religious practice. The findings are discussed in the context of gender, religion, culture and mental health.

Clinical and laboratory predictors of Lassa fever outcome in a dedicated treatment facility in Nigeria: a retrospective, observational cohort study.

BACKGROUND: Lassa fever is a viral haemorrhagic disease endemic to west Africa. No large-scale studies exist from Nigeria, where the Lassa virus (LASV) is most diverse. LASV diversity, coupled with host genetic and environmental factors, might cause differences in disease pathophysiology. Small-scale studies in Nigeria suggest that acute kidney injury is an important clinical feature and might be a determinant of survival. We aimed to establish the demographic, clinical, and laboratory factors associated with mortality in Nigerian patients with Lassa fever, and hypothesised that LASV was the direct cause of intrinsic renal damage for a subset of the patients with Lassa fever. METHODS: We did a retrospective, observational cohort study of consecutive patients in Nigeria with Lassa fever, who tested positive for LASV with RT-PCR, and were treated in Irrua Specialist Teaching Hospital. We did univariate and multivariate statistical analyses, including logistic regression, of all demographic, clinical, and laboratory variables available at presentation to identify the factors associated with patient mortality. FINDINGS: Of 291 patients treated in Irrua Specialist Teaching Hospital between Jan 3, 2011, and Dec 11, 2015, 284 (98%) had known outcomes (died or survived) and seven (2%) were discharged against medical advice. Overall case-fatality rate was 24% (68 of 284 patients), with a 1·4 times increase in mortality risk for each 10 years of age (p=0·00017), reaching 39% (22 of 57) for patients older than 50 years. Of 284 patients, 81 (28%) had acute kidney injury and 104 (37%) had CNS manifestations and thus both were considered important complications of acute Lassa fever in Nigeria. Acute kidney injury was strongly associated with poor outcome (case-fatality rate of 60% [49 of 81 patients]; odds ratio [OR] 15, p<0·00001). Compared with patients without acute kidney injury, those with acute kidney injury had higher incidence of proteinuria (32 [82%] of 39 patients) and haematuria (29 [76%] of 38) and higher mean serum potassium (4·63 [SD 1·04] mmol/L) and lower blood urea nitrogen to creatinine ratio (8·6 for patients without clinical history of fluid loss), suggesting intrinsic renal damage. Normalisation of creatinine concentration was associated with recovery. Elevated serum creatinine (OR 1·3; p=0·046), aspartate aminotransferase (OR 1·5; p=0·075), and potassium (OR 3·6; p=0·0024) were independent predictors of death. INTERPRETATION: Our study presents detailed clinical and laboratory data for Nigerian patients with Lassa fever and provides strong evidence for intrinsic renal dysfunction in acute Lassa fever. Early recognition and treatment of acute kidney injury might significantly reduce mortality. FUNDING: German Research Foundation, German Center for Infection Research, Howard Hughes Medical Institute, US National Institutes of Health, and World Bank.

Psychopathology, Psychiatric Symptoms and their Demographic Correlates in Female Adolescents Flood Victims.

OBJECTIVE: To estimate the incidence of psychopathology, frequency of psychiatric symptoms, and their demographic correlates in flood affected female adolescents. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: District Muzaffargarh, Pakistan, from July to October 2011. METHODOLOGY: Female adolescent flood victims, aged 13 - 19 years, were recruited. Screening was done and Diagnostic Questionnaire for Psychiatric Disorders was administered to confirm the diagnosis according to DSM-IV-TR. Demographic information was also obtained regarding nature of personal and financial damages to the participants due to flood. RESULTS: The mean age of 205 participants was 15.78 ±2.13 years. Post-flood diagnoses of Post-Traumatic Stress Disorder (PTSD), Generalized Anxiety Disorder (GAD), and Major Depressive Disorder (MDD) had the highest frequency rates in female adolescents flood victims i.e., 4 (2%), 2 (1%) and 2 (1%), respectively. Psychiatric symptoms of GAD and PTSD were reported most by the screened-out participants; whereas participants who were still living in personal tents and received late arrival of any kind of aid, reported more psychopathology. CONCLUSION: Flood and consequent financial damages may pose a risk factor for development of psychiatric symptoms and psychopathology. Results have implications for the need of improved mental health services for female adolescent flood victims.