Vaccine Hesitancy in the Autism Spectrum Disorder Context: Parental Vaccine Decision-Making and Coping with Stress Strategies.

BACKGROUND: Despite no scientific evidence linking vaccines to Autism Spectrum Disorder (ASD), vaccine hesitancy persists among parents of children with ASD. This study aims to compare vaccine hesitancy and behaviors among parents of children with ASD, other Neurodevelopmental Disorders (NDD), and without NDD, and to examine the relationship between stress coping mechanisms and vaccine hesitancy, including comparing coping mechanisms between diagnostic groups as well as their association with hesitancy. METHODS: In this cross-sectional study, one parent of each child with ASD, non-ASD NDD, or without NDD was included. Data were collected using a researcher-created form, the Vaccine Hesitancy Scale in Turkish, and the Coping Style Scale Brief Form. Vaccine hesitancy, parents' COVID-19 vaccination status, and vaccination status of children's younger siblings were analyzed through univariate and multivariate analyses, with a focus on correlations between vaccine hesitancy and coping styles. RESULTS: The study included one parent from each of 299 children. Parents of children with ASD showed an adjusted odds ratio of 2.66 (95% CI 1.35-5.06) for high vaccine hesitancy, 2.57 (95% CI 1.17-5.65) for not receiving the COVID-19 vaccine, and 1.40 (95% CI 0.45-4.40) for younger siblings not receiving routine vaccines. A weak but significant correlation was observed between vaccine hesitancy and the use of restraint coping style among these parents (r = 0.280; p = 0.010). CONCLUSIONS: The study underscores the importance of targeted educational efforts and personalized communication to address vaccine hesitancy among parents of children with ASD. Enhancing vaccination coverage in this community requires further research to develop interventions tailored to their specific needs.

Caregivers' voices: From the world of autism spectrum disorder.

BACKGROUND:  Caring for a child with autism spectrum disorder (ASD) is a challenging and stressful task, especially in countries with limited resources. Additional research is necessary, considering the increasing prevalence of children with ASD, to gain increased knowledge of the complex difficulties faced by caregivers of ASD children and to offer insights into the coping strategies and support networks that parents utilise. OBJECTIVES:  The objective of this study was to explore and describe the experiences and coping mechanisms of caregivers of children with ASD in Dr Kenneth Kaunda district, North West province, South Africa. METHOD:  Qualitative explorative, contextual and descriptive design with purposive sampling technique and semi-structured interviews were conducted. Data were analysed following the six steps of reflexive thematic analysis. RESULTS:  Two themes were identified: Caregivers' experiences in raising a child with autism, and caregivers' coping in raising a child with autism. CONCLUSION:  The research established caregivers' experiences and coping mechanisms in raising a child with ASD and the effects on different aspects of their lives including emotional, social and financial aspects, which contribute negatively to their holistic well-being. These impediments warrant the establishment of emotional support groups, empowerment of caregivers and awareness-raising through campaigns to educate the family and the community on the diverse challenges.Contribution: The findings of this study contribute to a deeper understanding of the multifaceted challenges faced by caregivers of children with ASD and provide insights into the support systems and coping mechanisms employed by these caregivers within the socio-ecological context.

Dentally Anxious Patients' Perceptions of Oral Health Care.

Purpose Many adults in the United States struggle with mild, moderate, or severe dental anxiety (DA). Understanding the perspectives of patients with DA may help oral health professionals gain greater insight into their needs and learn how to provide an improved experience for these patients. The purpose of this study was to identify patients' perspectives on factors that impact anxiety in a dental practice setting.Methods A qualitative, descriptive case study design was used to identify patients' perspectives on factors impacting anxiety in a dental practice setting. Potential participants were screened using the Modified Dental Anxiety Scale (MDAS) and needed a moderate DA score to qualify for the study. An interview guide focused on obtaining information about the etiology, contributing factors, management strategies, and participant experiences of DA was used for the semi-structured virtual interviews. Responses were coded using a qualitative research analytic platform (Dedoose; Los Angeles, CA, USA). The co-investigators systematically reviewed the codes using the classic qualitative analysis strategies and journal notes to identify themes and subthemes.Results Twenty-two individuals qualified for participation in this study. Most participants reported having DA beginning in early childhood and throughout their adult life. Seven themes, including Avoidance, Supportive Behaviors, Confidence in Provider, Diversion, Enduring, Adaptations, and Benevolence emerged. Participants reported their primary method for managing DA was to avoid attending their dental appointments.Conclusion Participants in this study expressed various coping mechanisms and management strategies to alleviate the symptoms of DA. Multiple opportunities exist for increasing patient-provider trust and patient comfort to reduce DA, and ultimately improve the oral health status of individuals with DA.

The Role of Perceived Stress in the Relation between Childhood Maltreatment and Severity of Alcohol Use Disorder: A Mediation Analysis.

INTRODUCTION: Experiences of Childhood Maltreatment (CM) relate to relapse and lower treatment success in Alcohol Use Disorder (AUD), one of the most prevalent substance use disorders. However, the exact mechanisms of this relationship still remain unclear. This study examines perceived stress and "drinking to cope with negative affect" (coping) as possible mediators in this relationship. Moreover, it aims at uncovering the differential effects of the subtypes of CM. METHODS: N = 96 individuals (42% women; mean age 41 ± 13 years) including healthy controls and individuals with varying severity of AUD and CM completed the Alcohol-Dependence Scale, Childhood Trauma Questionnaire, Perceived Stress Scale and German Inventory of Drinking Situations. Mediation analyses including perceived stress as a mediator between CM (and subtypes) and severity of AUD, as well as a serial mediation of the relationship between CM and AUD severity by perceived stress and coping were conducted. RESULTS: Perceived stress significantly mediated the relation between CM and AUD severity and the serial mediation by perceived stress and coping turned out significant. Subtype-specific analyses did not yield significant results. CONCLUSION: This study reinforces perceived stress as a potential mechanism in the relation between CM and AUD severity. Moreover, coping further mediated the relationship between CM and AUD severity. Our results suggest including screening for CM (subtypes) in clinical routine in order to individually emphasize interventions focusing on stress regulation, as well as on developing healthy coping mechanisms, in patients with AUD. This might prevent heightened stress sensitivity, relapse and further maintenance of AUD.

Investigating fear, depressive symptoms and coping mechanisms among Egyptian nursing students amidst the covid-19 pandemic: a cross-sectional study.

BACKGROUND: Amidst the ongoing COVID-19 pandemic, nursing students' contribution to combating this global health crisis is becoming more significant. However, we need a more comprehensive understanding of the psychological impact of this crisis on these students. Therefore, this study holds immense importance as it offers valuable insights into the connection between COVID-19 pandemic fear, coping strategies, and depressive symptoms among nursing students. METHODS: A cross-sectional survey was conducted to collect and analyze data from 319 undergraduate nursing students. They participated in the study by responding to an online questionnaire. The questionnaire consisted of the Fear of the Coronavirus Questionnaire, Brief Coping Orientation to Problems Experienced, and the Beck Depression Inventory-II. RESULTS: The study revealed that 45.5% of the participants had a severe fear of COVID-19, 21.9% showed severe depressive symptoms, and 64.6% used moderate coping mechanisms. A positive correlation (r = 0.160, p = 0.01) was found between the fear of COVID-19 and depressive symptoms. Interestingly, this correlation turned negative (r = -0.074, p = 0.01) when adaptive coping strategies such as religion, acceptance, planning, positive reframing, instrumental support, emotional support, active coping, and humor were used. However, when participants resorted to maladaptive coping strategies like venting, self-distraction, self-blame, behavioral disengagement, denial, and substance abuse, the correlation between high fear levels and depressive symptoms became positive (r = 0.352, p = 0.01). CONCLUSION: The study demonstrated that the fear of COVID-19 and depressive symptoms among nursing students are significantly correlated. However, the nature of this correlation is influenced by the type of coping strategies employed. Adaptive coping mechanisms can mitigate the impact of fear on depressive symptoms. In contrast, maladaptive coping can exacerbate the relationship between fear and depressive symptoms. Therefore, promoting adaptive coping strategies could be a crucial approach to managing the psychological impact of the COVID-19 pandemic.

Differences in the Communication of Cancer Diagnoses by Different Health Professionals and the Impact of Oncologist Communication on Patients' Emotions.

The field of healthcare is increasingly adopting a humanistic perspective in the physician-patient relationship. One of the more salient aspects being studied is the communication between the two. This study serves a dual purpose. Our initial aim was to study how a cancer diagnosis is disclosed to patients by different physicians (GPs/other specialists/oncologists). Secondly, we set out to study how the way in which oncologists normally communicate with their patients impacts variables such as a patient's anxiety, depression, coping mechanisms, and perception of both their health and their quality of life. A total of 177 patients answered a battery of questionnaires on sociodemographic and disease data: the SPIKES protocol, the EORTCQLQ-COMU26, and the ADAF screening questionnaire. The analyses recorded medium or high scores for some of the steps in the SPIKES protocol when delivering the diagnosis, and significant differences were observed for some of them among different physicians. The level of a cancer patient's satisfaction with the communication by oncologists was related to their levels of anxiety, depression, vulnerability, and perception of their health and quality of life. Better communication strategies are called for among all healthcare professionals to facilitate the task of breaking bad news to their patients.

Pregnancy loss among Muslim women: A narrative review.

Background: Diversity in spirituality, religion, and cultural norms among women leads to varying attitudes, grieving processes, and coping mechanisms after a pregnancy loss. Despite this, there is a limited understanding of grief, coping mechanisms, and mental health outcomes following pregnancy loss among Muslim women. Objectives: This study aims to examine the impact of religion, spirituality, and faith communities on the psychological health of Muslim women during pregnancy loss. Method: We systematically searched six databases with the key concepts, 'pregnancy loss' and 'Muslim women,' in PubMed, CINAHL, Embase, Web of Science, APA PsycINFO, and Academic Search. The search strategy was developed in line with the PCOT framework: Population - Muslim Women with "pregnancy loss," "miscarriage," "stillbirth, Context - "religion," faith, "spirituality," "faith communities," Outcome - "religious practices," perception, coping mechanism, "psychological health."Studies were screened, their quality appraised, and narratively sized in line with the review aim. The review protocol was registered at Open Science Framework (OSF): https://doi.org/10.17605/OSF.IO/52QTA. Result: Findings from the reviewed articles addressed the following themes: (a) Overwhelming Grief and Loss, (b) social isolation and stigmatization, (c) impact on mental health, and (d) trust in divine destiny. Islamic beliefs were strongly featured in how Muslim women processed pregnancy loss. Concepts such as tawakkul and yaqeen (trusting and certainty) were used to interpret pregnancy loss, with many women acknowledging that their Islamic faith eased the sorrow of pregnancy loss, facilitated acceptance, and strengthened their Islamic belief system. Conclusion: This review revealed that there is limited information on Muslim women's experience of pregnancy loss. Professionals helping Muslim women dealing with the grief of pregnancy loss need to be aware that spirituality and faith communities play a major role in shaping their coping mechanisms. Future studies on the development of culturally congruent bereavement care models and supportive interventions for Muslim women facing pregnancy loss.

Risk factors to mental health challenges among the LGBTI+ community in Gaborone, Botswana.

BACKGROUND:  Lesbian, Gay, Bisexual, Transgender, Intersex and other gender diverse groupings symbolised by + (LGBTI+) individuals experience adverse mental health problems, and several factors have been documented to facilitate such problems. However, in Botswana, the factors facilitating LGBTI+ individuals to experience mental health challenges have not been explored with previous studies only highlighting the poor mental health outcomes they experience. OBJECTIVES:  The aim of the study was to explore and describe factors that could cause mental health challenges in LGBTI+ individuals in Gaborone, Botswana. METHOD:  A qualitative, descriptive, phenomenological design was employed to examine the research question. In data collection, 15 unstructured in-depth telephonic interviews were conducted until data saturation. Data were analysed with a co-coder using the data analysis method by Colaizzi. RESULTS:  Three themes emerged following data analysis and were reasons for experiencing mental health challenges, experiences of challenges in accessing healthcare services and the social challenges of everyday life. CONCLUSION:  The findings indicate that a variety of factors influence the mental health problems in some LGBTI+ individuals.Contribution: The knowledge of the factors that cause LGBTI+ individuals' mental health challenges can inform mental healthcare to be rendered. The findings can apprise nursing curriculum development and policy regarding the needs of LGBTI+ individuals.

Coping mechanisms used by caregivers of HIV/AIDS orphans in North West province, South Africa.

BACKGROUND:  Human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is a pandemic that has affected families and left many children orphaned worldwide. After the death of their parents, HIV/AIDS orphans are often taken care of by caregivers who are faced with overwhelming challenges that affect their capabilities to perform caring tasks. It has been reported that caregivers of HIV/AIDS orphans use different coping mechanisms to deal with the challenges faced during caring. Coping mechanisms play an integral role in maintaining individuals' physical and mental well-being, particularly those caring for orphans. This study explored coping mechanisms used by caregivers of HIV/AIDS orphans. METHODS:  A qualitative design was adopted, and individual semi-structured interviews were used to collect data from 13 caregivers of HIV/AIDS orphans in North West province. Non-probability purposive sampling was used to select the participants. Thematic analysis was used to analyze data. Rigor was maintained throughout the study. RESULTS:  Three main themes were identified with eight subthemes. The first theme includes support from significant others, and subthemes are family support, neighbour support, and life partner support. The second main theme emerged from this study was religious practices and two subthemes namely singing gospel songs and using prayer to cope. The third main theme identified includes the use of social support services, and subthemes were government support, support from local schools, and stokvels and social clubs. CONCLUSION:  The identified coping mechanisms in this study improved caregiving skills of caregivers to better care for children orphaned by HIV/AIDS.

Depression Related to COVID-19, Coping, and Hopelessness in Sports Students.

This study aimed to explore the impact of the first two waves of the COVID-19 pandemic on the mental and physical states of sports students from Romania and also to compare the differences according to gender and the type of sport. Initially, in order to collect demographic data and health reports, a cross-sectional survey was developed to evaluate the emotional needs of sports students during the pandemic. After the second wave, the coping strategies used by the participants to fight negative emotions were assessed using the CERQ questionnaire. The results indicate that depression symptoms are the most reported psychological issues among the participants and that there are differences according to gender concerning the cognitive schemas they use in order to reduce the symptoms. Also, it was found that there are differences, corresponding to the type of sport, in choosing adaptive coping mechanisms. Ultimately, it was confirmed that higher levels of hopelessness among sports students are associated with increased vulnerability to substance use, with the correlation between those two indicators being strong. Delving deeper into this relationship can help identify critical points for intervention to prevent substance abuse. At the same time, the dichotomic analysis of the results found as moderators-the gender and the type of sport in decreasing the severity of depression could be an important aspect of the next counseling interventions.

Exploring society-to-cells resilience among community members: A multidisciplinary study in outpatient clinics with diverse participant demographics.

AIM: This study explores and understands community members' resilience in outpatient clinics, considering various dimensions and types of resilience. DESIGN: A cross-sectional study. METHODS: This study was conducted in Saudi outpatient clinics from September to December 2023 and included 384 individuals chosen through systematic random sampling. Various tools were used, such as Social Cohesion and Trust Scale, Community Resilience Assessment Tool, Community Assessment of Psychic Experiences, Environmental Resilience Assessment, Economic Resilience Index, Connor-Davidson Resilience Scale, Brief Resilience Scale, Resilience Scale for Adults and Healthcare Resilience Index. RESULTS: Participants displayed a robust overall resilience level, as indicated by Total Connor-Davidson Resilience Scale score of 63.0 ± 9.0. Additionally, they demonstrated commendable levels of resilience in Total Brief Resilience Scale (56.04 ± 8.6), Resilience Scale for Adults (82.5 ± 7.2) and Healthcare Resilience Index (45.8 ± 5.5). These findings offer significant insights into psychological and emotional well-being of the study population, highlighting their adaptive capacities and coping mechanisms across various life domains. CONCLUSION: This study provides valuable insights into the multidimensional nature of resilience in outpatient settings. The cross-sectional design sets the groundwork for future longitudinal investigations, highlighting the need for a holistic approach to understanding and promoting resilience. IMPACT: This study holds immediate implications for participants and their communities. It underscores the adaptive capacities and coping mechanisms prevalent in the outpatient population by revealing commendable resilience levels. This insight enhances individuals' psychological and emotional well-being, contributing positively to the overall resilience and communal strength. Additionally, this study sheds light on how resilience among community members in Saudi Arabia relates to international advanced nursing communities, providing insight into their work. PATIENT OR PUBLIC CONTRIBUTION: Patients who have received outpatient services in the past 6 months were purposively chosen to ensure a diverse representation across age, gender and socio-economic backgrounds in this study.

Challenges and coping mechanisms of parents of children with attention deficit hyperactivity disorder in Addis Ababa, Ethiopia: a qualitative study.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that has manifestations of inattention, hyperactivity, and impulsivity. It affects every facet of a child's life, including one's own emotions, family and school life, and social interaction. The few available studies on ADHD conducted in Ethiopia focus on teachers' awareness and the prevalence of ADHD. None of these studies has taken into account parents of children who have ADHD. The present study, therefore, aimed to find out the challenges and coping mechanisms of parents who have children with ADHD. METHODS: A phenomenological qualitative study was conducted to explore the experiences of parents who have children with ADHD. The study was carried out in Addis Ababa, the capital city of Ethiopia. Fourteen parents and two healthcare providers were involved in the study. Participants were selected using a purposive sampling technique. In-depth interviews were conducted with parents of children with ADHD (n = 8) and healthcare providers (n = 2). One focus group discussion (FGD), consisting of six members, was also conducted with parents. A topic guide for conducting the interviews and FGD was developed. Interviews and the FGD were audio-recorded. The data were transcribed verbatim, translated into English, and then analyzed using a thematic analysis approach. RESULTS: With regard to challenges of parents of children with ADHD, three themes emerged: social challenges, economic challenges and psychological challenges. Stigma is found to be the most common challenge. Other challenges included worry about the child's future, lack of social support, strained relationships with others, impact on their job, and marital conflict. Concerning coping mechanisms, two themes emerged: Inward and outward means of coping. The inward means of coping included prayer and developing an optimistic mindset whereas the outward means were family support, healthcare providers' guidance, and social avoidance. CONCLUSIONS: The study found that parents of children with ADHD experience several aspects of psychological, social, and economic challenges. Support from healthcare professionals, family members, and the community at large is found to be useful for parents to cope with these challenges. Future research should focus on evaluating interventions that would help parents with ADHD cope with the challenges they experience.

Health service providers experience of psycho-emotional violence and associated factors among urban hospitals in Eastern Ethiopia.

Background: Psycho-emotional violence, a type of workplace violence targeting healthcare workers, varies across countries, occasions, and professions in the healthcare sector. Unfortunately, there is a scarcity of comprehensive studies focusing on violence against healthcare workers in Ethiopia, which may also encompass psycho-gender-based emotional violence against healthcare workers. Therefore, there is a compelling need for in-depth research to address this gap and develop effective strategies to mitigate psycho-emotional violence in the healthcare sector in Ethiopia, especially in the eastern region. Hence, we aimed to identify the prevalence of and factors associated with workplace psycho-emotional violence against healthcare providers in eastern Ethiopia. Methods: This institution-based cross-sectional study was conducted among 744 health professionals working in urban public hospitals in eastern Ethiopia. Multistage stratified random sampling was used, and data were collected using a standardized structured tool adopted from the WHO workplace violence assessment tool. Binary and multivariable logistic regression analyses were employed to identify factors associated with psycho-emotional workplace violence. Adjusted odds ratio (OR) with 95% confidence interval (CI) was reported, and a p-value of 0.05 was used as the cut-off point to declare significance. Results: Workplace psycho-emotional violence was reported by 57.39% of the healthcare workers. The absence of guidelines for gender-based abuse [AOR = 35.62, 95% CI:17.47, 72.64], presence of measures that improve surroundings (class lighting and privacy) [AOR = 0.58, 95% CI: 0.35, 0.98], training on workplace violence coping mechanism [AOR = 0.16, 95%CI: 0.26, 0.98], spending more than 50% of their time with HIV/AIDS patients [AOR = 1.96, 95%CI:1.05, 3.72], and spending more than 50% of their time with psychiatric patients [AOR = 1.92, 95%CI:1.08, 3.43] were factors significantly associated with workplace violence against health professionals. Conclusion: The prevalence of workplace psycho-emotional violence against health professionals in eastern Ethiopia was relatively high. Improving the working environment decreases the chance of workplace violence; however, there is a lack of guidelines for gender-based violence, the absence of training on coping mechanisms, and spending more time with psychiatric and HIV/AIDS patients' increases workplace violence. We recommend that health institutions develop gender abuse mitigation guidelines and provide training on coping mechanisms.

A double-blind randomized clinical trial on the suggestive effect of anxiety management questionnaires in dental emergencies.

Objective: Dental anxiety is widespread among both children and adults. To diagnose dental anxiety, standardized anxiety questionnaires are recommended. Based on the suggestive nature of the questionnaires, the study aimed to find out whether asking respondents about personal coping strategies before dental treatment influences their anxiety. Methods: This prospective, double-blind, randomized controlled clinical trial included a total of 158 patients of a university dental clinic on emergency service. The intervention group (n = 82) received the Coping with Anxiety Questionnaire (CAQ) and the control group (n = 76) the Hierarchical Anxiety Questionnaire (HAF). State anxiety scores were assessed by using the State-Trait Anxiety Inventory (STAI) before and after the completion of each questionnaire. Results: Anxiety decreased in the intervention group (CAQ) (p < 0.001) and increased in the control group (HAF) (p < 0.001). Conclusion: Within the limitations of the current study, a diagnostic tool of a standardized questionnaire for the assessment to assess personal coping strategies decreased state anxiety in comparison to a questionnaire assessing anxiety. Clinical trial registration: https://www.drks.de, German Trials Register (DRKS00032450).

Health effects of caregiving and coping with severe mental disorders: A caregivers' experience.

Background: Informal caregivers are an essential health resource in the care of persons with severe mental disorders, particularly in South Africa where access to mental healthcare services is limited. Aim: The study aimed to explore and describe the coping strategies used by informal caregivers and the specific health impacts they face in the context of severe mental disorders in South Africa. Setting: The study was conducted in Bushbuckridge municipality situated in the northeastern parts of Mpumalanga province, South Africa. Methods: A descriptive qualitative methodology was used to conduct semi-structured interviews with 12 purposefully selected participants. Audio-recorded interviews were translated, transcribed and analysed inductively on NVivo12 using reflexive thematic analysis. Results: The themes identified were caregivers' experience of consequences of caregiving and caregivers' experience of coping with their caregiving role. Participants experienced negative consequences on their emotional, mental and physical health. The participants use internal and external resources to cope with the challenges they face, and many highlighted using emotion-focused coping strategies. Conclusion: The findings revealed an urgent need to develop support strategies to strengthen informal caregivers' coping and promote good health particularly in rural South Africa where informal caregivers play a crucial role in the management of severe mental disorders. Contribution: The finding demands that policymakers and healthcare providers prioritise the health and well-being of the informal caregivers. There should be policies targeted specifically at developing and implementing caregiver-orientated healthcare services.

The personality traits with depression and suicidal ideation among Thai medical students: a university-based multiregional study.

BACKGROUND: The prevalence of depression in medical students was greater than in the general population. Knowing of predictive factors for depression among medical students is useful. The objectives of this study included the assessment of personality traits as well as the association between the personality traits and the presence of symptoms of depression, and suicidal ideation among medical students covering several regions of Thailand. METHODS: From April to July 2023, a cross-section study was conducted. The participants included first to sixth-year medical students studying at three Faculties of Medicine in Thailand; Prince of Songkla University; Ramathibodi Hospital, Mahidol University; and Chiang Mai University. Using the online process, the questionnaires were composed of three sections; demographic data; the International Personality Item Pool-NEO (IPIP-NEO), Thai version; and the Patient Health Questionnaire-9 (PHQ-9), Thai version. Demographics, personality traits, depression, and suicidal ideation were analyzed using descriptive statistics. The results were presented as frequency, mean, and standard deviation (SD) or median and interquartile range (IQR). The association between independent variables and the presence of depression was identified using binary logistic regression analysis, and the association with suicidal ideation was identified using ordinal logistic regression analysis. RESULTS: The 868 medical students participated in this study. Most of them were female (63.5%), Buddhist (82.0%), and first-year medical students (31.8%). The mean age (SD) was 20.8 (2.2) years, and the mean cumulative Grade Point Average (SD) was 3.5 (0.4). They reported the median (IQR) score of PHQ-9 as 6.0 (3.0-9.0), 238 participants (27.4%) presented with depression, and 138 (15.9%) participants reported suicidal ideation. According to the IPIP-NEO, participants with depression or suicidal ideation had higher Neuroticism scores and lower Extraversion, Agreeableness, and Conscientiousness scores compared to those without such issues. An increase in the Neuroticism score was linked to higher odds of depression, while an increase in the Conscientiousness score was associated with lower odds of depression. Suicidal ideation significantly increased with higher Neuroticism scores and the presence of a psychiatric illness. CONCLUSIONS: More than a quarter of Thai medical students reported depression. A higher Neuroticism and lower Extraversion, Agreeableness, and Conscientiousness scores related to depression. Therefore, medical schools may benefit from knowing medical students' personality traits, to identify coping mechanisms and predict those at a higher risk of developing depression in the future.

Catastrophic Health Expenditure and Associated Factors Among Hospitalized Cancer Patients in Addis Ababa, Ethiopia.

Background: Out-of-pocket (OOP) health expenditures for cancer care expose households to unanticipated economic consequences. When the available health services are mainly dependent on OOP expenditure, the household faces catastrophic health expenditure (CHE). This study aimed to estimate the incidence and intensity of CHE in hospitalized cancer patients and identify coping strategies and associated factors. Method and Material: Hospital-based cross-sectional study design was conducted on 305 cancer inpatients in Addis Ababa between November 2021 and February 2022. All patients with cancer who were hospitalized during the data collection period were included in the study. The incidence of CHE was estimated at the 40% threshold of households' non-food expenditure and the intensity of CHE was captured based on the amount by which household expenditure exceeded the threshold and mean positive overshoot, the mean level by which CHE exceeds the threshold used. Multivariate logistic regression was used to assess the relationship between CHE levels and the independent variables. Results: The incidence of CHE at the 40% threshold of households' non-food expenditure was 77.7%, while the O and MPO were 36.2% and 46.6%, respectively. CHE for cancer care was significantly associated with patient residence, increased number of chemotherapy cycles, increased duration of hospital admission, lack of insurance enrolment, and lower-income quintiles. Saving and selling assets were identified as the primary coping mechanisms. Conclusion: The incidence and intensity of CHE among inpatients with cancer were high and which could lead to impoverishment of households. Improved quality and coverage of health insurance and decentralizing cancer care to regions standards similar to Addis Ababa will save households from incurring CHE.

Smoothing consumption in times of illness: Household recourse mechanisms.

We study the welfare impacts of illness shocks on rural agricultural households in the semi-arid tropical and humid eastern regions of India. These regions are characterized by rainfed agriculture, missing markets for credit and insurance, and limited access to publicly funded healthcare infrastructure. We find that illness shocks increase households' medical expenditures and reduce wage income. However, aggregate non-medical, food, and non-food consumption expenditures are insensitive to illness shocks. Disaggregating illness by the age and the gender of the household members, we observe that illness in male children leads to the largest increase in medical expenditure, and illness in prime-aged adults leads to the largest decline in per-capita wage earnings. We also find illness shocks leading to changes in household dietary diversity, higher travel expenditures, and a compensating reduction in spending on education and entertainment. Analysis of risk-coping strategies reveals that households rely on transfers from kinship networks and loans from informal sources like local moneylenders to smooth consumption. While large landowners rely on gifts from kinship networks, landless and smallholders increase borrowings from informal sources.

Assessing the health consequences of northern Ethiopian armed conflict, 2022.

Armed conflict is a complicated topic with multidimensional impact on population health. This study aimed to assess of the health consequences of the northern Ethiopian conflict, 2022. We used a mixed method study design with a retrospective cross-sectional study supplemented by a qualitative study conducted from May to June 2022. We interviewed 1806 individuals from 423 households and conducted 100 in-depth interviews and focused group discussion. We identified 224 people who self-reported cases of illness (124/1000 people) with only 48 (21%) people who fell ill visited a health institution. We also detected 27 cases of deaths (15/1000 people) during the conflict. The collapse of the health system, evacuation of health personnel, and shortage of medical supplies, and instability with a lack of transportation were consequences of the conflict. The northern Ethiopian conflict has greatly affected the community's health through the breakdown of the health system and health-supporting structures.

Study of the genetic variability of durum wheat (Triticum durum Desf.) in the face of combined stress: water and heat.

The devastating effects and extent of abiotic stress on cereal production continue to increase globally, affecting food security in several countries, including Tunisia. Heat waves and the scarcity of rainfall strongly affect durum wheat yields. The present study aims to screen for tolerance to combined water and heat stresses in durum wheat at the juvenile stage. Three combined treatments were tested, namely: T0 (100% field capacity (FC) at 24 °C), T1 (50% FC at 30 °C), and T2 (25% FC at 35 °C). The screening was carried out based on morphological, physiological, and biochemical criteria. The results showed that the combined stress significantly affected all the measured parameters. The relative water content (RWC) decreased by 37.6% under T1 compared to T0. Quantum yield (Fv/m) and photosynthetic efficiency (Fv/0) decreased under severe combined stress (T2) by 37.15% and 37.22%, respectively. Under T2 stress, LT increased by 63.7%. A significant increase in osmoprotective solutes was also observed, including proline, which increased by 154.6% under T2. Correlation analyses of the combination of water and heat stress confirm that the traits RWC, chlorophyll b content, Fv/m, proline content, Fv/0 and leaf temperature can be used as reliable screening criteria for the two stresses combined. The principal component analysis highlighted that Aouija tolerates the two levels of stresses studied, while the genotypes Karim and Hmira are the most sensitive. The results show that the tolerance of durum wheat to combined water and heat stress involves several adaptation mechanisms proportional to the stress intensity.