Stress, Anxiety and Coping in Adults With Down Syndrome: An Exploratory Co-Research Study.

BACKGROUND: At least half of children and adults with Down syndrome have a major mental health concern during their life but few studies ask people with Down syndrome directly about their experience. We used a co-research model to explore anxiety, stress, and coping in adults with Down syndrome. METHODS: Our group of researchers and adults with Down syndrome conducted an online survey on mental health for adults with Down syndrome. We analysed quantitative data and thematically grouped coping mechanisms. RESULTS: Sixty adults with Down syndrome completed the survey, mean age was 30 years, and 55% of respondents had some employment. Approximately 80% of respondents reported experiencing stress and 75% reported experiencing anxiety. Employed respondents were more likely to use social coping mechanisms. CONCLUSION: Soliciting responses from adults with Down syndrome about their mental health can provide valuable insights. Mental health is a concern for people with Down syndrome that should be addressed.

Mental Health Services for Adults With Intellectual Disabilities: A Qualitative Study of Patient Characteristics, Associated Factors and Consequent Needs for Adaptation in Assessment and Treatment.

BACKGROUND: Individuals with intellectual disabilities are at increased risk of mental health disorders, but may struggle to access appropriate services. While assessment/treatment may need to be adapted, knowledge is limited about what such adaptations may entail. METHOD: During a service development project, the participants (33 professionals, 13 family members) were asked to identify the characteristics/associated factors of individuals with intellectual disabilities and co-occurring mental health disorders. Using thematic analysis, 1103 participant responses were analyzed to identify the needs for adaptation in assessment/treatment. RESULTS: Three core themes were identified: (1) A broader assessment: Gaining an accurate and comprehensive understanding of the individual's history, abilities and difficulties, (2) Adjusting/modifying existing treatment strategies, (3) Ensuring that the individual's day-to-day needs are met. CONCLUSIONS: According to the participants, assessment/treatment of mental health disorder in this population requires more time and broader assessments are necessary. Family/caregiver involvement and cross-service organisation/collaboration represent other important adaptations.

'It's Got Its Ups and Downs': What People With Intellectual Disabilities Living in Supported Living and Residential Care Like and Dislike About Their Home.

BACKGROUND: Given the current sociopolitical climate, people with intellectual disabilities are spending more time at home. Much housing-related research focuses on informant-completed measures and quantifiable outcomes. By contrast, this article explores the perspectives of adults with intellectual disabilities concerning what they liked or disliked about their homes. METHOD: Data is drawn from 53 semi-structured interviews with people with intellectual disabilities in supported living or residential care in England. RESULTS: Three themes were generated: space and place; people make or break a home; and day-to-day autonomy. These highlight the importance of belonging and the significance of other people in the creation of 'home'. CONCLUSION: If people are to flourish, attention must be paid to aspects of the home that provide comfort, enjoyment, and a sense of belonging. These findings can benefit professionals, family members and people with intellectual disabilities, when considering current or future living arrangements.

Physical Activity, Sedentary Behaviour, Sleep and Mental Wellbeing in Family Caregivers of Adults With Intellectual and/or Developmental Disabilities.

BACKGROUND: Canadian 24-h movement guidelines recommend that adults achieve 150 min per week of moderate-to-vigorous physical activity (MVPA), 7-9 h of sleep per night and spend no more than 8-h per day sedentary to optimise health and wellbeing. METHOD: Using a cross-sectional survey of 131 family caregivers of adults with intellectual and developmental disabilities, we aimed to (a) determine whether adherence to these guidelines predicts mental wellbeing in family caregivers and (b) explore the relationship between movement behaviours of family caregivers and their loved ones. RESULTS: While MVPA was found to weakly predict wellbeing, sleep and sedentary behaviour did not. The movement behaviours of the family caregivers were not closely related to that of their loved ones. CONCLUSIONS: Fostering physical activity is important to promote the wellbeing of adults with intellectual and developmental disabilities, as well as their family caregivers. Opportunities to be active together may be even more beneficial.

Rural women's voices revealing perceptions about decisions on where to give birth in Gabon: A qualitative study.

OBJECTIVE: This study aimed to clarify the perceptions of rural women about their decisions on where to give birth in Gabon. METHOD: This study used a qualitative descriptive design using semi-structured interviews. Study participants were women at least 20 years old and had given birth within the past 2 years. The study area was approximately 25-30 km from the capital of Gabon. Data collection was conducted between May and mid-July 2023. The interview guide was based on the Ottawa Decision Support Framework (ODSF) 2020 model. The data obtained were analyzed using content analysis for "perceptions in deciding the place of birth." RESULTS: A total of 18 women participated in the study. Six categories of reasons were identified for women's choice of birth location: (1) childbirth environment with physical safety; (2) childbirth environment with psychological safety; (3) physical accessibility; (4) affordable health facilities; (5) concerns about homebirth risks; and (6) unpleasant aspects of the hospital. Items (1)-(4) were the reasons for actively choosing the hospital as a birth location, whereas items (5) and (6) were the reasons for avoiding a place to give birth. CONCLUSIONS: Women positively perceived and chose facilities that offer physical and mental safety, geographic accessibility, and affordable costs. Conversely, an environment where the safety of the mother and the child is threatened and the lack of respectful maternity care by the medical staff served as deterrents to facility use.

A novel analysis of interoceptive underpinnings of anxious psychopathology in COVID-19 survivors.

INTRODUCTION: SARS-CoV-2 affects brain, body, and their interchange. We investigated interoceptive mechanisms in COVID-19 survivors focusing on their potential link with psychopathology and inflammatory biomarkers. METHODS: We assessed interoceptive accuracy (IAc) and time-perceiving (TA) skills of 57 COVID-19 survivors one month after hospital discharge through, respectively, a heartbeats perception task and a time duration task. Each participant was assessed about his interoceptive awareness (IAw) through Multidimensional Assessment of Interoceptive Awareness questionnaire (MAIA) and then, screened for post-traumatic (Impact of Events Scale - IES-R), anxious (State-Trait Anxiety Inventory - STAI-Y1) and depressive (Zung Self-Rating Depression Scale - ZSDS; Beck Depression Inventory - BDI-13) symptoms. Biomarkers of inflammation (platelet count, PC; mean platelet volume, MPV and systemic immune-inflammation index, SII) were obtained in a subsample of 40 survivors by a blood sampling conducted at admission and discharge time from the hospital. Correlational, GLM, GLMZ, and mediation analyses were performed. RESULTS: IAc did not correlate with TA confirming the reliability of interoceptive measure. IAc positively predicts MAIA's Trusting subscale and negatively predicts anxious psychopathology which fully mediates the effect of IAc on Trusting.PC at hospital admission predicts anxiety at one month after recovery. Again, a higher decrease of SII during hospitalization predicts higher IAc skill and lower anxiety state at one month. The link between SII change and anxiety is fully mediated by IAc. CONCLUSIONS: Our results unveil a potential key role of interoception and brain-body interchange in the exacerbation and maintenance of anxiety psychopathology in COVID-19 survivors.

Association of psychosocial factors at work with fertility and menstrual disorders: A systematic review.

OBJECTIVES: This systematic review aimed to assess the association between psychosocial factors in the workplace and menstrual abnormalities or fertility, focusing on literature implementing a prospective cohort design. METHODS: We searched MEDLINE, EMBASE, PsycINFO, PsycARTICLES, and Japan Medical Abstracts Society electronic databases for studies published from inception to February 26, 2020, and updated the search in PubMed on May 29, 2024. Inclusion criteria were (P) adult female workers (over 18 years old), (E) presence of adverse psychosocial factors at work, (C) absence of adverse psychosocial factors at work, and (O) any menstrual cycle disorders, menstrual-related symptoms, or fertility issues. Prospective cohort studies were included. The included studies were summarized descriptively. RESULTS: Database searching yielded 14,238 abstracts, with nine studies meeting the inclusion criteria. Outcomes included fertility (n = 5), irregular menstrual cycle (n = 1), early menopause (n = 1), endometriosis (n = 1), and serum hormones (n = 1). Study findings included that women with high job demands and low job control were less likely to conceive, and working over 40 h per week and frequent heavy lifting, and rotating night shift work increased the risk of earlier menopause. Studies on night shift/rotating work and fertility outcomes showed no significant differences. CONCLUSION: This review underscores the insufficient high-level evidence regarding the association of psychosocial factors at work with fertility and menstrual disorders, emphasizing the necessity for future well-designed studies.

The role of family support in medication adherence and quality of life among tuberculosis patients: A scoping review.

BACKGROUND: Tuberculosis (TB) remains one of the leading infectious diseases globally, causing high mortality rates. A significant factor contributing to this issue is nonadherence to treatment, which is influenced by family support and impacts the quality of life (QoL) of patients. AIM: The purpose of this study was to describe the role of family support in enhancing medication adherence and improving QoL in individuals with TB. METHODS: This study utilized a scoping review method to examine literature from the PubMed, Scopus, and EBSCO databases. The keywords used in the search included "social support OR online social support OR perceived social support OR family support" AND "Tuberculosis OR TB OR TBC" AND "medication adherence OR medication compliance OR drug adherence OR drug compliance OR adherence OR compliance OR lost to follow-up" AND "QoL OR HRQoL OR health-related QoL." The inclusion criteria were full-text articles in English, primary research studies, and publications from the last 10 years (2012-2022). RESULTS: Thirteen articles met the inclusion criteria, with sample sizes ranging from 50 to 1342 respondents, predominantly using cross-sectional methods. The study found that family support is crucial in promoting medication adherence and positively influencing the QoL of TB patients. Family members provide emotional and practical support, including supervision of medication intake and encouragement of healthy habits. This support enhances patients' confidence, motivation, and overall treatment outcomes. CONCLUSIONS: The findings underscore the indispensable role of family support in addressing the complex interplay between medication adherence and QoL for individuals with TB.

Medical faculty's perception of students' mental health: a qualitative survey study / Percepción de los profesores de medicina sobre la salud mental de los estudiantes: un estudio cualitativo / Percepção dos docentes de medicina sobre a saúde mental dos estudantes: um estudo qualitativo

This study sought to explore the perspective of medical faculty on the mental health of their students. This qualitative study based on a focus group is part of a longitudinal research that studied the mental health of Brazilian students. One group was conducted with faculty employed at a medical school. Topics discussed covered the concept of mental health and medical education. Six professors participated in one group. The mental health of medical students is a construct that encompasses emotional aspects, ability to solve problems and multiple facets of a human being, according to the participants. Artistic practices, moments of socialization and leisure were perceived as stimulating students' good mental health. Excessive demands generate competitiveness and the teacher's expectation of the student's good performance based on their own experience can harm the student's mental health. Participants also highlighted that a pedagogical reformulation that makes sense for the student's learning process is necessary to update traditional curricula. Medical students' mental health is influenced by experiences and exchanges during the medical school, mainly between professor and student, understood as necessary and inherent to the process of becoming physician. The findings of this study show the need for curriculum changes in the medical education process and updating teacher training for good practices that reinforce good mental health.

Este estudio buscó explorar la perspectiva de los profesores de medicina sobre la salud mental de sus estudiantes. Este estudio cualitativo basado en un grupo focal es parte de una investigación longitudinal que estudió la salud mental de estudiantes brasileños. Un grupo se llevó a cabo con profesores empleados en una escuela de medicina. Los temas tratados abarcaron el concepto de salud mental y educación médica. Seis docentes participaron en un grupo. La salud mental de los estudiantes de medicina es un constructo que abarca aspectos emocionales, capacidad de resolución de problemas y múltiples facetas del ser humano, según los participantes. Las prácticas artísticas, los momentos de socialización y el ocio fueron percibidos como estimulantes de la buena salud mental de los estudiantes. Las exigencias excesivas generan competitividad y la expectativa del docente sobre el buen desempeño del estudiante basándose en su propia experiencia puede perjudicar la salud mental del estudiante. Los participantes también resaltaron que es necesaria una reformulación pedagógica que tenga sentido para el proceso de aprendizaje del estudiante para actualizar los currículos tradicionales. La salud mental de los estudiantes de medicina está influenciada por las experiencias y los intercambios durante la carrera de medicina, principalmente entre profesor y estudiante, entendidos como necesarios e inherentes al proceso de convertirse en médico. Los hallazgos de este estudio muestran la necesidad de cambios curriculares en el proceso de formación médica y de actualización de la formación docente hacia buenas prácticas que refuercen la buena salud mental.

Este estudo buscou explorar a perspectiva dos docentes de medicina sobre a saúde mental de seus alunos. Este estudo qualitativo baseado em grupo focal faz parte de uma pesquisa longitudinal que estudou a saúde mental de estudantes brasileiros. Um grupo foi conduzido com professores empregados em uma faculdade de medicina. Os temas discutidos abrangeram o conceito de saúde mental e educação médica. Seis professores participaram de um grupo. A saúde mental dos estudantes de medicina é um construto que engloba aspectos emocionais, capacidade de resolução de problemas e múltiplas facetas do ser humano, segundo os participantes. As práticas artísticas, os momentos de socialização e de lazer foram percebidos como estimuladores da boa saúde mental dos estudantes. Exigências excessivas geram competitividade e a expectativa do professor pelo bom desempenho do aluno com base na própria experiência pode prejudicar a saúde mental do aluno. Os participantes destacaram também que é necessária uma reformulação pedagógica que faça sentido para o processo de aprendizagem do aluno para atualizar os currículos tradicionais. A saúde mental dos estudantes de medicina é influenciada pelas experiências e trocas durante o curso de medicina, principalmente entre professor e aluno, entendidas como necessárias e inerentes ao processo de tornar-se médico. Os achados deste estudo mostram a necessidade de mudanças curriculares no processo de formação médica e de atualização da formação docente para boas práticas que reforcem a boa saúde mental.

Visual Event-Related Potentials under External Emotional Stimuli as Early Signs for Mild Cognitive Impairment.

BACKGROUND: Alzheimer's disease (AD) is a neurodegenerative disorder featured by progressive cognitive decline, which manifests in severe impairment of memory, attention, emotional processing and daily activities, leading to significant disability and social burden. Investigation on Mild Cognitive Impairment (MCI), the prodromal and transitional stage between normal aging and AD, serves as a key in diagnosing and slowing down the progression of AD. Numerous effects have been made up to date, however, the attentional mechanisms under different external emotion stimuli in MCI and AD are still unexplored in deep. OBJECTIVE: To further explore the attentional mechanisms under different external emotion stimuli in both MCI and AD patients. DESIGN/SETTING/PARTICIPANTS/MEASUREMENTS: In 51 healthy volunteers (Controls, 24 males and 27 females), 52 MCI (19 males and 33 females), and 47 AD (15 males and 32 females) patients, we administered the visual oddball event-related potentials (ERPs) under three types of external emotional stimuli: Neutral, Happiness and Sadness, in which the components N1, P2, N2 and P3 as well as the abnormal cortical activations corresponding to the significant ERP differences in the three groups were observed. RESULTS: Under all three external emotions, in AD patients, N2 and P3 latencies were significantly prolonged compared to both Controls and MCI. In addition, under Happiness, in MCI, P3 latencies were significantly delayed compared to Controls. Meanwhile, under both Happiness and Sadness, in AD patients, P3 amplitudes were significantly decreased compared to Controls and MCI, respectively. During N2 time window, under Neutral emotion, significant hypoactivation in the right superior temporal gyrus was found in AD patients compared to Controls, and under Happiness, the activation of the right inferior frontal gyrus was significantly attenuated in MCI compared to Controls. Under Sadness, in AD patients, the activation of the right superior frontal gyrus was significantly decreased compared to MCI. During P3 time window, under both Happiness and Sadness, when AD patients compared to MCI, the significantly attenuated activations were located in the right fusiform gyrus and the right middle occipital gyrus, respectively. CONCLUSION: Our results demonstrated visual attentional deficits under external emotional stimuli in both MCI and AD patients, highlighting the function of Happiness for early detecting MCI, in which the P3 latency and the hypoactivation of right inferior frontal gyrus during N2 time window can be early signs. The current study sheds further light of attentional mechanisms in MCI and AD patients, and indicates the value of emotional processing in the early detection of cognitive dysfunction.

[Preliminary Study on the Relationship Between Organizational Climate, Leadership Style, and Job Satisfaction in the Context of Nurse Practitioners].

BACKGROUND: Job satisfaction in nurse practitioners is influenced by the level of autonomy and empowerment they perceive within their practice environment. Little in-depth research has been done to explore the relationship among organizational climate, leadership style, and job satisfaction in the context of nurse practitioners. PURPOSE: This study was developed to explore the relationship among organizational climate, leadership style, and job satisfaction in nurse practitioners with the goal of enhancing their job satisfaction. METHODS: A cross-sectional correlational approach and snowball sampling method were employed to recruit 400 qualified nurse practitioners to complete an online survey. This survey was a structured questionnaire consisting of the Practice Organizational Climate Scale, Leadership Style Scale, and Job Satisfaction Scale. Statistical analyses used included the independent t test, one-way ANOVA, Pearson's correlation, and multiple linear regression analysis. RESULTS: Most of the participants were 31 to 50 years old. A significant and positive correlation was identified among overall organizational climate, leadership style, and job satisfaction. In terms of organizational climate components, only professional visibility was not found to significantly correlate with job satisfaction. Transformational leadership, servant leadership, independent work, and relationships with support and management departments collectively explained nearly 72.4% of overall job satisfaction. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The findings demonstrate job satisfaction in nurse practitioners to be significantly influenced by organizational climate and leadership style. Thus, fostering a positive organizational climate and enhancing transformational and servant leadership styles may be expected to improve job satisfaction in this group substantively. Therefore, it is recommended healthcare institutions focus on improving the organizational climate, providing more autonomy and support, and enhancing leadership training for supervisors with the goal of increasing overall job satisfaction and retention rates among nurse practitioners.

[A Study on the Life Attitudes, Fear of Death, and Dying Care Abilities of Nursing Assistants in Long-Term Care Institutions].

BACKGROUND: End-of-life care in long-term care institutions is increasingly important. Nursing assistants are the primary care workforce, and their end-of-life care capabilities affect the quality of care provided to residents as well as residents' physical and mental health. PURPOSE: This study was designed to explore the life attitudes, fear of death status, end-of-life care abilities and experience, and coping styles of nursing assistants in long-term care institutions in the eastern region and the effects of these variables on care. METHODS: A cross-sectional, mixed-methods research design was used. The study included 165 nursing assistants working in long-term care facilities in Taitung and Hualien counties. The study questionnaire included items covering life attitudes, fear of death, and dying care abilities. In addition, in-depth interviews were conducted with 12 of the participants. RESULTS: Most of the participants held positive attitudes toward life and reported having a low to moderate fear of death. A significant and positive correlation between life attitude and dying care ability was identified (r = .426, p < .001). Although average ability to provide physical care to residents at end of life was found to be relatively good, ability to provide emotional support and allow residents to express their emotions was generally poor. The scales of fear of death, life attitude toward love and care, ideals, and high school education were identified as significant predictors of dying care ability, together explaining 22.8% of the variance. The interview results were summarized into five major themes that also echoed the quantitative results. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Attitudes toward life and fear of death partially were shown to influence the dying care ability of the nursing assistants in this study. Dying care skills should be strengthened in nursing assistants, and they should be encouraged to explore the meanings of life and death through on-the-job education. Also, long-term care institutions should show concern for and support their nursing assistants by sponsoring case discussions, care experience sharing sessions, and support groups.

[Caregiving Experience With a Young Father With Multiple Myeloma Undergoing Renal Dialysis and Autologous Stem Cell Transplantation].

This case report addresses the author's experience providing nursing care to a 37-year-old patient diagnosed with multiple myeloma requiring regular renal dialysis due to disease progression who received autologous stem cell transplantation. The patient was diagnosed with cancer in young adulthood and, as a father figure, faced various psychological issues associated with the unexpected challenges encountered during their treatment phase. Psychosocial health, which is closely associated with quality of life in patients with cancer, has gained increasing attention in recent years. The limited research published on the subject of fathers diagnosed with cancer encouraged the author to detail her experience with this case. The care period was from August 5th to August 19th, 2022. During the care period, the Gordons's 11 functional health assessment was applied, with potentially severe infections, coping disorders, anxiety, potential risk of injury existing or potential nutritional deficiencies, oral mucosal changes, and diarrhea identified as the primary health problems of concern. Nursing interventions applied included providing protective isolation measures to prevent post-transplant infection, helping the patient learn effective ways to cope with emotional distress, and providing comprehensive follow-up care information and health education to alleviate the anxiety associated with hospital discharge and life after discharge. The challenges of providing nursing care to adolescent and young adult patients differ significantly from those faced in the care of either elderly or pediatric patients. Furthermore, although extensive research has been conducted on mothers diagnosed with cancer, little research has addressed the impact on the paternal role when fathers are diagnosed with cancer, with limited information available regarding their psychological concerns and issues or the impact on family dynamics. The author hopes this case care experience offers an insightful reference and guide for nursing practice that contributes to a better understanding of the psychological aspects of young adult fathers diagnosed with cancer and facilitates more appropriate care in clinical settings.

Evaluating the Acceptance and Awareness of GPT-Based AI for Health Assistance in Clinical Practice among Registered Physicians of Bangladesh.

In the changing field of healthcare, AI models based on GPT technology have the potential to bring about changes in how diseases are diagnosed and treated. Despite global enthusiasm, there is a critical gap in exploring the acceptance and awareness of these AI tools among doctors in Bangladesh. This investigation becomes crucial as it navigates the challenges faced by physicians in middle-income countries like Bangladesh, providing a foundation for future implementations and advancements in AI-assisted healthcare. Therefore, this study aims to explore the acceptance and awareness of GPT-based AI for clinical practice among doctors in Bangladesh. In this study, we looked at 398 registered physicians in Bangladesh. The research used a convenient sampling method and employed a questionnaire to collect information. The size of the sample was chosen using a calculation for a 95% confidence level. Statistical analysis included looking at combined data, calculating frequencies and percentages well, and using the Chi-square test and multivariate logistic regression bivariate and multivariate analysis was done. All statistical analysis was done using Stata 17 software. This study examines GPT-based AI acceptance and awareness among Bangladeshi physicians. Key findings reveal a prevalence of 26.13% for acceptance and 71.11% for awareness. Acceptance significantly varies with age (p=0.013), preferring those aged 21-30. Gender (p=0.001) influences awareness, showing in females. Physicians aged 41-50 exhibit lower acceptance odds (AOR=0.13), and females have decreased acceptance odds (AOR=0.29). Demographics don't significantly impact awareness. This study sheds light on Bangladeshi doctors' views on GPT-based AI in healthcare. While some actively support its use, a majority are aware. Age, gender, and workplace influence acceptance. Tailored strategies are vital for addressing concerns. Future research should focus on understanding physicians' adoption of GPT-based AI.

Development of a Artificial Intelligence Dental Anxiety Scale (AI -CDAS) For Children: Validation And Reliability.

Assessing children's pain using patient-based pain scales can be challenging. Hence, there is a need of new version Artificial Intelligence Child Dental Anxiety Scale (AI-CDAS) to scale and test its psychometric properties (validity and reliability). This study was conducted to evaluate the validity and reliability of Artificial Intelligence version of the Child Dental Anxiety Scale (AI-CDAS) for anxiety detection scale in children using face as a response set from October 2022 to December 2023. Aim of this study was to examine the reliability and validity of Artificial Intelligence based Child Dental Anxiety Scale (AI-CDAS) using a wide range of age samples in dental clinics. A total of 100 outpatients (Age 03-09 years) from Bharati Vidyapeeth Deemed to be University Dental College and Hospital, Pune, India participated in this study. Dental anxiety was assessed using the Artificial Intelligence Child Dental Anxiety Scale (AI-CDAS) and comparing with a valid and reliable scale of Colored Version of Modified Facial Affective Scale. Reliability and validity was good and significant correlations were found between the AI-CDAS and the Colored Version of Modified Facial Affective Scale. This study suggests that the Artificial Intelligence based Child Dental Anxiety Scale (AI-CDAS) is a valid and reliable measure for assessing children's dental anxiety and may help encourage dentists to formally assess dental anxiety scale in day to day practice. Self-report measures are commonly employed in dental anxiety assessments. One advantage of self report measures is the ease of administration, taking relatively short period of time to complete. They can also assess the reaction to different aspects of the dental experience.