Exploring Knowledge about Fang Traditional Medicine: An Informal Health Seeking Behaviour for Medical or Cultural Afflictions in Equatorial Guinea.

This study explores a range of informal health-seeking behaviors, including the use of Fang Traditional Medicine (FTM) for medical or cultural afflictions in Equatorial Guinea (EQ), the therapeutic methods used, the health problems handled, the learning process, traditional medicine user profiles and the social images of Fang Traditional Healers (FTHs). Ethnography was employed as a qualitative strategy using emic-etic approaches. Semi-structured interviews were conducted with 45 individuals, including 6 community leaders, 19 tribal elders, 7 healthcare professionals, 11 FTHs and 2 relatives of traditional healers in 5 districts of EQ. FTM offers a cure for malaria and treatments for reproductive health issues, bone fractures and cultural illnesses. Several methods used to learn FTM are based on empirical observation, and without the need for traditional schooling, unlike with Western medical professionals: for example, watching a family member, or the spirits or ancestors, can reveal healing knowledge. Materials from forests, including tree barks and plants, and rituals are used to keep Fang populations healthy; in addition, two rituals known as "osuiñ" and "etoak" (infusions of tree barks with the blood of sacrificed animals) are the most commonly used treatments. In addition, elders and women are the most active consumers of FTM. FTM plays a relevant role in curing medical and cultural afflictions in Fang communities. The informal health-seeking behavior among the Fang community is conditioned by the explanation model of illness.

Mother-Child Bond through Feeding: A Prospective Study including Neuroticism, Pregnancy Worries and Post-Traumatic Symptomatology.

Post-traumatic stress disorder (PTSD) is a common postpartum problem and influences maternal bonding with the infant. However, the relationship between this disorder, maternal personality, and the infant's emotional state during feeding is not clear. The aim of the present study was to explore the contribution of neuroticism on the infant's emotional state during feeding, by attending to the mediating role of postpartum PTSD (P-PTSD) symptoms and the moderating role of worries during pregnancy. A prospective design study was developed with 120 women with a low pregnancy risk. They responded to a questionnaire assessing maternal personality (first trimester), worries during pregnancy (third trimester), P-PTSD symptoms, and mother-baby bonding (4 months postpartum). The results showed a positive association among neuroticism, infant irritability during feeding, and P-PTSD symptoms, suggesting the latter plays a mediating role in the relationship between neuroticism and infant irritability (B = 0.102, standard error (SE) = 0.03, 95% coefficient interval (CI) [0.038, 0.176]). Excessive worries, related to coping with infant care, played a moderating role between neuroticism and P-PTSD symptoms (B = 0.413, SE = 0.084, p = 0.006, 95% CI [0.245, 0.581]). This relationship was interfered with by depressive symptoms in the first trimester (covariate) (B = 1.820, SE = 0.420, p = 0.016, ci [2.314, 0.251]). This study contributes to a better understanding of the role of neuroticism as an influential factor in the occurrence of P-PTSD symptoms, and in the impairment of infant bonding during feeding. Paying attention to these factors may favor the development of psychological support programs for mothers, with the aim of strengthening the bond with their child.

Does pain after delivery unequivocally lead to postpartum depression? The moderating role of religious coping.

OBJECTIVE: The objective of this work is to explore whether the relationship between pain after delivery and postpartum depression is increased or decreased by the use of religion as a coping strategy (moderation). METHODS: A longitudinal cohort study was conducted. The sample was evaluated on three occasions: third trimester of pregnancy (religious coping), after birth (pain severity) and four months after delivery (postpartum depression). Participants were 122 women (mean age = 31.29; SD = 4.9: range = [22, 42 years]) with low obstetric risk. RESULTS: Both pain severity and religious coping contributed to postpartum depression (r = .20, p = .029 and r = .28, p = .04, respectively). Religious coping exacerbated the relationship between pain after delivery and postpartum depression (B = -0.11, t = -2.48, p = .014, [-0.20, -0.02]). Depression was highest in participants using religious coping irrespective of pain severity levels. CONCLUSION: These findings support the importance of person-environment interaction studies and provide new evidence on the deleterious role of religious coping in the well-being of women after childbirth.

Relationship Between Postpartum Depression and Psychological and Biological Variables in the Initial Postpartum Period.

Objectives The aims of this study were to evaluate the predictive relationship between psychological symptomatology 24 h postpartum and depression 4 months postpartum, and analyze the relationship between estradiol and postpartum mood. Methods Two hundred women participated in an assessment 24 h postpartum and gave a blood sample for estradiol analysis. One hundred eleven of these women completed the second assessment 4 months postpartum. The Beck Depression Inventory II and the Scale of State-Trait Anxiety were used to assess psychological symptoms. Results At 24 h postpartum, symptoms of depression, trait anxiety, and state anxiety were all significantly correlated with each other. Depression at 24 h postpartum was the only significant independent predictor of depression at 4 months postpartum, explaining 28.7% of the variance. No statistically significant relationship was found between levels of estradiol and mood. Symptoms of depression immediately postpartum thus appear to be a predictor of postpartum depression. Conclusions for Practice These results suggest that early postpartum psychological evaluation of the mother, and intervention as warranted, might prevent or lessen postpartum depression.

Evolution of childbirth expectations in Spanish pregnant women.

PURPOSE: To analyze the change of childbirth expectations over the course of pregnancy as well as their relation to socio-demographic and clinical variables. BACKGROUND: The study of expectations in pregnant women is gaining more interest from a biopsychosocial approach because of its consequences on pregnant women's wellbeing. To our knowledge there are no previous studies analyzing the evolution of childbirth expectations over the course of pregnancy. METHODS: Longitudinal study (first trimester and third trimester). Women were evaluated for childbirth expectations in their first trimester (n=285) and third trimester (n=122) of pregnancy. They also completed questionnaires collecting socio-demographic information. RESULTS: Childbirth expectations appear to remain more or less stable over the course of pregnancy, although they tend to become slightly negative at the end of gestation, specifically referring to personal control and delivery circumstances. Multiparity and planned pregnancy are associated with higher positive expectations. CONCLUSION: It seems essential to explore and to try to adjust childbirth expectations to more realistic ones, in order for them to be fulfilled. Midwives and other maternity healthcare providers play a key role in this regard.

Post-Partum Depression, Personality, and Cognitive-Emotional Factors: A Longitudinal Study on Spanish Pregnant Women.

In this study, our purpose was to examine whether personality and cognitive factors could be related to post-partum depression (PPD), mediated by anxiety, in Spanish women. Women were evaluated for personality and cognitive factors after the first trimester, for anxiety in the third trimester, and for PPD 4 months after childbirth. A structural equation model revealed that personality and cognitive factors were associated with anxiety and PPD as predictors. Neuroticism and extroversion proved to be the most relevant factors. Conscientiousness was associated with pregnancy anxiety. Pregnancy anxiety appeared as an independent predictor of PPD. The model presented here includes personality and cognitive and emotional factors as predictors of PPD. Comprehensive care for pregnant women should contemplate assessment and intervention on all these aspects. Special focus should be on cognitive factors and emotional regulation strategies, so as to minimize the risk of later development of emotional disorders during puerperal phases.

Personality, depressive symptoms during pregnancy and their influence on postnatal depression in Spanish pregnant Spanish women / Personalidad, síntomas depresivos en el embarazo y su influencia en la depresión postparto en gestantes españolas

The aim of this study was to analyze the influence of personality factors in postnatal depression. A prospective ex post facto design was carried out. The sample consisted of 116 women, recruited in their first trimester of pregnancy and followed up until four months postpartum. The instruments used were the Edinburg Postnatal Depression Scale (EPDS) to assess postpartum depression and the NEO-Five Factor Inventory (NEO-FFI) to analyze personality traits. Socio-demographic variables (age, parity, educational level, employment status, and planning of pregnancy) and clinical variables (neonatal Apgar score and mode of delivery) were also taken into account. We performed a regression analysis observing that neuroticism was the only factor that predicted depressive symptoms, explaining 23.8% of the variance. We found no interaction effect of sociodemographic or clinical variables. Neuroticism significantly influences psychological health, in life events such as motherhood. Due to its stable condition, personality could be assessed from the beginning of pregnancy, contributing to the care of pregnant women with high scores in neuroticism, to prevent, detect and treat early postnatal depression

El objetivo del presente estudio es analizar la influencia de los factores de personalidad y los síntomas depresivos antenatales en la depresión puerperal. Se elaboró un diseño ex post facto prospectivo, con una asignación voluntaria de los sujetos. La muestra se compuso de 116 mujeres, captándose en el primer trimestre de embarazo y terminando el estudio a los cuatro meses postparto. Los instrumentos de medición empleados fueron la escala Edinburg Postnatal Depression Scale (EPDS) para evaluar la depresión postparto, el NEO-Five Factor Inventory (NEO-FFI) para analizar la personalidad y la subescala de depresión del Symptoms Check List 90-R (SCL 90-R) para valorar la depresión en el embarazo. Se tuvieron en cuenta variables sociodemográficas (edad, paridad, nivel de estudios, situación laboral, y planificación de embarazo) y clínicas (Apgar neonatal y tipo de parto). Se encontró una relación positiva entre la depresión post-parto y los síntomas depresivos durante la gestación, sin embargo tras realizar un análisis de regresión se vio que el neuroticismo era el único factor que predecía los síntomas depresivos post-parto, explicando un 24.8% de la varianza. El neuroticismo influye considerablemente en la salud psicológica ante acontecimientos vitales como es la maternidad. Debido a su condición estable, la personalidad podría evaluarse desde el inicio del embarazo, incidiendo en la atención de aquellas mujeres con un rasgo predominante de neuroticismo para prevenir, detectar y tratar precozmente la depresión puerperal

Psychopathological symptoms and locus of control in women with low-risk pregnancies.

This study investigated the role of locus of control in the development of psychopathological symptoms during pregnancy and postpartum in women with low-risk pregnancies. Pregnant women participated during the first trimester of pregnancy (n = 285), third trimester (n = 122), and in the postpartum (n = 116). Participants were assessed for locus of control (first and third trimesters) and psychopathological symptoms (first and third trimesters and postpartum). Sociodemographic and pregnancy variables (previous childbirth, previous miscarriage, and whether the pregnancy was planned) were also assessed. Significant differences were observed in the development of somatization and obsessive-compulsive symptoms during pregnancy and postpartum. Both increased in the third trimester and decreased after delivery. Previous births, planned pregnancy, having a job, and increasing age were protective variables. As pregnancy progressed, locus of control was significantly externalized. In the first trimester, significant differences were found for locus of control (internal vs. external) among almost all the psychopathological symptoms, but in the third trimester, significant differences were only found in obsessive-compulsiveness and interpersonal sensitivity. In two trimesters, internal locus of control was a protective health variable. Regression analysis showed that external locus of control was related only to phobic anxiety in the third trimester. Adoption of a bio-psycho-social model, such as internal locus of control, may increase personal resources in pregnant women.

Evaluation of the nursing workload through the Nine Equivalents for Nursing Manpower Use Scale and the Nursing Activities Score: a prospective correlation study.

OBJECTIVE: To determine the relationship between nursing workload measured through the nine equivalents of nursing manpower use (NEMS) scale and that measured through the nursing activities score (NAS) scale and to analyse staff needs as determined through each of the scales. METHODS: The study used a descriptive prospective correlational design to collect data between October 2007 and July 2009. Nursing workload data for 730 ICU patients were collected daily using the NAS and NEMS scales. Both scales were then correlated and used to estimate staff needs. FINDINGS: 6815 score pairs were collected, which reflected the nursing workload for each patient as calculated daily using both scales. Pearson's correlation coefficient for individual measurements obtained through the NAS and the NEMS corresponded to .672, and to .932 for the daily total workload in the unit. The staffing requirements based on the NAS scale scores were significantly higher than those based on the NEMS scale. A high correlation existed for individual measurements using both scales and for the total workload measurement in the unit. The main difference was found when analysing staffing requirements, with higher staff numbers needed for the NAS scale. CONCLUSION: Both NAS and NEMS can be used to measure the nursing workload in the ICU. Staffing requirements using NAS were higher than those using NEMS.

[Assessment of nursing workload in three groups of patients in a Spanish ICU using the Nursing Activities Score Scale]. / Carga de trabajo en tres grupos de pacientes de UCI Española según el Nursing Activities Score.

The purpose of this study was to assess the nursing workload at admission to and discharge from intensive care of three groups of patients (i.e., acute coronary syndrome, acute respiratory failure, and sepsis). A prospective, descriptive study was performed over a 27-month period and included 563 patients. The workload was assessed using the Nursing Activities Score scale. Significant differences in the workload were determined on the days of admission and discharge: the workload was higher in both cases for patients with acute respiratory failure and sepsis compared with patients diagnosed with acute coronary syndrome. This difference was maintained over the first seven days of their hospital stay. From day 8 on, the difference disappeared, and a workload balance was achieved in the three groups. Good staffing requires adequate tools for measuring care needs and understanding the workload required in the groups of patients who are most frequently admitted to intensive care.

Carga de trabajo en tres grupos de pacientes de UCI Española según el Nursing Activities Score / Carga de trabalho em três grupos de pacientes em uma UTI espanhola segundo Nursing Activites Score / Assessment of nursing workload in three groups of patients in a Spanish ICU using the Nursing Activities Score Scale

Se objetivó valorizar la carga de trabajo al ingreso y al alta en tres grupos de pacientes (síndrome coronario agudo, insuficiencia respiratoria aguda y sepsis) en terapia intensiva. Estudio descriptivo, prospectivo, de 27 meses, incluyéndose 563 pacientes, valorando carga de trabajo según Nursing Activities Score. Existieron diferencias significativas en la carga de trabajo al ingreso y en el alta entre los grupos de pacientes, siendo superior en ambos momentos la de pacientes con insuficiencia respiratoria aguda y sepsis frente a pacientes coronarios. Durante los siete primeros días de estancia se mantuvo esta diferencia, desapareciendo a partir del octavo día, equilibrándose la carga de trabajo para los tres grupos. Para conseguir una adecuada dotación de personal es fundamental contar con instrumentos para medir las necesidades de cuidados y conocer la carga de trabajo de los distintos grupos de enfermos que ingresan con mayor frecuencia en las unidades de terapia intensiva.

O objetivo deste estudo foi avaliar a carga de trabalho na admissão e alta dos pacientes de três grupos (síndrome coronária aguda, insuficiência respiratória aguda e sepsis) em cuidados intensivos. Trata-se de estudo prospectivo, descritivo, que decorreu durante 27 meses, incluindo 563 pacientes. Para a avaliação da carga de trabalho utilizou-se a escala Nursing Activities Score. A partir dos resultados do estudo parecem existir diferenças significativas na carga de trabalho no dia da admissão e alta entre os grupos de pacientes, sendo a carga maior em ambos os tempos a dos pacientes com insuficiência respiratória aguda e sepsis. Durante os primeiros sete dias de internamento essa diferença manteve-se, desaparecendo no oitavo dia, o que equilibrou a carga de trabalho para os três grupos. Conclui-se que para se conseguir os recursos adequados é essencial dispor de instrumentos para medir as necessidades de cuidados e conhecer a carga de trabalho dos diferentes grupos de pacientes que passam com mais frequência pelas unidades de cuidados intensivos.

The purpose of this study was to assess the nursing workload at admission to and discharge from intensive care of three groups of patients (i.e., acute coronary syndrome, acute respiratory failure, and sepsis). A prospective, descriptive study was performed over a 27-month period and included 563 patients. The workload was assessed using the Nursing Activities Score scale. Significant differences in the workload were determined on the days of admission and discharge: the workload was higher in both cases for patients with acute respiratory failure and sepsis compared with patients diagnosed with acute coronary syndrome. This difference was maintained over the first seven days of their hospital stay. From day 8 on, the difference disappeared, and a workload balance was achieved in the three groups. Good staffing requires adequate tools for measuring care needs and understanding the workload required in the groups of patients who are most frequently admitted to intensive care.

Factor structure, validity, and reliability of the Spanish version of the Women's Views of Birth Labour Satisfaction Questionnaire.

OBJECTIVE: to analyse the factor structure of the Women's Views of Birth Labour Satisfaction Questionnaire (WOMBLSQ) using confirmatory factor analysis. DESIGN: prospective cross-sectional study. Data were collected through a mail questionnaire. SETTING: the study was conducted at a University Hospital in Madrid. PARTICIPANTS: 298 pregnant Spanish women. METHODS: confirmatory factor analysis was used to identify the best-fit model. FINDINGS: the best fit for the Spanish version of the scale was an eight-factor model, after removing the control factor from the original scale, and merging all items related to pain into one. Internal consistency was satisfactory for the full scale (.82), although the reliability of two factors was less than .45. CONCLUSION: this study has provided preliminary evidence that supports the use of the Spanish version of the WOMBLSQ to assess childbirth satisfaction in Spanish-speaking women. Nevertheless, further studies will be needed to determine the validity of the questionnaire and to compare it to other existing tools.

Coping strategies of Spanish pregnant women and their impact on anxiety and depression.

The aims of this study were to analyze the coping strategies used by women in the first trimester of low-risk pregnancies, their relationships to sociodemographic and pregnancy variables, and their ability to predict anxiety and depression in the third trimester. Participants in the first trimester were 285 Spanish pregnant women, of whom 122 were followed into the third trimester. The use of problem-focused coping was stable, whereas variations occurred in emotion-focused coping. Age, educational level, employment, planned pregnancy, previous childbirth, and previous miscarriage were associated with adaptive coping. Coping strategies predicting anxiety and depressive symptoms were overt emotional expression and social support seeking. Coping through religion predicted anxiety. Coping is a complex process influenced by sociodemographic and obstetric factors that can contribute to the onset of psychological symptoms.

Influencia de las estrategias de afrontamiento en las preocupaciones específicas del embarazo / Influence of coping strategies in the specific worries of pregnancy

El objetivo del presente estudio es analizar la influencia de las diferentes estrategias de afrontamiento en las preocupaciones específicas de embarazo. Se evaluó a una muestra formada por 286 gestantes en su primera mitad de embarazo, a las que se administró el Cuestionario de Afrontamiento al Estrés, y la Cambridge Worry Scale. Además se recogieron variables sociodemográficas (edad, nivel de estudios, embarazos previos, situación laboral y planificación de embarazo). Se observó una relación significativa entre las preocupaciones del embarazo y las estrategias de autofocalización negativa, expresión emocional abierta y evitación. El análisis de regresión evidenció una influencia significativa de la estrategia de autofocalización negativa y la paridad sobre las preocupaciones del embarazo. Estos resultados sugieren que un afrontamiento caracterizado por una percepción de incapacidad para manejar las situaciones, tiene un efecto negativo en la condición psicológica de la gestante. La experiencia de un parto previo podría atenuar este efecto. De este modo, se destaca la importancia de la atención psicológica en la embarazada, con la finalidad de que, desde el inicio de la gestación, y especialmente en primíparas, se desarrollen recursos para adaptarse a la nueva situación y mejorar la salud de la mujer (AU)

The aim of this study is to analyse the influence of the different coping strategies on specific pregnancy-related worries. We assessed a sample comprised of 285 pregnant women during the first half of pregnancy who underwent the Coping Strategies Questionnaire, and the Cam-bridge Worry Scale. In addition, sociodemographic variables were collected (age, education, prior pregnancies, occupational situation and pregnancy planning). We observed a significant relationship between pregnancy-related worries and negative auto-focused coping, overt emotional expression coping and avoidance coping. Regression analysis revealed a significant influence of negative auto-focused coping and number of children on pregnancy-related worries. These results suggest that coping characterised by perception of incapacity to handle situations has a negative effect on the pregnant woman’s psychological condition. The experience of a prior birth could reduce this effect. Therefore, we highlight the importance of psychological care for the pregnant woman with the purpose of, from the onset of gestation and especially in women pregnant for the first time, developing resources to adapt to the new situation and improve women’s health (AU)

Factor structure, validity and reliability of the Spanish version of the Cambridge Worry Scale.

OBJECTIVE: To analyse the factor structure and reliability of the Cambridge Worry Scale (CWS) in the Spanish population. DESIGN: Prospective cross-sectional study using a postal questionnaire. SETTING: The study was conducted at a university hospital in Madrid between October 2007 and December 2008. PARTICIPANTS: 285 Spanish pregnant women. METHODS: Factor structure of a Spanish version (original 16 items test and reduced 13 items version) of the scale was analysed through exploratory factor analysis. FINDINGS: The Spanish version of the reduced 13 items version replicated the original factor structure. The internal consistency was good for the total scale (0.83) and for the subscales (0.70-0.79). Significant positive correlations between the CWS and its subscales with anxiety, depression and neuroticism were found. Similarly, acceptable to good reliability and convergent validity indexes were obtained for the original 16 items test. DISCUSSION: The present study confirmed the validity of the two Spanish versions of the CWS (16 item and reduced 13 item). Considering the performance of two of the three items eliminated from the original version and the universality in the use of the short version we recommend the use of the reduced 13 item scale. Practical implications of the use of the CWS in maternity care are discussed.

Influence of coping strategies on somatic symptoms in pregnant Spanish women: differences between women with and without a previous miscarriage.

The aim of this research was to analyze the relation between coping strategies and somatic symptomatology in pregnant Spanish women and the influence of a previous miscarriage on these variables. We used a correlational retrospective design, which included 207 expectant mothers (44 with a previous miscarriage). The instruments included a questionnaire on coping with stress and questions about first-trimester symptoms. Regression analysis showed a significant positive relationship between sleep disturbances and overt emotional expression coping, between tiredness/fatigue and avoidance coping, and between nausea and religious coping. The influence of coping strategies on somatic symptomatology did not differ significantly between women who had had or had not had a previous miscarriage, although women with a previous miscarriage scored higher on the use of religious coping and positive reappraisal and reported more nausea.

La construcción social del duelo en el aborto espontáneo / The social construction of grief in mis carriage

Objetivo: conocer las diferentes vivencias del duelo en las mujeres conpérdida fetal espontánea en el primer trimestre de gestación. Objetivosespecíficos: identificar las distintas representaciones sobre la maternidad,la vida y la muerte de las mujeres con abortos espontáneos; explorar laspercepciones sobre el cuerpo femenino de las mujeres; comprender la relaciónque existe entre los mecanismos de afrontamiento ante un embarazono evolutivo y las representaciones sobre la maternidad, la muertey la corporalidad.Métodos: es de carácter exploratorio, utilizando una estrategia de tipocualitativa y fenomenológica, con perspectiva de género. Ámbito de estudio:el entorno del servicio de urgencias obstétricas del Hospital deFuenlabrada, pertenecientes al Área 9 de la Comunidad de Madrid.Sujetos de estudio: el muestreo fue teórico, a través de la codificaciónselectiva según categorías preconcebidas, siendo los participantes del estudiolas mujeres diagnosticadas de embarazo no evolutivo que acudíanal servicio de urgencias del Hospital de Fuenlabrada, así como el personalde Enfermería de los servicios de urgencias obstétricas, quirófanos yreanimación. Procedimientos: trabajo de campo. La recogida de datos seplanteó en tres fases consecutivas y los procedimientos seleccionadosfueron la observación participante (contexto etnográfico de los tres municipiosy observación intensiva del medio hospitalario), 16 entrevistasen profundidad y 9 entrevistas semiestructuradas al personal de Enfermería.Análisis de los datos: teoría fundamentada siguiendo a Corbin y Strauss.Se utilizó el programa informático Atlas ti. 5.0. Consideraciones éticas:todos los participantes han sido informados verbalmente por el equipo investigadory han firmado el consentimiento informado, aprobado por(..) (AU)

Objective: to ascertain the different experiences of grief in women whohave suffered spontaneous abortions during the first trimester of pregnancy.Specific objectives: to identify the different representations ofmotherhood, life and death of women who have suffered miscarriages;to explore women’s perceptions of the female body; to understand the relationshipbetween coping mechanisms in the face of a miscarriage andrepresentations of motherhood, death and corporality.Methods: exploratory study, using a qualitative and phenomenologicalstrategy, from a gender perspective. Scope of the study: obstetric emergenciesservice of the Hospital of Fuenlabrada, this service being the referenceservice for the cities of Fuenlabrada, Humanes and Moraleja deEnmedio, all belonging to Area 9 of the Community of Madrid. Study subjects:theoretical sampling, by means of selective coding according to predeterminedcategories; the study participants being women diagnosedwith miscarriage who attended the emergency service of the Hospitalof Fuenlabrada, as well the Nursing staff of the obstetric emergenciesservice, operating rooms and reanimation. Procedures: field work. Datacollection was structured in three consecutive phases and the proceduresselected were participant observation (ethnographic context of thethree cities and intensive observation of the hospital setting), 16 in-depthinterviews and 9 semi-structured interviews with Nursing professionals.Data analysis: theory based on following Corbin and Strauss. The softwareprogramme Atlas ti. 5.0. was used. Ethical considerations: all participantshave been verbally informed by the research team and havesigned the informed consent form (..) (AU)