-
Minerva Urology and Nephrology Jun 2024Lower urinary tract symptoms (LUTS) and nocturnal enuresis (NE) are complex conditions requiring a long-term follow-up. Telemedicine is an emerging technological tool in...
The digital era of pediatric urological clinical care: telemedicine for management of lower urinary tract symptoms and nocturnal enuresis - a comprehensive tertiary center insight.
BACKGROUND
Lower urinary tract symptoms (LUTS) and nocturnal enuresis (NE) are complex conditions requiring a long-term follow-up. Telemedicine is an emerging technological tool in the surgical field, and its availability exponentially grew during the COVID-19 pandemic, expanding its application fields, optimizing technical aspects, reducing costs, and ensuring high-quality standards. This work describes our experience with telemedicine in a Division of Pediatric Urology for the follow-up of enuresis and LUTS.
METHODS
A retrospective analysis of our telemedicine preliminary experience was conducted at Regina Margherita Children's Hospital in Turin, Italy. This study included all the patients aged <18 years who were monitored for enuresis and LUTS through telemedicine between September 1, 2021 and July 31, 2023. Clinical data and outcomes were analyzed, and patients and families were asked to voluntary fill an evaluation questionnaire on their satisfaction. Additionally, we focused on the post COVID-19 period, between September 2022 and July 2023, analyzing the data of two different patients' populations: the first one (G1) of patients choosing telemedicine outpatients visits (TOVs) and the second one (G2) of those choosing a face-to-face visit.
RESULTS
One hundred five patients were enrolled. One hundred sixty-two TOVs were performed. The median age at first visit was 9.7±0.66 years (range 7-16 years). Diagnosis were: 77/105 (67%) NE and 28/105 (33%) LUTS. The average referred distance between the patients' residence and the hospital was 46.35±129.37 km (range 2-1300 kilometers) and the time taken to overcome it was 44.21±77.29 minutes (range 10-780 minutes). In 64/105 cases (61%) the follow-up was interrupted for total healing or symptoms resumption. Only two cases (2%) required the conversion to an in-person ambulatory consult, due to a social-linguistic barrier. 146/162 families (90%) filled the survey questionnaire at the end of each TOV, reporting in 94% of cases a high satisfaction level. In the comparative statistical analysis of the two patient groups, G1 (52 telemedicine office visits, [TOVs]) vs. G2 (25 face-to-face visits), the average referred distance was 17.78±7.98 km (range: 5-35 km) for G1, contrasting with 7.04±3.35 km (range: 2.5-14 km) for G2 (P=0.00001). Additionally, the waiting time before the visit was 3.96±2.90 minutes (range: 0-10 minutes) for G1, in contrast to 26.52±11.22 minutes (range: 5-44 minutes) for G2 (P=0.00001). Furthermore, a higher compliance with behavioral or pharmacological indications was observed in the G1 group, exhibiting lower adherence in only 12 out of 52 cases compared to 14 out of 25 cases in G2 (P=0.0091).
CONCLUSIONS
Telemedicine is a proper solution and an effective tool to manage the therapeutic follow-up of NE and LUTS, ensuring suitable quality standards and reducing social costs, such as the loss of working days and transport costs. The implementation and complete integration of its use into the healthcare system should be the goals to pursue in order to take full advantage of all its potentials.
Topics: Humans; Telemedicine; Child; Retrospective Studies; Male; Female; COVID-19; Nocturnal Enuresis; Lower Urinary Tract Symptoms; Adolescent; Italy; Tertiary Care Centers; Patient Satisfaction
PubMed: 38920014
DOI: 10.23736/S2724-6051.24.05846-4 -
Frontiers in Public Health 2024Promoting wellness as a predictor of sustainable development empowers schools to model healthy behavior. The multiple interactions in real and virtual environments that...
BACKGROUND
Promoting wellness as a predictor of sustainable development empowers schools to model healthy behavior. The multiple interactions in real and virtual environments that today's youth are subjected to force schools to explore effective educational strategies to provide a quality education for students and their families.
PURPOSE
This study examines the relationship between academic procrastination, assessment anxiety, subjective wellbeing, and academic performance.
METHODS
A convenience sample of 322 undergraduate students () was used, and questionnaires were administered to students measuring academic procrastination, cognitive test anxiety, and subjective wellbeing. For the same target group, the level of academic performance was identified using personal reports. The questionnaires were administered between May and June 2023 in an online format. For the data analysis, we applied correlational analysis and path analysis using.
RESULTS
Both test anxiety and academic procrastination negatively correlate with performance and subjective wellbeing, leading to decreased performance and subjective wellbeing. Procrastination correlates positively with test anxiety. Cognitive test anxiety partially mediated the relationship between academic procrastination and subjective wellbeing and fully mediated the relationship between academic procrastination and academic performance. Thus, high procrastination leads to decreased performance and subjective wellbeing both directly and indirectly through increased test anxiety, leading to decreased performance and subjective wellbeing.
SIGNIFICANCE/DISCUSSIONS
As a result of theoretical and practical investigations, it emerges that joint action of educational actors is required in the generation of effective educational strategies for the prevention and control of procrastination and evaluation anxiety, given the fact that both a high level of procrastination as well as assessment anxiety led to the decrease of students' wellbeing, to the registration of low academic performances. In the long term, disruptive behavior (procrastination and anxious behavior) could generate low social and professional performance, which is a research question for a future longitudinal study.
Topics: Humans; Male; Female; Procrastination; Academic Performance; Students; Surveys and Questionnaires; Young Adult; Test Anxiety; Adolescent; Adult; Cognition; Universities; Anxiety
PubMed: 38919925
DOI: 10.3389/fpubh.2024.1336002 -
Frontiers in Public Health 2024Adolescent refugees are particularly vulnerable to mental health problems, as they experience many risk factors associated with their resettlement at crucial stages of... (Randomized Controlled Trial)
Randomized Controlled Trial
Testing the effectiveness of the culturally adapted skills training START NOW to reduce mental health problems in adolescent refugees: study protocol for a randomized controlled trial.
BACKGROUND
Adolescent refugees are particularly vulnerable to mental health problems, as they experience many risk factors associated with their resettlement at crucial stages of their physical and emotional development. However, despite having a greater healthcare needs than others, they face significant barriers to accessing healthcare services. Therefore, this study aims to test the effectiveness of a low-threshold, culturally adapted version of the skills training START NOW - START NOW Adapted - in reducing mental health problems among adolescent refugees.
METHODS
We will recruit 80 adolescent refugees (15-18 years) with symptoms of anxiety and depression or high perceived stress in Northwestern Switzerland. They will be randomly assigned to one of two study groups: an intervention group, receiving START NOW Adapted, and a control group, receiving treatment as usual (TAU). The intervention will last 10 weeks and will consist of one-hour sessions per week provided by a trained facilitator with the same cultural background, in the respective language. Assessments to collect depressive and anxious symptoms, perceived stress, social-ecological resilience, and emotion recognition abilities will be conducted pre-intervention, post-intervention (11 weeks later) and at the 3-month follow-up. Multilevel models will be computed with primary and secondary outcome measures as dependent variables. An effect of at least moderate size will be considered clinically relevant.
DISCUSSION
This randomized controlled trial aims to investigate the effectiveness of a culturally adapted version of START NOW, providing valuable insights to improve current health promotion for adolescent refugees in Switzerland (or rather lack thereof). Ultimately, the effects of START NOW may facilitate integration and promote healthy development while decreasing costs associated with treating migration- or conflict-related trauma.: ClinicalTrials.gov, identifier: NCT06324864.
Topics: Humans; Adolescent; Refugees; Switzerland; Female; Male; Depression; Anxiety; Stress, Psychological; Mental Health; Culturally Competent Care
PubMed: 38919921
DOI: 10.3389/fpubh.2024.1408026 -
Frontiers in Psychology 2024Metacognitive Training (MCT) is widely used and effective in reducing positive symptoms in psychosis. Physical exercise, such as Water Aerobics (WA), improves general...
Efficacy of the combination of water aerobics and metacognitive training on psychological and physical health variables and their relationship with SP1 and SP4 biomarkers in people with psychosis: a study protocol.
BACKGROUND
Metacognitive Training (MCT) is widely used and effective in reducing positive symptoms in psychosis. Physical exercise, such as Water Aerobics (WA), improves general health, quality of life and symptoms as a low impact activity that allows social interactions. Preliminary results suggest a relationship between dopamine and psychotic symptoms, through SP transcription factors, SP1 and SP4 biomarkers. The aims of the project are to evaluate the efficacy of a combined intervention (WA and MCT) for psychosis to improve psychotic symptoms, physical health, and transcription levels of SP biomarkers.
MATERIALS AND METHODS
This is a unicentric randomized controlled trial of three parallel intervention groups: MCT, WA and combined intervention. The estimated sample will be 48 patients with a psychotic spectrum disorder diagnosis. The assessment will be performed at baseline and at 2-months' follow-up. Instruments used in the assessment will include clinical, cognitive, metacognitive, social cognitive and psychosocial variables.
DISCUSSION
This will be the first study investigating the impact of the combination of MCT and WA in psychosis. Moreover, it will be the first study analyzing changes in the transcriptional biomarkers SP1 and SP4 after interventions. The results of this study may have clinical implications contributing to the improvement of treatment selection.
CLINICAL TRIAL REGISTRATION
https://clinicaltrials.gov/, identifier: NCT05455593.
PubMed: 38919799
DOI: 10.3389/fpsyg.2024.1360004 -
Frontiers in Psychology 2024To tackle the global waste crisis, there is an urgent need for decisive and joint action at multiple levels. The collective behavior of a community could make a...
To tackle the global waste crisis, there is an urgent need for decisive and joint action at multiple levels. The collective behavior of a community could make a significant contribution. This paper presents the results of a field experiment designed to promote packaging waste prevention - called precycling - in a newly formed community setting, in Berlin, Germany. The aim was to examine the effect of the intervention on precycling and to examine the underlying social identity processes. Over a four-week period, 132 participants from 96 different households digitally received a combination of different interventions, that were theoretically informed by the Social Identity Model of Pro-Environmental Action (SIMPEA). Households were assigned to two intervention groups and a waiting control group. Data was collected before, immediately after and four months after the intervention to assess the impact of the intervention using multilevel models. After the intervention, the overall precycling behavior increased significantly, but not as a result of the different group conditions. In the more comprehensive intervention group, which included social interaction and behavioral experimentation, the community identification was strengthened and the reuse behavior, as a subset of precycling, increased. While a number of social identity processes (collective efficacy beliefs, having a precycling action goal, crisis appraisal, and sufficiency attitudes) were found to positively predict the precycling behavior, surprisingly, the predictive power of social norms and ingroup identification could not be confirmed. Overall, the presented community intervention promoted precycling. However, in this dynamic real-world setting, not all intervention elements worked as expected. The pitfalls and opportunities of this intervention are discussed, and ideas for translating the results into everyday precycling activities are presented.
PubMed: 38919797
DOI: 10.3389/fpsyg.2024.1340305 -
Geopolitics 2024The contributions in this Forum analyse the Russian war against Ukraine from the micro perspective of everyday life, conveyed by scholars who have been impacted at a...
The contributions in this Forum analyse the Russian war against Ukraine from the micro perspective of everyday life, conveyed by scholars who have been impacted at a variety of personal levels. Framed within the existential threat that continues to endanger Ukrainians and Ukraine, the contributions collected here embrace the messiness of lived experience away from the grand narratives that circulate at global scales. Instead, the authors explore a variety of processes of situated bordering that fracture not just territory, but also families and individual lives. In so doing, they shine light on the people and places where geopolitics takes shape on the ground. Taken together, this collection provides a nuanced and human-scale exploration of one of the most momentous geopolitical events in recent history.
PubMed: 38919735
DOI: 10.1080/14650045.2023.2222936 -
Journal of Asthma and Allergy 2024Oral corticosteroid (OCS) use for asthma is associated with considerable healthcare resource utilization (HCRU) and costs. However, no study has investigated this in...
PURPOSE
Oral corticosteroid (OCS) use for asthma is associated with considerable healthcare resource utilization (HCRU) and costs. However, no study has investigated this in relation to patterns of intermittent OCS prescription.
METHODS
This historical UK cohort study used primary care medical records, linked to Hospital Episode Statistics, from 2008 to 2019, of patients (≥4 years old) with asthma prescribed intermittent OCS. Patients were categorized by OCS prescribing pattern (one-off [single], less frequent [≥90-day gap] and frequent [<90-day gap]) and matched 1:1 (by sex, age and index date) with people never prescribed OCS with/without asthma. HCRU (reported as episodes, except for length of hospital stay [days] and any prescription [records]) and associated costs were compared between intermittent OCS and non-OCS cohorts, and among intermittent OCS prescribing patterns.
RESULTS
Of 149,191 eligible patients, 50.3% had one-off, 27.4% less frequent, and 22.3% frequent intermittent OCS prescribing patterns. Annualized non-respiratory HCRU rates were greater in the intermittent OCS versus non-OCS cohorts for GP visits (5.93 vs 4.70 episodes, p < 0.0001), hospital admissions (0.24 vs 0.16 episodes, p < 0.0001), and length of stay (1.87 vs 1.58 days, p < 0.0001). In the intermittent OCS cohort, rates were highest in the frequent prescribing group for GP visits (7.49 episodes; p < 0.0001 vs one-off), length of stay (2.15 days; p < 0.0001) and any prescription including OCS (25.22 prescriptions; p < 0.0001). Mean per-patient non-respiratory related and all-cause HCRU-related costs were higher with intermittent OCS than no OCS (£3902 vs £2722 and £8623 vs £4929, respectively), as were mean annualized costs (£565 vs £313 and £1526 vs £634, respectively). A dose-response relationship existed; HCRU-related costs were highest in the frequent prescribing cohort (p < 0.0001).
CONCLUSION
Intermittent OCS use and more frequent intermittent OCS prescription patterns were associated with increased HCRU and associated costs. Improved asthma management is needed to reduce reliance on intermittent OCS in primary care.
PubMed: 38919734
DOI: 10.2147/JAA.S452305 -
Frontiers in Oral Health 2024People experiencing homelessness are often marginalised and encounter structural barriers when seeking healthcare. Community-based oral health interventions highlighted...
INTRODUCTION
People experiencing homelessness are often marginalised and encounter structural barriers when seeking healthcare. Community-based oral health interventions highlighted the need of well-trained practitioners for the successful engagement of service users and behaviour change. However, a lack of adequate information and specific training has been previously reported. The adoption of inclusive approaches, such as co-design, to develop tailored and meaningful health promotion training and educational materials capable of addressing the specific needs of this group is required. Co-design entails active involvement of different groups in research processes that acknowledge participants' needs and expectations. This scoping review aims to identify the available literature on the participation of people experiencing homelessness and/or their support workers in co-designing health and oral health promotion training/educational materials, approaches adopted, and barriers and enablers to develop these materials.
METHODS
The Joanna Briggs Institute (JBI) Scoping Review Methodology informed the development of the scoping review. The protocol was registered on the Open Science Framework. Six electronic databases (Medline (OVID), PsychInfo (OVID), Scopus, Web of Science, Applied Social Sciences Index and Abstracts (ASSIA) (ProQuest) and CINHAL) were systematically searched using MeSH terms. An extensive grey literature search, consultation with experts and hand searching of reference lists took place. Records were screened independently and in duplicate using the Rayyan Qatar Computing Research Institute (QCRI) online tool, followed by qualitative content analysis involving descriptive data coding.
RESULTS
Eight studies/materials were included. Key approaches adopted to co-design, enablers and barriers were captured. The enablers were inclusivity, a safe environment for positive participation, empowerment and flexibility, the barriers were difficulty in recruiting and sustaining participation, power differentials, and limited resources.
CONCLUSION
The evidence in this area is limited. This scoping review provided foundations for further research to examine the impact of different components of the co-design process including the environment in which the co-design process is conducted. Further studies with experimental design and reported using appropriate study design frameworks detailing active components of the co-design process would strengthen the evidence base in this area.
PubMed: 38919732
DOI: 10.3389/froh.2024.1355349 -
Ecology and Evolution Jun 2024Maternal monitoring of conspecifics is a crucial anti-predator strategy that also protects infants against risks within the social group. This study examines how...
Maternal monitoring of conspecifics is a crucial anti-predator strategy that also protects infants against risks within the social group. This study examines how maternal characteristics, infant characteristics, mother-infant distance, and the social environment affect maternal monitoring behaviors in free-ranging Tibetan macaques (). We observed 12 females with infants and analyzed their visual monitoring patterns. Our findings indicate that maternal rank significantly influences the time allocated to maternal visual monitoring, higher-ranking mothers spending less time than lower-ranking mothers. Maternal experience also played a role in monitoring strategies. Differences in monitoring strategies were observed based on maternal experience: first-time mothers (primiparity) engaged in longer but less frequent monitoring sessions compared to experienced mothers (multiparity). The time and frequency of maternal monitoring decreased as infants aged, and mothers with male infants showed higher levels of monitoring than those with female infants. The distance between mother and infant also affected visual monitoring behavior, with mothers increasing their monitoring levels when infants were nearby (1-5 m), rather than within reach (0-1 m) or beyond nearby (>5 m). Additionally, the presence of kin and non-kin influenced monitoring: as the number of nearby kin increased, monitoring levels decreased, while the presence of more non-kin males led to an increase in monitoring time, and higher-ranking non-kin neighbors increased the frequency of monitoring. These results suggest that Tibetan macaque mothers can adapt their visual monitoring to the social risks faced by their infants, adjusting their strategies to their status and the needs of their offspring.
PubMed: 38919651
DOI: 10.1002/ece3.11626 -
Frontiers in Psychiatry 2024The present study aimed to investigate age-group-specific incidence rates and risk factors for depressive symptoms in the highest age groups.
PURPOSE
The present study aimed to investigate age-group-specific incidence rates and risk factors for depressive symptoms in the highest age groups.
METHODS
Data were derived from a prospective multicenter cohort study conducted in primary care - the AgeCoDe/AgeQualiDe study. In total, 2,436 patients 75 years and older were followed from baseline to ninth follow-up. To assess depressive symptoms, the short version of the Geriatric Depression Scale (GDS-15, cutoff score 6) was used. Age-specific competing risk regressions were performed to analyze risk factors for incident depressive symptoms in different age groups (75 to 79, 80 to 84, 85+ years), taking into account the accumulated mortality.
RESULTS
The age-specific incidence rate of depression was 33 (95% CI 29-38), 46 (95% CI 40-52) and 63 (95% CI 45-87) per 1,000 person years for the initial age groups 75 to 79, 80 to 84 and 85+ years, respectively. In competing risk regression models, female sex, mobility as well as vision impairment, and subjective cognitive decline (SCD) were found to be risk factors for incident depression for age group 75 to 79, female sex, single/separated marital status, mobility as well as hearing impairment, and SCD for age group 80 to 84, and mobility impairment for age group 85+.
CONCLUSION
Depressive symptoms in latest life are common and the incidence increases with increasing age. Modifiable and differing risk factors across the highest age groups open up the possibility of specifically tailored prevention concepts.
PubMed: 38919640
DOI: 10.3389/fpsyt.2024.1367225