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PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253087
Miriam S. Johnson ◽  
Nora Skjerdingstad ◽  
Omid V. Ebrahimi ◽  
Asle Hoffart ◽  
Sverre Urnes Johnson

Background In these unpredictable times of the global coronavirus disease 2019 (COVID-19) pandemic, parents worldwide are affected by the stress and strain caused by the physical distancing protocols that have been put in place. Objective In a two‐wave longitudinal survey, we investigated the levels of parental stress and symptoms of anxiety and depression in a sample of parents at two time points; during the implementation of the strictest physical distancing protocols following the onset of the COVID-19 pandemic (T1, N = 2,868) and three months after the discontinuation of the protocols (T2, N = 1,489). Further, we investigated the relationships between parental stress and anxiety and depression relative to relationship quality and anger toward their children at the two aforementioned time points, including subgroups based on age, parental role, cultural background, relationship status, education level, number of children, employment status and pre-existing psychiatric diagnosis. Methods and findings Parents were asked to fill out a set of validated questionnaires on the two measurement points. Parental stress significantly decreased from T1 to T2, indicating that the cumulative stress that parents experienced during the implementation of the distancing protocols declined when the protocols were phased out. The decrease of perceived parental stress was accompanied by a significant decrease in the symptoms of both depression and anxiety among the participating parents. Symptoms meeting the clinical cut-offs for depression (23.0%) and generalized anxiety disorder (23.3%) were reported among participating parents at T1, compared to 16.8% and 13.8% at T2, respectively. The reduction in depression and anger toward their child(ren) from T1 to T2 was associated with a reduction of parental stress. Relationship quality and anger toward their child(ren) at T1 further predicted a change in the level of parental stress from T1 to T2. Conclusions The study underlines the negative psychological impacts of the implementation of the distancing protocols on parents’ health and well-being. Uncovering the nature of how these constructs are associated with parents and families facing a social crisis such as the ongoing pandemic may contribute to the design of relevant interventions to reduce parental distress and strengthen parental coping and resilience.

2021 ◽  
Francesca FILIPPI ◽  
Laura BENAGLIA ◽  
Federica ALAGNA ◽  
Irene LA VECCHIA ◽  
Rossella BIANCARDI ◽  

Abstract Decidualization is the process of endometrial change in pregnancy, a phenomenon that can involve also ovarian endometriomas. However, the frequency of this event remains unknown. In addition, there is no evidence on the decidualization of deep invasive endometriosis (DIE). To shed more light on this issue, we prospectively recruited women with ovarian endometriomas or DIE who underwent IVF. They were subsequently excluded if they did not become pregnant or if they had a miscarriage. The evaluation was repeated in 5 time points during pregnancy and post-partum. The primary outcome was the rate of decidualized endometriomas at 11-13 weeks’ gestation. Data from 45 endometriomas and 15 nodules were available for data analyses. At the 11-13 weeks’ ultrasound, endometriomas’ decidualization was observed in seven cases, corresponding to 16% (95%CI: 8-29%). Subsequent assessments in pregnancy failed to identify any additional case. DIE also underwent significant changes during pregnancy. An increase in mean diameter (at least 50%), an increase in color score or both were documented in seven, eight and five cases, respectively. In conclusion, decidualization of ovarian endometriomas in IVF pregnancies is common. DIE may also undergo decidualization, but further evidence is needed for a robust and shared definition of this process.

Epidemiologia ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 227-242
Paula McFadden ◽  
Ruth D. Neill ◽  
John Moriarty ◽  
Patricia Gillen ◽  
John Mallett ◽  

As the COVID-19 pandemic continues to evolve around the world, it is important to examine its effect on societies and individuals, including health and social care (HSC) professionals. The aim of this study was to compare cross-sectional data collected from HSC staff in the UK at two time points during the COVID-19 pandemic: Phase 1 (May–July 2020) and Phase 2 (November 2020–January 2021). The HSC staff surveyed consisted of nurses, midwives, allied health professionals, social care workers and social workers from across the UK (England, Wales, Scotland, Northern Ireland). Multiple regressions were used to examine the effects of different coping strategies and demographic and work-related variables on participants’ wellbeing and quality of working life to see how and if the predictors changed over time. An additional multiple regression was used to directly examine the effects of time (Phase 1 vs. Phase 2) on the outcome variables. Findings suggested that both wellbeing and quality of working life deteriorated from Phase 1 to Phase 2. The results have the potential to inform interventions for HSC staff during future waves of the COVID-19 pandemic, other infectious outbreaks or even other circumstances putting long-term pressures on HSC systems.

2021 ◽  
pp. 1-9
Birgitta Jakobsson Larsson ◽  
Anneli Ozanne ◽  
Karin Nordin ◽  
Ingela Nygren

Abstract Objective Relatives are often central in caring for patients with amyotrophic lateral sclerosis (ALS), involving considerable physical, emotional, and social challenges. The aim of this study was to describe individual quality of life (iQoL) among relatives of patients with ALS, from diagnosis through disease progression. Method A total of 31 relatives were included. Data collection was performed at five time points: 1–3 months after their relatives had been diagnosed with ALS and every 6 months for 2 years. Quality of life was determined using the Schedule of Evaluation of Individual Quality of Life — Direct Weighting (SEIQoL-DW), emotional distress with the Hospital Anxiety and Depression Scale (HADS), and the illness severity of the patients was determined with the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALS FRS-R). Results The SEIQoL-DW involves participants nominating the important life areas. The most nominated areas were family, friends, health, and leisure. Although most relatives had overall good and stable iQoL, several had scores indicating poor iQoL on some occasions during the disease trajectory. The relatives’ iQoL correlated with emotional well-being and the patient's physical function at different time points. Significant of result Social relations, emotional well-being, and rapid decline in the patient's physical function influence the relatives’ iQoL. Measuring both emotional well-being and iQoL, with a focus on the relatives’ own descriptions of perceived iQoL and those factors contributing to their iQoL during the disease trajectory may improve the possibility of identifying and supporting those relatives with poor iQoL.

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 490
Simon Herger ◽  
Werner Vach ◽  
Anna-Maria Liphardt ◽  
Corina Nüesch ◽  
Christian Egloff ◽  

Purpose: To determine the suitability of selected blood biomarkers of articular cartilage as mechanosensitive markers and to investigate the dose-response relationship between ambulatory load magnitude and marker kinetics in response to load.  Methods: Serum samples were collected from 24 healthy volunteers before and at three time points after a 30-minute walking stress test performed on three test days. In each experimental session, one of three ambulatory loads was applied: 100% body weight (BW); 80%BW; 120%BW. Serum concentrations of COMP, MMP-3, MMP-9, ADAMTS-4, PRG-4, CPII, C2C and IL-6 were assessed using commercial enzyme-linked immunosorbent assays. A two-stage analytical approach was used to determine the suitability of a biomarker by testing the response to the stress test (criterion I) and the dose-response relationship between ambulatory load magnitude and biomarker kinetics (criterion II).  Results. COMP, MMP-3 and IL-6 at all three time points after, MMP-9 at 30 and 60 minutes after, and ADAMTS-4 and CPII at immediately after the stress test showed an average response to load or an inter-individual variation in response to load of up to 25% of pre-test levels. The relation to load magnitude on average or an inter-individual variation in this relationship was up to 8% from load level to load level. There was a positive correlation for the slopes of the change-load relationship between COMP and MMP-3, and a negative correlation for the slopes between COMP, MMP-3 and IL-6 with MMP-9, and COMP with IL6.  Conclusions: COMP, MMP-3, IL-6, MMP-9, and ADAMTS-4 warrant further investigation in the context of articular cartilage mechanosensitivity and its role in joint degeneration and OA. While COMP seems to be able to reflect a rapid response, MMP-3 seems to reflect a slightly longer lasting, but probably also more distinct response. MMP-3 showed also the strongest association with the magnitude of load.

2021 ◽  
Vol 7 (1) ◽  
Jamie M. Zoellner ◽  
Kathleen J. Porter ◽  
Donna-Jean P. Brock ◽  
Emma Mc Kim Mitchell ◽  
Howard Chapman ◽  

Abstract Background The objectives are to: 1) describe engagement processes used to prioritize and address regional comprehensive cancer control needs among a Community-Academic Advisory Board (CAB) in the medically-underserved, rural Appalachian region, and 2) detail longitudinal CAB evaluation findings. Methods This three-year case study (2017–2020) used a convergent parallel, mixed-methods design. The approach was guided by community-based participatory research (CBPR) principles, the Comprehensive Participatory Planning and Evaluation process, and Nine Habits of Successful Comprehensive Cancer Control Coalitions. Meeting artifacts were tracked and evaluated. CAB members completed quantitative surveys at three time points and semi-structured interviews at two time points. Quantitative data were analyzed using analysis of variance tests. Interviews were audio recorded, transcribed, and analyzed via an inductive-deductive process. Results Through 13 meetings, Prevention and Early Detection Action Teams created causal models and prioritized four cancer control needs: human papillomavirus vaccination, tobacco control, colorectal cancer screening, and lung cancer screening. These sub-groups also began advancing into planning and intervention proposal development phases. As rated by 49 involved CAB members, all habits significantly improved from Time 1 to Time 2 (i.e., communication, priority work plans, roles/accountability, shared decision making, value-added collaboration, empowered leadership, diversified funding, trust, satisfaction; all p < .05), and most remained significantly higher at Time 3. CAB members also identified specific challenges (e.g., fully utilizing member expertise), strengths (e.g., diverse membership), and recommendations across habits. Conclusion This project’s equity-based CBPR approach used a CPPE process in conjunction with internal evaluation of cancer coalition best practices to advance CAB efforts to address cancer disparities in rural Appalachia. This approach encouraged CAB buy-in and identified key strengths, weaknesses, and opportunities that will lay the foundation for continued involvement in cancer control projects. These engagement processes may serve as a template for similar coalitions in rural, underserved areas.

Madeline Wollersheim ◽  
Jessica A. Brown ◽  
Karen Hux ◽  
Kelly Knollman-Porter ◽  
Sarah E. Wallace

Purpose Technological supports provide multimodal presentation of text, which may increase understandability of written materials by people with aphasia (PWA). Extant literature reveals that digitized natural speech and synthetic computer-generated speech within these supports are comprehensible by PWA at discrete time points; however, understandability following repeated exposure is unexplored. This pilot study evaluated understanding of, and preference regarding, synthetic and digitized natural speech during and following repeated exposures by PWA. Method This multiple–case-study project included four adults with aphasia. Participants independently completed various listening tasks in a single digitized natural speech condition and one of two synthetic speech conditions across a 2-week period. Participants completed sessions to evaluate maintenance effects and generalization to novel stimuli and an untrained synthetic voice condition 1 week and 1 month following daily practice. Results Study participants demonstrated understandability evident by at- or near-ceiling performance during baseline, practice, and follow-up sessions in the digitized natural condition and one synthetic speech condition. Individuals with mild aphasia achieved relatively consistent performance during independent practice, whereas performance of individuals with moderate aphasia fluctuated in both conditions. All four participants demonstrated variable understanding during generalization and maintenance tasks at follow-up time points. Participants most frequently indicated preference for digitized natural speech over either synthetic speech condition. Conclusions Findings hold important clinical implications when considering feasibility of utilizing these speech forms as compensatory strategies for PWA. Further research is needed to more fully understand the effects of repeated exposure to synthetic speech on comprehension among PWA.

2021 ◽  
pp. emermed-2020-210299
Kate Bradman ◽  
Katherine Stannage ◽  
Sharon O'Brien ◽  
Simon Green ◽  
Natasha Bear ◽  

BackgroundManagement of common childhood spiral tibial fractures, known as toddler’s fractures, has not significantly changed in recent times despite the availability of immobilisation devices known as controlled ankle motion (CAM) boots. We compared standard therapy with these devices on quality-of-life measures.MethodsA prospective randomised controlled trial, comparing immobilisation with an above-knee plaster of Paris cast (AK-POP) with a CAM boot in children aged 1–5 years with proven or suspected toddler’s fractures presenting to a tertiary paediatric ED in Perth, Western Australia, between March 2018 and February 2020. The primary outcome measure was ease of personal care, as assessed by a Care and Comfort Questionnaire (eight questions scored from 0, very easy, to 8, impossible) completed by the caregiver and assessed during three treatment time-points and preintervention and postintervention. Secondary outcome measures included weight-bearing status as well as complications of fracture healing and number of pressure injuries.Results87 patients were randomised (44 CAM boot, median age 2 (IQR 1.5–2.3), 71% men; 43 AK-POP, median age 2 (IQR 1.7–2.8), 80% men), a significant difference in the care and comfort score was demonstrated at all treatment time-points; with the AK-POP group reporting greater personal care needs on assessment on day 2, day 7–10 and 4-week review (all p≤0.001). Weight-bearing status was significantly different at day 7–10 (77.5% CAM vs 53.8% AK-POP, p=0.027). There was no difference in fracture healing or pressure areas between the two treatment groups.ConclusionsImmobilisation of toddler’s fractures in a CAM boot allows faster return to activities of daily living and weight-bearing without any effect on fracture healing.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12618001311246).

2021 ◽  
Vol 13 (1) ◽  
Lynn R Tanner ◽  
Kathy Grinde ◽  
Cristin McCormick

This study describes the feasibility of using the Canadian Occupational Performance Measure (COPM) as a multidisciplinaryoutcome measure for pediatric telerehabilitation (TR). The COPM was administered at monthly time points over four months. A follow-up survey was conducted with the therapists to assess clinical utility of the COPM. Seventy-three percent of the children seen in TR > one month had at least two administrations of the COPM. Eighty percent of therapists agreed or strongly agreed that the COPM was easy to use in a reasonable amount of time, helped identify functional goals, could be used with various children with varied diagnoses, and measured functional change. In 37 children, the median clinical change in performance and satisfaction was two points or greater on the COPM over the episode of TR. The COPM is a feasible measure perceived positively by pediatric therapists for TR use.

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