Being honest with causal language in writing for publication

The misleading use of causal language in publication is problematic for authors, reviewers and consumers of the information. Published research in quality journals has important knowledge implications and it is, therefore, contingent on authors to use language that is accurate and appropriate to their work. Language implying unsupported causal relationships may overstate the evidence-base, especially if accepted by uncritical readers or unwitting members of the general public who may not understand how to interpret inferential statistics

Exploratory factor analysis and principal component analysis in clinical studies: Which one should you use?

Factor analysis covers a range of multivariate methods used to explain how underlying factors influence a set of observed variables. When research aims to identify these underlying factors, exploratory factor analysis (EFA) is used. In contrast, when the aim is to test whether a set of observed variables represents the underlying factors, in accordance with an existing conceptual basis, confirmatory factor analysis is performed. EFA has many similarities with a commonly used data reduction technique called principal component analysis (PCA). These similarities, along with using the related terms factor and component interchangeably, contribute to confusion in analysis. The difficulty in identifying the appropriate use of statistical methods and their application and interpretation impacts clinical and research implications (Beavers et al., 2013; Tabachnick & Fidell, 2001). We acknowledge previous articles in nursing journals offering guidance on the use of factor analysis (Gaskin & Happell, 2014; Watson & Thompson, 2006)

Using risk and odds ratios to assess effect size for meta-analysis outcome measures

Best practice is built on the principle of aggregating all available evidence on a topic to make a clinical decision on the most appropriate intervention for the situation at hand. Systematic reviews and meta-analyses are powerful tools that summarize the evidence for current best practice guidelines for the available interventions for a particular problem (Moher, Liberati, Tetzlaff, & Altman, 2009). Meta-analysis combines the results of multiple studies to produce an aggregated and more precise estimates of the benefits of the interventions. Meta-analysis of high-quality randomized trials is considered the highest level of evidence to inform practice

#Stressed: Covid-19, Chronic Illness and Technostress

The use of online resources, particularly search engines and social media, for health-related information is on a steady upward trajectory. With its accessibility and ease of use, the Internet has founded a new era of information gathering and society has naturally gravitated towards the use of internet-based resources to find out more about all aspects of our own health (West et al., 2020). This has had rather unsurprising results for the way in which consumers engage with their health and with healthcare professionals, with many consumers armed and ready with some level of online-sourced health information prior to engaging with their local GP or specialist. The COVID-19 pandemic, with its sudden onset and widespread ramifications, gave many people yet another reason to pick up their smartphones and utilise online health resources to understand something that came to affect almost every person in one way or another, and became a pervasive part of our everyday lives. Indeed, with COVID-19 necessitating a reduced amount of travel and face to face contact with healthcare professionals, online platforms have become an essential way of accessing this information. However, research assessing knowledge and perceptions of COVID-19 among the general public indicates that participants have been prone to believe some misconceptions and falsehoods circulated particularly on social media (Geldsetzer, 2020). Ready access to a large amount of information about COVID-19 on social media coupled with its problematic use, including misinformation, has contributed to high levels of stress and cognitive symptoms called ‘technostress’. Brod (1984) originally defined ‘technostress’ as the inability to adapt to computer technology in a healthy way. Tarafdar et al. (2011) describe five technostress conditions: namely techno-overload, where users cannot determine whether the information is useful or not; techno-invasion, where technology users never feel free from technology; techno-complexity, where users experience feelings of incompetency and powerlessness from an inability to learn or deal with technology; techno-insecurity, marked by feelings of anxiety about using technology; and techno-uncertainty, where constant changes in technology cause stress to the user. While patients with health conditions require timely access to healthcare information, they often use information technology, including social media, to access such information. Subsequently, patients with chronic illnesses, who have a higher-than-average need for health information, may be exposed to information that is incomplete, conflicting, misleading, or inaccurate. This may place patients at increased risk of technostress. Couple this with an increased urgency in accessing online health information to stay abreast of COVID-19 information and there is an increased risk for technostress amongst an already vulnerable group, and scope for this technostress to tip over into the realm of physical and mental health impact. What needs to be understood is the extent to which technostress, exacerbated by COVID-19 information-seeking and coupled with chronic illness, manifests as a mental health challenge for those experiencing this. If the need for information draws those with a chronic illness further into the use of media platforms that can, in turn, trigger technostress, how can we identify and manage the potential mental health impacts of this illness-stress combination? Additionally, is this group more likely to experience technostress and ensuing physical and mental health impacts as a consequence of their chronic illnesses during the COVID-19 pandemic? With these questions in mind the authors undertook research into this area of crossover between chronic illness and technostres

Health facility readiness to provide antenatal care (ANC) and non-communicable disease (NCD) services in Nepal and Bangladesh: Analysis of facility-based surveys.

BackgroundAntenatal care (ANC) visits provide an important opportunity for diagnostic, preventive, and curative services for non-communicable diseases (NCDs) during pregnancy. There is an identified need for an integrated, system-wide approach to provide both ANC and NCD services to improve maternal and child health outcomes in the short and long term.ObjectiveThis study assessed the readiness of health facilities to provide ANC and NCD services in Nepal and Bangladesh, identified as low-and middle-income countries.MethodThe study used data from national health facility surveys in Nepal (n = 1565) and Bangladesh (n = 512) assessing recent service provision under the Demographic and Health Survey programs. Using the WHO's service availability and readiness assessment framework, the service readiness index was calculated across four domains: staff and guidelines, equipment, diagnostic, and medicines and commodities. Availability and readiness are presented as frequency and percentages, while factors associated with readiness were examined using binary logistic regression.ResultsOf the facilities, 71% in Nepal, and 34% in Bangladesh reported offering both ANC and NCD services. The proportion of facilities which showed readiness for providing ANC and NCD services was 24% in Nepal and 16% in Bangladesh. Gaps in readiness were observed in the availability of trained staff, guidelines, basic equipment, diagnostics, and medicines. Facilities managed by the private sector or a Non-Governmental Organization, located in an urban area, with management systems to support the delivery of quality services were positively associated with readiness to provide both ANC and NCD services.ConclusionThere is a need to strengthen the health workforce by ensuring skilled personnel, having policy, guidelines and standards, and that diagnostics, medicines, and commodities are available/provided in health facilities. Management and administrative systems are also required, including supervision and staff training, to enable health services to provide integrated care at an acceptable level of quality

Burnout, compassion fatigue, and resilience among healthcare professionals

Healthcare professionals face numerous challenges and multiple stressors in their practice – such as time constraints, inadequate support, and exposure to trauma, morbidity, and mortality. Such stressors seem to be worsening, particularly in an environment of international pandemic, and few healthcare environments can be consistently described as predictable, well-funded, and calm. Consequently, the importance of protecting staff against burnout and building workplace resilience has received increasing attention. Healthcare professionals commonly work with limited resources and inadequate support, impeding their capacity to deliver the care they aspire to provide. This can culminate in burnout, secondary traumatic stress, and compassion fatigue, a state that is uncommon among the general population but all too common in healthcare professionals

The homeless and their animal companions : an integrative review

Research indicates a strong bond between those who are homeless and their companion animals. This relationship provides a number of benefits to the homeless person as well as to the animal, including safety, responsibility and improved emotional and mental health. However, the relationship can also add challenges, including decreased access to accommodation, decreased effort to find shelter as a consequence, and emotional vulnerability relating to fear of losing their companion pet. This integrative review examined the benefits and challenges of companion animals for the homeless to determine the consistency of findings to aid better service delivery to the homeless population

Prevalence and factors associated with depression, anxiety, and stress symptoms among older adults: A cross-sectional population-based study

Despite population aging and the increase in mental health problems, studies on the mental health of older people in developing countries are lacking. This population-based cross-sectional study estimated the prevalence and associated factors for depression, anxiety and stress symptoms among older adults in Nepal. Community-dwelling older adults (N = 794) were interviewed using a questionnaire which consisted of the 21-item Depression Anxiety Stress Scales; and a wide range of sociodemographic, health-related, and lifestyle characteristics; functional ability, social support, participation in social activities, and adverse life events. The prevalence of symptoms was 15.4% for depression, 18.1% for anxiety, and 12.1% for stress. Risk factors for symptoms included female gender, working in agriculture, lower household wealth, perceived poor health, smoking, chronic conditions, migration of adult children, and exposure to adverse life events. Receiving an allowance, physical exercise, functional ability, social support, and participation in social activities were found to have protective effects. The findings indicate the need for community-based interventions, including appropriate diagnosis and treatment of mental health conditions, and mental health promotion programs targeting the risk and protective factors

Migration of adult children and quality of life of older parents left-behind in Nepal

Aim: Studies regarding the impact of adult children's migration on older parents left-behind have focused on physical and mental health. This study assessed the relationship between migration of adult children and quality of life (QOL) of older parents left-behind in Nepal. Methods: A cross-sectional community-based survey was carried out (May–July 2019) among 791 randomly selected older adults aged ≥60 years. QOL was measured using the World Health Organization Quality of Life-abbreviated scale, and migration status was assessed into three categories: no migration, internal migration only and any international migration. A range of sociodemographic characteristics were measured for adjustment. Associations between migration of children and each domain of the QOL were examined by multilevel mixed regression. Results: Scores for QOL were; 58.8 ± 19.8 for physical, 63.7 ± 18.0 for psychological, 60.7 ± 16.2 for social, and 61.8 ± 15.0 for environmental domains. This study identified positive and null associations between the migration of children and QOL for parents, with higher scores for physical (b = 5.16, P = 0.017) and environmental (b = 3.19, P = 0.046) domains among left-behind parents whose children migrated internally compared with parents whose children did not migrate. Conclusions: The findings differ from previous research showing poorer QOL among left-behind older parents. Migration plays a significant role in shaping physical and environmental QOL among left-behind parents living in rural areas with important implications for migrants, their families, researchers and social scientists. Geriatr Gerontol Int 2020; 20: 1061–1066

Internet addiction and sleep quality among adolescents in a peri-urban setting in Nepal: A cross-sectional school-based survey.

BackgroundExcessive use of the internet among adolescents often led to later bedtimes and poor sleep quality. This study assessed the relationship between internet addiction and sleep quality among adolescents in a peri-urban setting in Nepal.MethodThis cross-sectional study employed a questionnaire survey among 390 adolescent students recruited from two schools in Kirtipur Municipality in Nepal. The Internet Addiction Test and the Pittsburgh Sleep Quality Index were used to assess internet addiction and poor sleep quality respectively. The association between internet addiction and sleep quality was analysed by logistic regression.ResultsOne-fifth (21.5%) of the participants were identified with borderline internet addiction and 13.3% with possible internet addiction. Poor sleep quality was found among 31% of the participants. Internet addiction was significantly associated with poor sleep quality (OR = 1.85, p = 0.022 for borderline, and OR = 3.98, p = ConclusionAdolescents with internet addiction were more vulnerable to suffer from poor sleep quality. It is recommended that municipalities and schools should aware the adolescent students on the adverse effects of excessive internet use including poor sleep quality. The findings have implications for adolescents, parents, school authorities and researchers