Loneliness is understood as a painful negative emotion. Since its introduction into the psychiatric literature in 1959, the understanding of loneliness has improved considerably, and is now understood to be a distinct entity to such issues as social isolation, solitude, and depression. However, there is still a lack of consensus on the general definition of loneliness. Similarly, different dimensions of loneliness have been described in the literature. It is understood in terms of either transient versus situational versus chronic loneliness; state versus trait loneliness; and the concept of unidimensional versus multidimensional loneliness. The reported prevalence of loneliness varies considerably in the literature, with evidence from metanalysis suggesting the prevalence of moderate loneliness that ranges from 31 to 100% with a mean of 61%, and that of severe loneliness ranging from 9 to 81%, with a mean prevalence of 35% among the elderly. Loneliness among the elderly is associated with significant adverse mental and physical health outcomes in the form of cardiovascular diseases, stroke, diabetes mellitus, arthritis, depression, anxiety, dementia, and even problematic internet use. Over the years, different instruments [University of California Los Angeles Loneliness Scale (UCLA-LS), De Jong Gierveld Loneliness Scale, Single-Item direct measure of loneliness] have been designed to assess loneliness among the elderly. Some of the interventions suggest that persons experiencing loneliness could benefit from improved social skills, enhanced social support, increased opportunities for social contact, and addressing maladaptive social cognition.
Одиночество — болезненное состояние, сопряженное с отрицательными эмоциями. С момента появления термина в психиатрической литературе в 1959 году понимание одиночества значительно улучшилось. На сегодняшний день его считают самостоятельной нозологической единицей и воспринимают отдельно от социальной изоляции, уединения и депрессии, однако согласованного определения одиночества до сих пор нет. В литературе описаны различные параметры одиночества: разделяют временное или ситуативное одиночество и одиночество хроническое; одиночество может расцениваться как самостоятельное состояние или как проявление другого состояния; также одиночество может восприниматься как концепция, характеризующаяся одним или множеством параметров. Распространенность одиночества, по данным литературы, существенно варьирует: результаты метаанализа свидетельствуют о том, что распространенность умеренно выраженного одиночества составляет от 31% до 100% (при среднем значении 61%), а распространенность тяжелого одиночества — от 9% до 81% (при среднем значении 35% среди пожилых людей). Одиночество у пожилых людей сопряжено со значительными неблагоприятными последствиями для психического и физического здоровья, которые выражаются в виде сердечно-сосудистых заболеваний, инсульта, сахарного диабета, артрита, депрессии, тревоги, деменции и проблем с использованием интернета. За последние годы для оценки одиночества среди пожилых людей были разработаны различные инструменты [Шкала оценки одиночества Калифорнийского университета в Лос-Анджелесе (University of California Los Angeles Loneliness Scale, UCLA-LS), Шкала оценки одиночества де Джонга Гервельда (De Jong Gierveld Loneliness Scale), однокомпонентный инструмент, направленный на непосредственную оценку одиночества]. Некоторые вмешательства, предлагаемые для коррекции состояния лиц, испытывающих одиночество, включают совершенствование социальных навыков, усиление социальной поддержки, расширение возможностей для социальных контактов и устранение дезадаптивного социального познания.

OBJECTIVE: Whether hypoglycaemia increases the risk of other adverse outcomes in diabetes remains controversial, especially for hypoglycaemia episodes not requiring assistance from another person. An objective of the Hypoglycaemia REdefining SOLutions for better liVEs (Hypo-RESOLVE) project was to create and use a dataset of pooled clinical trials in people with type 1 or type 2 diabetes to examine the association of exposure to all hypoglycaemia episodes across the range of severity with incident event outcomes: death, CVD, neuropathy, kidney disease, retinal disorders and depression. We also examined the change in continuous outcomes that occurred following a hypoglycaemia episode: change in eGFR, HbA1c, blood glucose, blood glucose variability and weight.
METHODS: Data from 84 trials with 39,373 participants were pooled. For event outcomes, time-updated Cox regression models adjusted for age, sex, diabetes duration and HbA1c were fitted to assess association between: (1) outcome and cumulative exposure to hypoglycaemia episodes; and (2) outcomes where an acute effect might be expected (i.e. death, acute CVD, retinal disorders) and any hypoglycaemia exposure within the last 10 days. Exposures to any hypoglycaemia episode and to episodes of given severity (levels 1, 2 and 3) were examined. Further adjustment was then made for a wider set of potential confounders. The within-person change in continuous outcomes was also summarised (median of 40.4 weeks for type 1 diabetes and 26 weeks for type 2 diabetes). Analyses were conducted separately by type of diabetes.
RESULTS: The maximally adjusted association analysis for type 1 diabetes found that cumulative exposure to hypoglycaemia episodes of any level was associated with higher risks of neuropathy, kidney disease, retinal disorders and depression, with risk ratios ranging from 1.55 (p=0.002) to 2.81 (p=0.002). Associations of a similar direction were found when level 1 episodes were examined separately but were significant for depression only. For type 2 diabetes cumulative exposure to hypoglycaemia episodes of any level was associated with higher risks of death, acute CVD, kidney disease, retinal disorders and depression, with risk ratios ranging from 2.35 (p<0.0001) to 3.00 (p<0.0001). These associations remained significant when level 1 episodes were examined separately. There was evidence of an association between hypoglycaemia episodes of any kind in the previous 10 days and death, acute CVD and retinal disorders in both type 1 and type 2 diabetes, with rate ratios ranging from 1.32 (p=0.017) to 2.68 (p<0.0001). These associations varied in magnitude and significance when examined separately by hypoglycaemia level. Within the range of hypoglycaemia defined by levels 1, 2 and 3, we could not find any evidence of a threshold at which risk of these consequences suddenly became pronounced.
CONCLUSIONS: These data are consistent with hypoglycaemia being associated with an increased risk of adverse events across several body systems in diabetes. These associations are not confined to severe hypoglycaemia requiring assistance.

UNASSIGNED: Single parenthood is becoming increasingly common in today\'s society for various reasons such as divorce, the death of a spouse, or the choice of parenthood. Regrettably, there seems to be no significant concern among world leaders regarding depression arising from single parenting.
UNASSIGNED: This article aimed to explore the prevalence of depression in single parents, the factors contributing to it, and its effects on their physical and emotional well-being. Additionally, it aims to investigate the long-lasting effects of depression in single parents, effective therapeutic approaches to tackle these issues and offer proactive suggestions for relevant global stakeholders.
UNASSIGNED: A selection of studies was identified through electronic databases such as PubMed, Embase, and PsycINFO databases. The search strategy encompassed terms related to single parenthood, depression, mental health, prevalence, risk factors, and treatment modalities. Included studies comprised of peer-reviewed research articles, systematic reviews, meta-analyses, and observational studies published in English.
UNASSIGNED: Today, there is a growing prevalence of single parenthood due to a range of factors, including divorce, the loss of a partner, and intentional decisions regarding single parenthood. However, this transition comes with challenges, including the risk of developing depression. Depression is a serious mental health condition affecting many individuals worldwide. Raising a child alone increases the likelihood of developing depression for the parent due to the increased burden and responsibilities. Such parents tend to have low self-esteem, suicide/suicide attempts, and so forth and children born by those parents are vulnerable to depression, physical abuse, infections, etc.
UNASSIGNED: Future research should focus on identifying effective interventions for treating depression among single parents and improving the availability of mental health facilities for this vulnerable population, especially in places with a high prevalence of depression. Mental health physicians in collaboration with obstetricians and gynecologists across the globe should offer counseling and mediation services during pre-conception care visits for both single and partnered parents.

Background and Objectives: The coronavirus disease 2019 (COVID-19) preventive measures affected various aspects of people\'s lives, while also representing an important risk factor for people\'s mental health. In the present study, we examined the negative psychological consequences of the preventive measures on people\'s mental health and the protective factors that strengthened their mental health and well-being during the pandemic. Materials and Methods: A study, using a combination of qualitative and quantitative methods based on a Delphi protocol, was conducted with a sample of Slovenian professionals who worked with people from different demographic groups (i.e., children and adolescents, emerging adults, the adult working population, the elderly) during the pandemic. We conducted (i) a qualitative study involving semi-structured interviews with 11 professionals and (ii) a quantitative study where 73 professionals completed a structured online questionnaire. Results: Experts recognized the disruption of informal face-to-face social contacts as the measure with the greatest impact on people\'s lives across all groups studied, the effect being particularly evident in relation to individuals\' development period and socio-demographic characteristics. An individual\'s ability to adapt to change and emotional support provided by family or other close persons contributed significantly to maintaining mental health and well-being during the pandemic. Conclusions: Considering the interplay of various COVID-19-related risk and protective factors for mental health, enabling and promoting the maintenance and development of social relationships (including through alternative pathways) should be a priority aspect of (mental health) intervention for all demographic groups.

Catheter-related infections (CRI) are a serious healthcare problem due to their potential to cause serious complications, including bacteraemia or infective endocarditis, and to increase patient morbidity and mortality. In addition, these in fections significantly prolong hospital stay and cost. Preventing CRI is crucial and is considered a criterion for quality and safety in healthcare. For these reasons, the Spanish Society of Cardiovascular Infections (SEICAV) has considered it pertinent to review this topic, with experts in different areas including clinical microbiologists, infectious disease specialists, surgeons and nurses. The data were presented at a session held at the Ramón Areces Foundation, which was organised in the form of specific questions grouped into three round tables. The first panel analysed the scale of the problem including epidemiological, clinical and diagnostic aspects; the second panel addressed advances in the treatment of CRI; and the third panel reviewed developments in the prevention of CRI. The recorded session is available on the Areces Foundation website and we believe it maybe of interest not only to health professionals, but also to any non-expert citizen interested in the subject.

Introduction Caregivers of individuals with head, neck, and face cancer play a pivotal role in providing support, yet they face distinct challenges. This study aims to explore caregiving experiences and consequences among this population. Methods A multicentric cross-sectional study involving 200 caregivers using a convenience sampling method was conducted in Pune. Caregivers involved in patient care were included in head, neck, and face cancer. The Cancer Caregiving Consequences Inventory (CaTCoN) questionnaire was utilized to assess various dimensions of caregiving. Ethical clearance was obtained from institutional review boards. Results The demographic profile revealed that 89% of caregivers were spouses/partners, primarily females (77%), aged 25-40 (81.5%), and urban dwellers (68.5%). Caregivers were predominantly married or cohabiting (100%) and had children (95%). Most had a graduate-level education (97.5%) and were employed full-time (82.5%). The mean scores from the CaTCoN questionnaire highlighted substantial caregiving responsibilities, with significant associations found in multivariate regression analysis. Spouses/partners showed stronger correlations with increased workload, personal growth challenges, financial difficulties, and the need to maintain an everyday life. Conclusion This study comprehensively explains caregiving consequences among head, neck, and face cancer cases. The predominance of spouses/partners as caregivers emphasizes the need for targeted interventions to address their unique challenges. The study highlights the demanding nature of caregiving, with potential positive outcomes.

UNASSIGNED: A humanitarian crisis means any event or series of events that are harmful to the health or security of the general population. The Niger Republic is currently facing a serious crisis amid the military coup of July 26, 2023. We fear that if nothing is done about it quickly, there could be a civil war in Niger and other neighboring countries.
UNASSIGNED: This present article aims to provide comprehensive knowledge about the ongoing humanitarian crisis in Niger, highlighting the factors that caused it and providing possible solutions for them.
UNASSIGNED: A literature search was conducted on the recent humanitarian crisis caused by the military coup in Niger Republic using databases such as PubMed, ResearchGate, Google Scholar, World Health Organization, United Nations, online newspapers, and reports from 2013 to 2023.
UNASSIGNED: We found that the humanitarian crisis amid the military coup in Niger Republic has further amplified the vulnerability of millions of Nigeriens to more problems in the Niger Republic. The number of Nigeriens in need of humanitarian assistance has reportedly increased by 65%, from 2.3 million in 2019 to 3.8 million in 2021. More than two million children in Niger have been impacted by the crisis in the country and need humanitarian assistance. Furthermore, other causes of the humanitarian crisis in the Niger Republic include sociodemographic factors, climate change, and other natural disasters.
UNASSIGNED: The humanitarian crisis in Niger, caused by different factors such as socioeconomic stagnation, environmental causes, food insecurity, terrorist activities, and internal displacement, is an alarming situation that requires an urgent solution and a response from the international community. There is a need to analyze all the underlying causes of humanitarian crises and find long-lasting solutions for them.

UNASSIGNED: Understanding antecedents and consequences of incivility across higher education is necessary to create and implement strategies that prevent and slow uncivil behaviors.
UNASSIGNED: To identify the nature, extent, and range of research related to antecedents and consequences of incivility in higher education.
UNASSIGNED: 1) To identify disciplines and programs sampled in higher education incivility research, and 2) to compare antecedents and consequences examined in nursing education research with other disciplines and programs in higher education.
UNASSIGNED: A scoping review of the literature.
UNASSIGNED: Eight electronic databases searched in January 2023 including MEDLINE Ovid, CINAHL, ERIC, PsycINFO, Scopus, ProQuest Education Database, Education Research Complete, and ProQuest Dissertations and Theses Global.
UNASSIGNED: We included primary research articles examining antecedents or consequences of incivility in higher education. Two reviewers independently screened and determined inclusion of each study. Data extraction was completed. We employed a numerical descriptive summary to analyze the range of data and content analysis to categorize the antecedents and consequences of incivility in higher education.
UNASSIGNED: Database searches yielded 6678 unique articles. One hundred and nineteen studies published between 2003 and 2023 met the inclusion criteria, of which, 65 reported research in nursing education, and 54 in other programs and disciplines. A total of 91 antecedents and 50 consequences of incivility in higher education were reported. Stress (n = 12 nursing, n = 4 other programs), faculty incivility (n = 9 nursing, n = 5 other programs), and student incivility (n = 4 nursing, n = 5 other programs) were reported as antecedents of incivility in higher education. Physiological and psychological negative outcomes (n = 25 nursing, n = 12 other programs), stress (n = 6 nursing, n = 6 other programs), and faculty job satisfaction (n = 3 nursing, n = 2 other programs) were reported as consequences of incivility in higher education.
UNASSIGNED: Supporting development of teaching practices and role modeling of civility by faculty is a crucial element to slowing the frequency of uncivil interactions between faculty and students. Specific strategies that target stress, such as, cognitive behavioral therapy, coping skills, and social support could mitigate incivility in higher education. Future research needs to examine the strength of the negative effects of incivility on physiological and psychological outcomes through advanced statistical methods, as well as the cumulative effects of uncivil behavior on these outcomes over time for both students and faculty. Application of advanced statistical methods can also support our understanding of sources of incivility as well as the accuracy of causal connections between its antecedents and consequences.

UNASSIGNED: Anastomotic leaks (ALs) are a significant and feared postoperative complication, with incidence of up to 30% despite advances in surgical techniques. With implications such as additional interventions, prolonged hospital stays, and hospital readmission, ALs have important impacts at the level of individual patients and healthcare providers, as well as healthcare systems as a whole. Challenges in developing unified definitions and grading systems for leaks have proved problematic, despite acknowledgement that colorectal AL is a critical issue in intestinal surgery with serious consequences. The aim of this study was to construct a narrative review of literature surrounding definitions and grading systems for ALs, and consequences of this postoperative complication.
UNASSIGNED: A literature review was conducted by examining databases including PubMed, Web of Science, OVID Embase, Google Scholar, and Cochrane library databases. Searches were performed with the following keywords: anastomosis, anastomotic leak, colorectal, surgery, grading system, complications, risk factors, and consequences. Publications that were retrieved underwent further assessment to ensure other relevant publications were identified and included.
UNASSIGNED: A universally accepted definition and grading system for ALs continues to be lacking, leading to variability in reported incidence in the literature. Additional factors add to variability in estimates, including differences in the anastomotic site and institutional/individual differences in operative technique. Various groups have worked to publish guidelines for defining and grading AL, with the International Study Group of Rectal Cancer (ISGRC/ISREC) definition the current most recommended universal definition for colorectal AL. The burden of AL on patients, healthcare providers, and hospitals is well documented in evidence from leak consequences, such as increased morbidity and mortality, higher reoperation rates, and increased readmission rates, among others.
UNASSIGNED: Colorectal AL remains a significant challenge in intestinal surgery, despite medical advancements. Understanding the progress made in defining and grading leaks, as well as the range of negative outcomes that arise from AL, is crucial in improving patient care, reduce surgical mortality, and drive further advancements in earlier detection and treatment of AL.

OBJECTIVE: This research aims to provide an overview of the consequences of undiagnosed nonadherence (noninitiation, suboptimal implementation, nonpersistence) in randomized clinical trials (RCTs).
METHODS: This research was conducted by combining a literature review and qualitative semistructured interviews with key opinion leaders. Based on this groundwork, the consequences of undiagnosed nonadherence in RCTs were summarized and reported in a figure. This study focused on phases II, III and post-marketing in ambulatory settings across a variety of therapeutic areas and indications.
RESULTS: Various consequences of nonadherence in RCTs were investigated. In phase II, drug efficacy may be underestimated, variability in the outcomes may be high and a distorted picture of side effects could be reported, resulting in an uncertain impression of the investigational product\'s profile and complicating decision-making. The sponsor may need to increase the sample size of the upcoming phase III study to improve its power, representing additional costs, or even terminate the study. In phase III, similar phenomena may be observed, making demonstration of efficacy to the regulatory bodies more difficult. Lastly, after commercialization, a distortion in pharmacometrics may occur: the drug may underperform, prescriptions may be refilled less often than expected or extra expenses may be incurred by the payers. This can result in post-marketing dose reduction, new competitors coming into the market and, eventually, product withdrawal.
CONCLUSIONS: This research highlighted the many potential adverse consequences of undiagnosed nonadherence in RCTs, including additional costs. Collecting accurate data appeared to be crucial for decision-making throughout the drug development process.