Ecological Momentary Assessment of Social Interactions: Associations With Depression,Anxiety, Pain,and Fatigue in Individuals With Mild Stroke

ObjectivesTo examine real-time relationships between social interactions and poststroke mood and somatic symptoms in participants’ daily environments.DesignProspective observational study using smartphone-based ecological momentary assessment (EMA) surveys 5 times a day for 2 weeks. Multilevel models were used to analyze data for concurrent and lagged associations.SettingCommunity.ParticipantsAdults (N=48) with mild stroke.InterventionsNot applicable.Main Outcome MeasuresEMA measures of self-appraisal of social interactions (confidence, satisfaction, and success), as well as mood (depression and anxiety) and somatic (pain and fatigue) symptoms.ResultsIn concurrent associations, increased depressed mood was associated with reduced ratings of all aspects of social interactions. Fatigue was associated with reduced ratings of social satisfaction and success. In lagged associations, increased anxious mood preceded increased subsequent social confidence. Higher average social satisfaction, confidence, and success were related to lower momentary fatigue, anxious mood, and depressed mood at the next time point. Regarding clinicodemographic factors, being employed was concurrently related to increased social interactions. An increased number of comorbidities predicted higher somatic, but not mood, symptoms at the next time point.ConclusionsThis study provides preliminary evidence of dynamic relationships between social interactions and somatic and mood symptoms in individuals with mild stroke. Interventions to not only address the sequelae of symptoms, but also to promote participation in social activities in poststroke life should be explored.     

From political to personal violence: Links between conflict and non-partner physical violence in post-conflict Liberia

ABSTRACT

War and interpersonal violence together account for a large burden on global health. Yet very few studies look at the relationship between these types of aggression. Non-partner physical violence (NPPV) is an often-understudied form of gender-based violence (GBV). This analysis draws on two datasets from one conflict-affected country, Liberia, to evaluate the impact of conflict on NPPV post-conflict. The Armed Conflict Location and Event Dataset (ACLED) measures the intensity of the conflict in Liberia from 1999-2003, while the Demographic and Heath Survey (DHS) data measure women's experiences with violence four years post-conflict. Almost half of women surveyed (45%) indicated that they experienced any kind of NPPV, highlighting the widespread nature of this issue. A multilevel modelling approach was used to account for the nesting of individuals within districts. Women living in districts that experienced conflict events in four or five years were almost three times as likely (aOR 2.93, p?<?.001) to experience past-year NPPV compared to individuals living in no conflict districts. Findings from this study suggest women residing in a conflict event-affected district may be at heightened risk of increased violence even years after peace is declared.     

Histoire et fonctions des Unités pour Malades Difficiles (1re partie). Du quartier de sûreté à l’Unité pour Malades Difficiles de Villejuif,plus d’un siècle de prise en charge

This article is the first in a series of three, dedicated to the history and functions of what is known as a UMD in France: Unités pour Malades Difficiles, or “Units for Difficult Patients”. This particular article focuses on the oldest such secure structure, UMD Henri Colin, created in 1910 in Villejuif as a quartier de sûreté, or a “secure ward”. The article aims to detail evolutions in treatment and the types of patient treated over more than one hundred years, parallel to social change. Four distinct chronological periods are examined, for their perspective on professional practice as much as for the reasons given for patients’ admission and the psychopathological profiles of “dangerous” patients. Clinical vignettes are used to illustrate this historical evolution.