Adekunle Adedeji

Background: Parents of children with achondroplasia experience multidimensional impacts on quality of life (QoL), yet validated condition-specific instruments for assessing these outcomes across countries are scarce. This study evaluated the psychometric properties of the Quality of Life of Parents of Children with Achondroplasia (QOLA) questionnaire in three European settings. Methods: A multinational, multicentre observational psychometric validation study was conducted in Germany, Italy, and Portugal. Parents/primary caregivers ( N = 149) completed the 43-item QOLA (eight conceptual domains) and the EUROHIS-QOL-8 at baseline (T1); a subsample completed follow-up assessments (T2; n = 77) for test–retest analyses. Data quality (missingness, floor/ceiling effects), internal consistency (Cronbach’s α; composite reliability), temporal stability (Pearson correlations; intraclass correlation coefficients), and convergent validity (correlations with EUROHIS-QOL-8) were examined. Exploratory factor analysis informed item reduction and domain aggregation, followed by confirmatory factor analysis of the reduced model. Results: Item-level missingness was minimal, and no substantial floor/ceiling effects were observed. Eight-domain scores showed acceptable to excellent internal consistency (α = 0.706–0.905) and moderate-to-good temporal stability (single-measure ICCs = 0.64–0.75). Convergent validity was supported by negative associations between QOLA domains and generic QoL ( r = .15–0.69). Exploratory and confirmatory analyses supported a parsimonious three-factor, 20-item model, comprising Healthcare System Trust, Caregiving Burden and Daily Impact, and Worries About the Future and Social Relationships, with acceptable fit (CFI = 0.935, TLI = 0.925, RMSEA = 0.066), strong reliability (α = 0.852–0.918; CR = 0.864–0.914), and good test–retest stability ( r = .670–0.782; average-measure ICCs = 0.801–0.877). Conclusions: The QOLA demonstrates robust reliability and validity across three countries and offers both an eight-domain profile and a three-factor summary for assessing parental QoL in achondroplasia.

Background: Parents of children with achondroplasia face sustained caregiving demands that may affect multiple dimensions of well-being. Despite growing recognition of these challenges, no validated, condition-specific instrument exists to assess the quality of life (QoL) of parents of children with achondroplasia. This study aimed to develop, and pilot test the Quality of Life of Parents of Children with Achondroplasia (QOLA) questionnaire. Methods: QOLA was developed using a multi-phase mixed-methods design in accordance with established standards for developing self-reported outcome measures for caregivers and parents. Phase 1 comprised semi-structured qualitative interviews with 17 parents of children with achondroplasia to identify relevant QoL domains and language. Interview data were analysed using qualitative content analysis and informed systematic item generation (Phase 2). Conceptual structure was examined through researcher-led card sorting (Phase 3) and two rounds of international card sorting following translation (Phase 4). The resulting 63-item questionnaire across eight domains was pilot-tested in a cross-sectional, multi-country study with embedded cognitive debriefing in Germany, Italy, and Portugal (total N = 50). Results: The final pilot version of QOLA comprised 63 items across eight domains covering healthcare experiences, challenges and support, physical health, mental health, social life and relationships, coping, family and daily life, and worries and future concerns. Item-level missing data were minimal, and no pronounced floor or ceiling effects were observed. Internal consistency was acceptable to good for domains (α = 0.624–0.821) and good for the total scale (α = 0.798). Inter-domain correlations were generally moderate to strong. Cognitive debriefing was highly acceptable and relevant across countries, with some suggestions for further refinement. Conclusions: QOLA shows strong preliminary evidence of acceptability and internal consistency and addresses a key measurement gap in achondroplasia research. Further large-scale psychometric validation is warranted.

Background: Repeated exposure to microaggressions, subtle and often unintentional forms of discrimination, can undermine the well-being of migrant populations. This study examines the role of psychological capital, comprising hope, self-efficacy, resilience, and optimism, in mediating and moderating the association between perceived microaggressions and health outcomes among migrants in Germany. Methods: In the cross-sectional study, a total of 858 participants with a migration background residing across different federal states in Germany completed a questionnaire assessing sociodemographic factors, rates of perceived microaggression (BMS-9), psychological capital (PCQ-12), and mental (PHQ-9) and physical health (PHQ-15). Structural equation modelling (SEM) using AMOS 29 was conducted to examine whether psychological capital mediates the association between perceived microaggressions and health outcomes. Mediation was tested using bias-corrected bootstrapped confidence intervals, with model fit evaluated through established indices. Results: Psychological capital significantly mediated the association between perceived microaggressions and both mental and physical health outcomes. Higher levels of perceived microaggressions were associated with reduced psychological capital, which in turn negatively affected health outcomes. Psychological capital significantly moderated the association between microaggressions and depressive symptoms, with higher psychological capital intensifying the link between microaggressions and poorer mental health; however, it did not moderate the association between microaggressions and physical health. Conclusion: Perceived microaggressions were linked to poorer mental and physical health among migrants, partly through reduced psychological capital. Although psychological capital supported overall well-being, it did not consistently buffer the health impacts of microaggressions. In practice, this means that programs aimed at strengthening resilience, optimism, and self-efficacy should be combined with institutional measures to reduce discriminatory practices in healthcare, education, and the workplace. Policies that recognise microaggressions and promote inclusive, culturally sensitive environments are essential to improving health outcomes and advancing equity for migrants in Germany.

Background: A significant number of people with a refugee background suffer from depression and may benefit from psychological interventions. Culturally adapted Metacognitive Training for Depression (CA-D-MCT) is a low-threshold and resource-saving group intervention that has not yet been evaluated among refugees with depression.Objective: This study aimed to assess the feasibility, patient acceptance, and initial treatment effects on depression and other secondary outcomes of CA-D-MCT for refugees with depression, potentially presenting with comorbid post-traumatic stress disorder (PTSD).Method: In an uncontrolled feasibility trial, 50 adult refugees with a diagnosis of depression, who spoke Arabic or Farsi, received interpreter-assisted CA-D-MCT. Patients completed module evaluations to assess acceptability. Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9) at baseline (t0), post-treatment (t1) and at three-month follow-up (t2). Secondary outcomes included quality of life, subjective integration and PTSD symptoms.Results: Descriptive analysis showed a high level of acceptability of the intervention. A repeated-measure ANOVA revealed a large effect size associated with improvements in depressive symptoms (η² = .175, p = .010), suggesting a positive treatment effect. Medium effect sizes were observed for subjective integration, quality of life and PTSD symptoms, but differential values were not statistically significant.Conclusions: CA-D-MCT seems to be feasible and well accepted. The findings provide preliminary evidence for a treatment effect of CA-D-MCT. A randomized controlled trial is warranted to further investigate its efficacy.

The study explores the integration challenges of African refugees who fled the war in Ukraine and sought asylum in Germany amid the global refugee crisis. The research delves into language barriers, discriminatory encounters, administrative hurdles, and professional development complexities within the broader context of the war-induced displacement of individuals with a third-state status. Qualitative data were collected through semi-structured, in-depth interviews with five African refugees aged 23–27 in Germany. Analysing the data through qualitative content analysis, four main categories emerged: integration challenges, physical and mental health, quality of life, and factors influencing well-being. The findings highlight multifaceted integration challenges, encompassing language barriers, discrimination, administrative complexities, and professional development difficulties. Participants reported stress from simultaneous language learning and employment, social isolation, and fear of returning home. Although physical health was generally rated as good, mental health challenges arose, linked to the dual burden of integration and professional advancement. Unsatisfactory quality of life stemmed from unmet basic needs, including employment, housing, and travel to visit family. Despite significant challenges, participants displayed resilience and optimism. The study emphasises the need for targeted interventions and support systems tailored to the unique struggles of African refugees from the Ukrainian war in Germany. Policymakers, refugee-support organisations, and community-based groups can use these findings to develop programs enhancing integration and well-being for this population.

Short stature in children aged 0–4 years presents unique physical, social, and emotional challenges that significantly impact health-related quality of life (HRQoL). The QoLISSY 0–4 questionnaire was developed as a Patient Reported Outcome measure (PROMS) to address the absence of an age-specific, condition-focused HRQoL assessment tool for this population. A mixed-method approach was employed to adapt the original QoLISSY questionnaire for children aged 5–18. Qualitative interviews were conducted with 24 parents of children diagnosed with short-stature conditions, including achondroplasia, small for gestational age, growth hormone deficiency, and Silver-Russell Syndrome. Cognitive debriefing sessions and iterative feedback guided the development of new items tailored to the needs of children aged 0–4. Pilot testing involved 20 parents, who evaluated the questionnaire’s clarity, relevance, and comprehensiveness. The development process yielded an 8-domain, 55-item questionnaire addressing physical health, social interactions, emotions, coping mechanisms, medical care, future concerns, and parental impact. Cognitive debriefing results indicated high item clarity (100%), relevance (93%), and importance (94%), with parents confirming that the questionnaire effectively captured their child’s HRQoL experiences. The QoLISSY 0–4 questionnaire provides a tailored, parent-reported tool for assessing HRQoL in children aged 0–4 with short stature. Its development reflects a rigorous, participant-informed process ensuring its relevance and usability. Future validation studies will explore its cross-cultural applicability and psychometric properties to establish its utility in research and clinical settings.

Purpose: Despite significant advances in diabetes understanding and management, it remains a major global public health challenge. This study examines the influence of gender, body mass index (BMI), and lifestyle factors on developing type 2 diabetes (T2D) in the Ukrainian population. By exploring these key risk factors, the study aims to enhance understanding of T2D determinants and contribute to targeted prevention strategies in Ukraine. Methods: This current analysis uses cross-sectional secondary data from 12,092 individuals who visited medical mobile teams (MMTs) in four Ukrainian regions (Lviv, Rivne, Dnipro, and Poltava) between April 6 and August 8, 2023. Multiple logistic regression was employed to explore various risk factors associated with T2D. Results: The results suggest that overweight individuals were 3.02 times more likely to have T2D (Wald (1) = 233.10, p < 0.001, 95% CI: 2.62–3.48), while each unit increase in BMI raised the likelihood by 1.05-fold (Wald (1) = 56.26, p < 0.001). An unhealthy diet increased the risk by 1.29 times (Wald (1) = 13.99, p < 0.001). Women had 1.16 times higher T2D prevalence than men (Wald (1) = 3.93, p <0.05). Sedentary individuals were 16.1% less likely to have T2D (Wald (1) = 8.69, p < 0.01). Conclusion: This study is significant in that self-perceived overweight status was found to be the most important risk factor associated with T2D prevalence. This provides important guidance for organisations seeking to support T2D diagnosis and management efforts in Ukraine and emphasises the need to recognise self-perceived overweight status as an important consideration.

Background: Caring for individuals with a chronic disease imposes a substantial burden on parents, significantly impacting their quality of life. For parents of children with achondroplasia, caregiving has notable implications for coping mechanisms and overall wellbeing. This review summarizes findings on these parents’ coping strategies and quality of life.Methods: A narrative approach was employed to synthesize research on parental outcomes related to caring for a child with achondroplasia. The PRISMA chart flow was utilized to present the article screening strategy and results, following established guidelines for systematic reviews.Results: The review reveals a scarcity of studies examining the impact of caring for a child with achondroplasia on parental outcomes, with only two studies meeting the inclusion criteria. These studies suggest that having a child with achondroplasia significantly affects parental coping and quality of life, indicating substantial emotional and social implications. Additionally, no specific tools or measures to assess outcomes for these parents, highlighting a significant gap in research and resources.Conclusion: The parental experience of caring for a child with achondroplasia involves significant emotional and social challenges. Stressors from emotional distress, social isolation, altered family dynamics, and demanding healthcare interactions underscore the need for robust support systems. Addressing the research gaps requires developing and validating specific measures to assess the outcomes for parents of children with achondroplasia accurately. This will encourage further research and guide the development and evaluation of interventions to improve the coping and QoL of parents of children with achondroplasia.