Improving disease management of patients with inflammatory bowel disease: the potential role of self-concordant health goals.

Inflammatory bowel diseases (IBD) are chronic gastrointestinal conditions that significantly impact patients' quality of life. Previous research indicates that patients with IBD have a higher prevalence of anxiety compared to the general population and other chronic diseases. This pilot study aimed to investigate the relationships between goal integration, positive and negative emotions, goal self-efficacy, and trait anxiety as the outcome variable, focusing on patients' self-management strategies. Drawing from the Self-Concordance Model (SCM) of Self-Determination Theory (SDT), the study explored how goal integration is associated with more fulfilling and enjoyable experiences and fewer negative emotions, ultimately improving psychological well-being. Health-related goals were evaluated using the Personal Project Analysis technique, while the State-Trait Anxiety Inventory was utilized to measure general anxiety levels. Among the 141 participants with inflammatory bowel disease, 96 reported having health-related goals. Of these, 66 were female (68.75%), and 30 were male participants (31.25%). Path analysis revealed a moderate negative association between self-concordance (SC) and negative emotions, which, in turn, predicted higher levels of trait anxiety. Furthermore, the alternative model tested indicated that trait anxiety predicted a lower level of self-concordance. Setting well-integrated health goals involves an internal capacity, enabling patients to experience less negative emotions during self-management activities. Anxiety can hinder individuals from accessing their inner needs, resulting in less self-concordant aspirations and more negative emotions. These findings may contribute to developing prevention and intervention programs to enhance IBD patients' adherence to lifestyle changes, ultimately improving their overall well-being.

[Health goals amongst patients with Crohn's disease.] / Egészséggel kapcsolatos célok Crohn-betegek körében.

INTRODUCTION: Inflammatory bowel diseases, including Crohn's disease, have a significant impact on patients' lifestyle, requiring lifelong attention to health behavior. OBJECTIVE: The aim of our study was to investigate health-related goals, emotions related to health goals, the use of infocommunication tools and their associations. METHOD: 79 patients with Crohn's disease (59.5% female, mean age 40.7 years, SD = 11.89) participated in the study. They answered demographic and health behaviour questions and completed the Personal Health Plans Questionnaire, which assessed their personal health goals, positive and negative emotions about health goal(s), support for personal health goals from their physician, negative and positive effects (barriers/support) of achieving health goals, and digital technology and internet use. RESULTS: 70% of patients had at least 1 health goal. The health goals were classified into four categories: physical activity (43.6%), stress management (25.4%), nutrition (18%) and smoking cessation (7%). 71% of participants experienced at least average levels of positive emotions related to the health goal, but about 50% also experienced negative emotions. 51% of those with a health goal regularly use the internet and apps on smartphones. Infocommunication device use showed a medium-strength correlation with perceived health goal-related barrier/support (ρ = 0.55, p<0.01), support from the person's doctor (ρ = 0.45, p<0.05) and physical activity (ρ = 0.40, p<0.01). DISCUSSION: More than two-thirds of patients had a health goal; most of the goals were related to health behaviours that are also relevant to Crohn's disease, but few had healthy eating and smoking cessation as health goals. Half of those with a health goal regularly use the internet and apps on smartphones. Among health behaviours, physical activity was associated with infocommunication device use. CONCLUSION: It is recommended to investigate patients' health goals and infocommunication device use in the care of patients with Crohn's disease. This would allow the development of specific interventions to improve their health behaviour, which could increase the quality of life and disease prognosis. Orv Hetil. 2023; 164(28): 1102-1110.

Uranium isotopes as a possible tracer of terrestrial authigenic carbonate.

The concentration and isotopic composition of uranium (δ238U, 234U/238U activity ratio) in combination with traditional isotopes (δ18O, δ13C) were examined as potential tracers of authigenic carbonate formation in a karst aquifer. The U concentration and 234U/238U activity ratios in the tufa-precipitating sections of two connected karst rivers (Krka and Zrmanja, Croatia) decreased downstream in water and in precipitated carbonate due to active self-purification processes, i.e. adsorption of isotopically lighter U(VI) on mineral particles, sedimentation and co-precipitation with carbonate. The isotopic composition of carbonate in tufa mostly resembled the 234U/238U activity ratio and the δ238U values of dissolved U in water but was also affected by the presence of detrital carbonate flushed into the river from soil and weathered bedrock. This interpretation was supported by the δ18O and δ13C values of tufa, which were shifted out of equilibrium with river water and dissolved in organic carbon and in their isotopic signature, which showed the presence of lithic carbonate. Large fluctuations of the δ238U values of water, leachable U (eluted in acetic acid buffered with Na-acetate) and residual U fraction could not be fully explained by available data due to the overlapping U isotopic signatures of leachable (mainly carbonate) and residual fractions of soil, bedrock and tufa. Therefore, a long-term, systematic, seasonal and event-based observation of the isotopic composition of dissolved and suspended particulate U in water is necessary. Nevertheless, the U isotopes were found to have the potential to be used as identifiers of authigenic carbonate and the storage of CO2 in terrestrial river sediments, to improve knowledge on fluxes within local and global biogeochemical carbon cycle.

Influence of Particle Size on Compressive Strength of Alkali Activated Refractory Materials.

Influence of particle size on the mechanical strength of alkali activated material from waste refractory monolithic was investigated in this study. Precursor was chemically and mineralogically analysed, separated on 4 fractions and alkali activated with Na-water glass. Alkali activated materials were thoroughly investigated under SEM and XRD to evaluate the not predicted differences in mechanical strength. Influence of curing temperature and time dependence at curing temperatures on mechanical strength were investigated in the sample prepared from a fraction that caused the highest compressive strength.

Potential of Green Ceramics Waste for Alkali Activated Foams.

The aim of the paper is to research the influence of foaming and stabilization agents in the alkali activation process of waste green ceramics for future low cost up-cycling into lightweight porous thermal insulating material. Green waste ceramics, which is used in the present article, is a green body residue (non-successful intermediate-product) in the synthesis of technical ceramics for fuses. This residue was alkali activated with Na-water glass and NaOH in theoretically determined ratio based on data from X-ray fluorescence (XRF) and X-ray powder diffraction (XRD) that was set to maximise mechanical properties and to avoid efflorescence. Prepared mixtures were compared to alkali activated material prepared in theoretically less favourable ratios, and tested on the strength and density. Selected mixtures were further foamed with different foaming agents, that are Na-perborate (s), H2O2 (l), and Al (s), and supported by a stabilization agent, i.e., Na-dodecyl sulphate. The goal of the presented work was to prepare alkali activated foam based on green ceramics with density below 1 kg/l and compressive strength above 1 MPa.

The Potential of Ladle Slag and Electric Arc Furnace Slag use in Synthesizing Alkali Activated Materials; the Influence of Curing on Mechanical Properties.

Alkali activation is studied as a potential technology to produce a group of high performance building materials from industrial residues such as metallurgical slag. Namely, slags containing aluminate and silicate form a useful solid material when activated by an alkaline solution. The alkali-activated (AA) slag-based materials are promising alternative products for civil engineering sector and industrial purposes. In the present study the locally available electric arc furnace steel slag (Slag A) and the ladle furnace basic slag (Slag R) from different metallurgical industries in Slovenia were selected for alkali activation because of promising amorphous Al/Si rich content. Different mixtures of selected precursors were prepared in the Slag A/Slag R ratios 1/0, 3/1, 1/1, 1/3 and 0/1 and further activated with potassium silicate using an activator to slag ratio of 1:2 in order to select the optimal composition with respect to their mechanical properties. Bending strength of investigated samples ranged between 4 and 18 MPa, whereas compressive strength varied between 30 and 60 MPa. The optimal mixture (Slag A/Slag R = 1/1) was further used to study strength development under the influence of different curing temperatures at room temperature (R. T.), and in a heat-chamber at 50, 70 and 90 °C, and the effects of curing time for 1, 3, 7 and 28 days was furthermore studied. The influence of curing time at room temperature on the mechanical strength at an early age was found to be nearly linear. Further, it was shown that specimens cured at 70 °C for 3 days attained almost identical (bending/compressive) strength to those cured at room temperature for 28 days. Additionally, microstructure evaluation of input materials and samples cured under different conditions was performed by means of XRD, FTIR, SEM and mercury intrusion porosimetry (MIP).

Importance of an education programme for patients with chronic widespread pain.

The structured education programme for patients with chronic widespread pain is the first stage of the interdisciplinary group-based rehabilitation programme for those patients at the University Rehabilitation Institute in Ljubljana, Slovenia. The aim of our pilot study was to investigate the impact of the education programme on the patients' attribution of pain as dangerous. Ninety-three participants with chronic widespread pain volunteered for the study. They were first screened to verify whether they were suitable for inclusion in the rehabilitation programme. They filled in the Pain Catastrophizing Scale and the Tampa Scale of Kinesiophobia as part of the screening and after the education programme. The results showed a statistically significantly reduced fear of movement and catastrophizing. Hence, the education programme appears to be achieving its goals.