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We introduce and study the bounded word problem and the precise word problem for groups given by means of generators and defining relations. For example, for every finitely presented group, the bounded word problem is in

State agencies set up to manage the agricultural properties of the State Treasury, in subsequent years of their operation, have been implementing programs that are also intended to improve the social and living situation of the inhabitants of former state-owned farm villages. Such measures include non-refundable financial support distributed by the National Support Centre for Agriculture (NSCA). The research aimed to assess whether non-refundable financial aid improves the quality of life of local communities living in rural areas, particularly in former state-owned farm areas identified as problem areas. Another objective aspect of the research was to indicate the importance of this assistance in the opinion of the beneficiaries of this form of support (district authorities) and local communities. Improvement of the quality of life of rural inhabitants and support for the development of rural areas by local governments can be achieved by taking advantage of potential development factors and opportunities emerging in the environment and by being able to establish effective cooperation with various institutions. For local development to proceed smoothly, especially in rural areas, various institutions and economic players need to reach a consensus, become involved, and work together efficiently. A possible instrument to achieve this is the non-repayable financial support distributed by the National Support Centre for Agriculture (NSCA), which-according to the research-brings measurable effects.

Aims/hypothesis We wanted to identify a five-item short form of the Problem Areas in Diabetes Scale and a single-item measure for rapid screening of diabetes-related emotional distress. Methods Using an existing database of 1,153 patients with diabetes, we conducted a principal-components analysis to identify a set of five items and then conducted a reliability analysis and validity checks. From those five items, we identified the item with the strongest psychometric properties as a one-item screening tool. Results We identified a reliable and valid short version of the Problem Areas in Diabetes Scale (PAID) comprising five of the emotional-distress questions of the full PAID items (PAID-5, with items 3, 6, 12, 16, 19). The PAID-5 has satisfactory sensitivity (94%) and specificity (89%) for recognition of diabetes-related emotional distress. We also identified a one-item screening tool, the PAID-1 (Question 12: Worrying about the future and the possibility of serious complications), which has concurrent sensitivity and specificity of about 80% for the recognition of diabetes-related emotional distress. Conclusions/interpretation The PAID-5 and PAID-1 appear to be psychometrically robust short-form measures of diabetes-related emotional distress.

Aims/hypothesisThe absence of data on the direct association between diabetes-specific distress and all-cause mortality in individuals with diabetes prompted us to examine the temporal association between Problem Areas in Diabetes (PAID) survey scores and the subsequent risk of all-cause mortality in a cohort of individuals with type 2 diabetes.MethodsLongitudinal data from 3305 individuals with diabetes were obtained from a large Japanese diabetes registry. Independent correlations between quintiles of PAID total scores or PAID scores of ≥40 and all-cause mortality (median follow-up of 6.1 years) were examined using Cox proportional hazards models with adjustment for potential confounders.ResultsThe study population included 1280 women and 2025 men with a mean age of 64.9 years, BMI of 24.6 kg/m2 and HbA1c level of 58.7 mmol/mol (7.5%). In the multivariable-adjusted model, compared with the first quintile of PAID scores, the multivariable-adjusted HRs (95% CIs) for all-cause mortality for the second to fifth quintiles were 1.11 (0.77, 1.60; p = 0.56), 0.87 (0.56, 1.35; p = 0.524), 0.95 (0.63, 1.46; p = 0.802) and 1.60 (1.09, 2.36; p = 0.016), respectively. Compared with a PAID score of <40, the multivariable-adjusted HR for all-cause mortality of those with a score of ≥10 was 1.56 (95% CI 1.17, 2.08; p = 0.002). In subgroup analyses, the association between PAID score and all-cause mortality was found in men (HR 1.76; 95% CI 1.26, 2.46) but not in women (HR 1.09; 95% CI 0.60, 2.00), with a significant interaction between diabetes distress and sex (p = 0.0336).Conclusions/interpretationWe observed a significant positive association between high diabetes distress and all-cause mortality in men with diabetes.

Objective. Management of type 1 diabetes (T1DM) is quite challenging for both adolescents and their families. In this study, we aimed to translate the 14-item Problem Areas in Diabetes-Teen (PAID-T) scale, which measures variables that influence diabetes distress, to Turkish and investigate the Turkish version’s reliability and validity. Methods. One hundred and ninety-four adolescents with T1DM participated in the study. PAID-T and forms for sociodemographic and diabetes characteristics were used for data collection. The scale’s content validity was checked using the Davis technique. Cronbach’s α was used to analyze the scale’s internal reliability and the test-retest for the scale’s reliability. Exploratory factor analysis (EFA) was utilized to examine the factor structure. The fit of the scale was assessed using confirmatory factor analysis (CFA). Results. Of the participants, 54.6% (n=106) were girls. The content validity index values of the scale items ranged between 0.86 and 1.0. The PAID-T scores of girls and boys were similar. No significant difference was found between PAID-T scores with sociodemographic data and diabetes characteristics (p>0.05). The test-retest correlation coefficient of the scale was found to be 0.952. The three-factor (emotional burden, family and friend distress, and regimen-specific distress) model identified in EFA explained 61.8% of the common variance. Fit analysis was performed using CFA for the three-factor model, which did not show adequate fit (x2/df = 2.402, GFI = 0.822, CFI = 0.815, NFI = 0.727, NNFI = 0.772, RMSEA = 0.118). The Cronbach α value of the scale was 0.864. Conclusion. The Turkish version of the 14-item PAID-T showed moderate validity and strong reliability. Accordingly, it can be used as a reliable measurement tool to assess diabetes stress in adolescents with T1DM.

Background High prevalence rates in diabetes-related distress have been observed in several studies; however, in the region of Sub-Saharan Africa evidence is lacking as is, for example, the case for Rwanda, where diabetes prevalence is expected to increase over the next decade. The aim of this study is to report on the translation and cultural adaption of the problem areas in diabetes (PAID) questionnaire into Kinyarwanda and its psychometric properties. Methods The questionnaire was translated following a standard procedure. Interviews were conducted with 29 participants before producing a final version. For the psychometric evaluation, a sample of 266 patients with diabetes mellitus, aged 21–64 years old were examined. Participants either came from a separate cluster-randomised controlled trial or were recruited ad-hoc for this study. The evaluation included testing internal consistency, known groups validity, and construct validity. A series of confirmatory factor analysis were conducted investigating seven previously established factorial structures. An exploratory factor analysis (EFA) was also carried out to examine the structure further. Results The full scale showed good internal reliability (Cronbach’s α = 0.88). A four-factor solution previously tested in Spain with subdimensions of emotional, treatment, food-related and social-support problems demonstrated adequate approximate fit (RMSEA = 0.056; CFI = 0.951; TLI = 0.943). The EFA revealed a four-factor structure; however, two of these factors were not as homogeneous and easily interpretable as those of the Spanish model. Conclusions The psychometric properties of the Kinyarwanda version of PAID are acceptable. The questionnaire can be helpful in research and clinical practice in Rwanda, however certain cross-cultural differences should be taken into account.

The COVID-19 pandemic and subsequent governmental restrictions have had a major impact on the daily lives of Austrians and negatively affected their mental health. A representative sample of N = 1505 individuals was recruited via Qualtrics® to participate in an online survey between 23 December 2020 and 4 January 2021. A qualitative study design was used to determine the problem areas that emerged since the beginning of the pandemic (question 1), the factors that were the source of the greatest current concern (question 2), the biggest worries when thinking about the future (question 3), and what the most important source of support (question 4) during the pandemic was. The written responses were analyzed using conventional content analysis following a framework for qualitative research and reported in the form of descriptive statistics. Restrictions imposed by the government, sociopolitical developments, work- and health-related issues, and economic disruptions were identified as being the greatest concerns. Conversely, social contacts within and outside the family were the most important source of support, followed by recreational activities and distraction. Greater consideration should be given to psychosocial factors in future decisions to contain the pandemic. More detailed qualitative research, in particular, to collect the personal experience of more vulnerable groups such as young people, women, and the unemployed, is needed.

Diabetes is a highly prevalent metabolic disease worldwide. In Taiwan, healthcare services emphasize self-management strategies and interventions focusing on self-care. However, there is a lack of literature on diabetes distress (DD). Therefore, this study aims to explore the relationship between demographic characteristics, diabetes knowledge, and diabetes self-care behaviors with diabetes distress among Type 2 diabetes mellitus (T2DM) patients and identify predictive factors. This study employs a cross-sectional survey, targeting T2DM patients from the internal medicine outpatient clinic of a regional hospital in eastern Taiwan. Participants were recruited through purposive sampling from April 11, 2023, to May 16, 2023. The study examines the correlation between diabetes knowledge, diabetes self-care behaviors, and diabetes distress, as well as other influencing factors. The data analysis methods include (1) differences in diabetes knowledge, diabetes self-care behaviors, and diabetes distress scores, analyzed using -tests or ANOVA, (2) Scheffe's tests for significant differences identified by ANOVA to locate group differences in means, and (3) multiple regression analysis to identify key predictive factors of diabetes distress. The findings reveal that both diabetes knowledge (β=-0.046, p=0.029) and diabetes self-care behaviors (β=-0.186, p=0.006) significantly predict diabetes distress. Additionally, gender (β=0.251, p=0.004), family history of diabetes (β=0.213, p=0.017), and diabetes complications (β=0.228, p=0.018) are significant predictors of diabetes distress. The overall -test reached significance (F=7.61, p<0.001), and the explanatory power of the regression model (R²=0.17) is statistically significant, indicating that diabetes knowledge, diabetes self-care behaviors, gender, family history of diabetes, and diabetes complications are important predictors of diabetes distress in T2DM patients. These findings can provide valuable insights for clinicians in identifying risk factors for diabetes distress and understanding the factors that influence diabetes distress in T2DM patients. It is crucial to integrate the assessment and management of diabetes distress into routine diabetes care and even implement distress screening during the health promotion stage. Strengthening the ability of healthcare professionals to identify diabetes distress through early detection of risk factors and providing individualized interventions and care plans tailored to T2DM patients is of great importance.

This main aim of this study is the examination and discussion of a conceptual and theoretical model for Poland’s areas of strategic intervention. Following a review of the current strategic documents at national and regional levels, it is possible to propose two basic categories of areas of strategic intervention: 1) growth areas (territories with natural or socioeconomic properties particularly favourable for development); and 2)problem areas (territories with unfavourable features and socioeconomic and/or natural processes). Among the problem areas it is possible to distinguish three main types: the social, the economic and the natural, albeit with the possibility of applying an even more detailed typology that allows for combinations of these types. Scientific findings can be combined with the results of empirical research to encourage the proposal of a new method of delimiting areas of strategic intervention. The identification of growth areas is primarily based on expert knowledge, which is clearly qualitative. In turn, the processes by which problem areas are delimited is quantitative in nature, reflecting analyses of selected diagnostic indicators that take social, economic and natural issues into account. The results which were obtained relate to the concept of endogenous development, as well as the assumptions under pinning policies of territorial cohesion.

Type 2 diabetes mellitus is a prevalent issue in the United States. The Problem Areas in Diabetes (PAID) tool is an evidenced-based tool that helps clinicians screen for diabetes-related distress (DRD) and refer patients challenged with diabetes management. This project focused on training clinical staff in diabetes self-management education support (DSMES) to recognize and address DRD in primary care settings for patients with type 2 diabetes mellitus. This study presents a method for involving all clinicians in screening for DRD, especially in resource-limited primary care clinics. •One hundred percent of staff participated in mandatory diabetes-related distress (DRD) and Problem Areas in Diabetes (PAID) tool training.•The mean score on the post-DRD-knowledge check questionnaire was higher than the pre-DRD-knowledge check mean score.•At 12 weeks after project implementation, 90% of audited medical records of eligible patients had documented DRD screenings with the PAID screening tool.•At 12 weeks after project implementation, 90% of audited medical records of eligible patients with a DRD indication were referred to the American Diabetes Association-recommended diabetes self-management education support services.