Search

Before organizing mixed-mode data collection for the self-administered questionnaire of the Belgian Health Interview Survey, measurement effects between the paper-and-pencil and the web-based questionnaire were evaluated. A two-period cross-over study was organized with a sample of 149 employees of two Belgian research institutes (age range 22–62 years, 72% female). Measurement agreement was assessed for a diverse range of health indicators related to general health, mental and psychosocial health, health behaviors and prevention with kappa coefficients and intraclass correlation (ICC). The quality of the data collected by both modes was evaluated by quantifying the missing, ‘don’t know’ and inconsistent values and data entry mistakes. Good to very good agreement was found for all categorical indicators with kappa coefficients superior to 0.60, except for two mental and psychosocial health indicators namely the presence of a sleeping disorder and of a depressive disorder (kappa≥0.50). For the continuous indicators high to acceptable agreement was observed with ICC superior to 0.70. Inconsistent answers and data-entry mistakes were only occurring in the paper-and-pencil mode. There were no less missing values in the web-based mode compared to the paper-and-pencil mode. The study supports the idea that web-based modes provide, in general, equal responses to paper-and-pencil modes. However, health indicators based upon factual and objective items tend to have higher measurement agreement than indicators requiring an assessment of personal subjective feelings. A web-based mode greatly facilitates the data-entry process and guides the completing of a questionnaire. However, item non-response was not positively affected. [ABSTRACT FROM AUTHOR]

Introduction: Data collection using paper-based questionnaires can be time consuming and return errors affect data accuracy, completeness, and information quality in health surveys. We compared smartphone and paper-based data collection systems in the Burden of Obstructive Lung Disease (BOLD) study in rural Sudan. Methods: This exploratory pilot study was designed to run in parallel with the cross-sectional household survey. The Open Data Kit was used to programme questionnaires in Arabic into smartphones. We included 100 study participants (83% women; median age = 41.5 ± 16.4 years) from the BOLD study from 3 rural villages in East-Gezira and Kamleen localities of Gezira state, Sudan. Questionnaire data were collected using smartphone and paper-based technologies simultaneously. We used Kappa statistics and inter-rater class coefficient to test agreement between the two methods. Results: Symptoms reported included cough (24%), phlegm (15%), wheezing (17%), and shortness of breath (18%). One in five were or had been cigarette smokers. The two data collection methods varied between perfect to slight agreement across the 204 variables evaluated (Kappa varied between 1.00 and 0.02 and inter-rater coefficient between 1.00 and -0.12). Errors were most commonly seen with paper questionnaires (83% of errors seen) vs smartphones (17% of errors seen) administered questionnaires with questions with complex skip-patterns being a major source of errors in paper questionnaires. Automated checks and validations in smartphone-administered questionnaires avoided skip-pattern related errors. Incomplete and inconsistent records were more likely seen on paper questionnaires. Conclusion: Compared to paper-based data collection, smartphone technology worked well for data collection in the study, which was conducted in a challenging rural environment in Sudan. This approach provided timely, quality data with fewer errors and inconsistencies compared to paper-based data collection. We recommend this method for future BOLD studies and other population-based studies in similar settings. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the relative efficiencies of five Internet-based digital and three paper-based scientific surveys and to estimate the costs for different-sized cohorts. Methods: Invitations to participate in a survey were distributed via e-mail to employees of two university hospitals (E1 and E2) and to members of a medical association (E3), as a link placed in a special text on the municipal homepage regularly read by the administrative employees of two cities (H1 and H2), and paper-based to workers at an automobile enterprise (P1) and college (P2) and senior (P3) students. The main parameters analyzed included the numbers of invited and actual participants, and the time and cost to complete the survey. Statistical analysis was descriptive, except for the Kruskal-Wallis-H-test, which was used to compare the three recruitment methods. Cost efficiencies were compared and extrapolated to different-sized cohorts. Results: The ratios of completely answered questionnaires to distributed questionnaires were between 81.5% (E1) and 97.4% (P2). Between 6.4% (P1) and 57.0% (P2) of the invited participants completely answered the questionnaires. The costs per completely answered questionnaire were $0.57–$1.41 (E1–3), $1.70 and $0.80 for H1 and H2, respectively, and $3.36–$4.21 (P1–3). Based on our results, electronic surveys with 10, 20, 30, or 42 questions would be estimated to be most cost (and time) efficient if more than 101.6–225.9 (128.2–391.7), 139.8–229.2 (93.8–193.6), 165.8–230.6 (68.7–115.7), or 188.2–231.5 (44.4–72.7) participants were required, respectively. Conclusions: The study efficiency depended on the technical modalities of the survey methods and engagement of the participants. Depending on our study design, our results suggest that in similar projects that will certainly have more than two to three hundred required participants, the most efficient way of conducting a questionnaire-based survey is likely via the Internet with a digital questionnaire, specifically via a centralized e-mail. [ABSTRACT FROM AUTHOR]

The standard way to study Large Language Models (LLMs) through benchmarks or psychology questionnaires is to provide many different queries from similar minimal contexts (e.g. multiple choice questions). However, due to LLM's highly context-dependent nature, conclusions from such minimal-context evaluations may be little informative about the model's behavior in deployment (where it will be exposed to many new contexts). We argue that context-dependence should be studied as another dimension of LLM comparison alongside others such as cognitive abilities, knowledge, or model size. In this paper, we present a case-study about the stability of value expression over different contexts (simulated conversations on different topics), and as measured using a standard psychology questionnaire (PVQ) and behavioral downstream tasks. We consider 21 LLMs from six families. Reusing methods from psychology, we study Rank-order stability on the population (interpersonal) level, and Ipsative stability on the individual (intrapersonal) level. We explore two settings: with and without instructing LLMs to simulate particular personalities. We observe similar trends in the stability of models and model families—Mixtral, Mistral, GPT-3.5 and Qwen families being more stable than LLaMa-2 and Phi—over those two settings, two different simulated populations, and even on three downstream behavioral tasks. When instructed to simulate particular personas, LLMs exhibit low Rank-Order stability, and this stability further diminishes with conversation length. This highlights the need for future research directions on LLMs that can coherently simulate a diversity of personas, as well as how context-dependence can be studied in more thorough and efficient ways. This paper provides a foundational step in that direction, and, to our knowledge, it is the first study of value stability in LLMs. The project website with code is available at https://sites.google.com/view/llmvaluestability. [ABSTRACT FROM AUTHOR]

Background: Mobile electronic devices are replacing paper-based instruments and questionnaires for epidemiological and public health research. The elimination of a data-entry step after an interview is a notable advantage over paper, saving investigator time, decreasing the time lags in managing and analyzing data, and potentially improving the data quality by removing the error-prone data-entry step. Research has not yet provided adequate evidence, however, to substantiate the claim of fewer errors for computerized interviews. Methodology: We developed an Android-based illness explanatory interview for influenza vaccine acceptance and tested the instrument in a field study in Pune, India, for feasibility and acceptability. Error rates for tablet and paper were compared with reference to the voice recording of the interview as gold standard to assess discrepancies. We also examined the preference of interviewers for the classical paper-based or the electronic version of the interview and compared the costs of research with both data collection devices. Results: In 95 interviews with household respondents, total error rates with paper and tablet devices were nearly the same (2.01% and 1.99% respectively). Most interviewers indicated no preference for a particular device; but those with a preference opted for tablets. The initial investment in tablet-based interviews was higher compared to paper, while the recurring costs per interview were lower with the use of tablets. Conclusion: An Android-based tablet version of a complex interview was developed and successfully validated. Advantages were not compromised by increased errors, and field research assistants with a preference preferred the Android device. Use of tablets may be more costly than paper for small samples and less costly for large studies. [ABSTRACT FROM AUTHOR]

Rationale, aims and objective: Substituting outpatient hospital care with primary care is seen as a solution to decrease unnecessary referrals to outpatient hospital care and decrease rising healthcare costs. This systematic review aimed to evaluate the effects on quality of care, health and costs outcomes of substituting outpatient hospital care with primary care-based interventions, which are performed by medical specialists in face-to-face consultations in a primary care setting. Method: The systematic review was performed using the PICO framework. Original papers in which the premise of the intervention was to substitute outpatient hospital care with primary care through the involvement of a medical specialist in a primary care setting were eligible. Results: A total of 14 papers were included. A substitution intervention in general practitioner (GP) practices was described in 11 papers, three described a joint consultation intervention in which GPs see patients together with a medical specialist. This study showed that substitution initiatives result mostly in favourable outcomes compared to outpatient hospital care. The initiatives resulted mostly in shorter waiting lists, shorter clinic waiting times and higher patient satisfaction. Costs for treating one extra patient seemed to be higher in the intervention settings. This was mainly caused by inefficient planning of consultation hours and lower patient numbers. Conclusions: Despite the fact that internationally a lot has been written about the importance of performing substitution interventions in which preventing unnecessary referrals to outpatient hospital care was the aim, only 14 papers were included. Future systematic reviews should focus on the effects on the Triple Aim of substitution initiatives in which other healthcare professions than medical specialists are involved along with new technologies, such as e-consults. Additionally, to gain more insight into the effects of substitution initiatives operating in a dynamic healthcare context, it is important to keep evaluating the interventions in a longitudinal study design. [ABSTRACT FROM AUTHOR]

While measures to detect psychophysical olfactory ability are a crucial part of clinicians' assessment of potential olfactory loss, it gives no indication of how olfaction is experienced by the patient and these different aspects often deviate substantially. To ensure quality and reproducibility of subjectively reported olfactory experience and significance, the Importance of Olfaction Questionnaire (IO-Q) was introduced around a decade ago, and while initial validations have produced promising results, important aspects remain nearly unexamined. For example, the test-retest reliability has rarely been examined and the difference of online versus pen-and-paper administration remains unexplored. Here, we translated IO-Q to Danish and examined its validity, test-retest reliability and mode of administration. A cohort of 179 younger, Danish participants with a high level of English proficiency took the test twice with varying time in-between. The first test was taken digitally and in English, while the second was taken using pen-and-paper and in Danish. The distribution of scores and the relationship between the IO-Q and subscale scores were nearly identical between tests, indicating little to no influence of language/test modality in the sampled population. The internal consistency was comparable to previously published results. Likewise, an acceptable test-retest reliability was observed for the full IO-Q and slightly lower for subscales. No significant effect of time was found across several weeks. In conclusion, the IO-Q performed satisfactorily in all examinations and could therefore serve as a valuable clinical measure of subjective olfactory experience, and its Danish translation shows highly similar characteristics to the original, English version. [ABSTRACT FROM AUTHOR]

Some people report being able to spontaneously "time" the end of their sleep. This ability to self-awaken challenges the idea of sleep as a passive cognitive state. Yet, current evidence on this phenomenon is limited, partly because of the varied definitions of self-awakening and experimental approaches used to study it. Here, we provide a review of the literature on self-awakening. Our aim is to i) contextualise the phenomenon, ii) propose an operating definition, and iii) summarise the scientific approaches used so far. The literature review identified 17 studies on self-awakening. Most of them adopted an objective sleep evaluation (76%), targeted nocturnal sleep (76%), and used a single criterion to define the success of awakening (82%); for most studies, this corresponded to awakening occurring in a time window of 30 minutes around the expected awakening time. Out of 715 total participants, 125 (17%) reported to be self-awakeners, with an average age of 23.24 years and a slight predominance of males compared to females. These results reveal self-awakening as a relatively rare phenomenon. To facilitate the study of self-awakening, and based on the results of the literature review, we propose a quick paper-and-pencil screening questionnaire for self-awakeners and provide an initial validation for it. Taken together, the combined results of the literature review and the proposed questionnaire help in characterising a theoretical framework for self-awakenings, while providing a useful tool and empirical suggestions for future experimental studies, which should ideally employ objective measurements. [ABSTRACT FROM AUTHOR]

Scholars (n = 580) from 69 countries who had contributed articles in the field of Economics during the year 2015 participated in a survey that gauged their perceptions of various aspects of co-authorship, including its benefits, motivations, working relationships, order of authorship and association preferences. Among the main findings, significant differences emerged in the proportion of co-authored papers based on age, gender and number of years the researchers had spent in their present institution. Female scholars had a greater proportion of co-authored papers than male scholars. Respondents considered improved quality of paper, contribution of mutual expertise, and division of labor as the biggest benefits of and motivation for co-authorship. Contrary to common perceptions that Economics researchers used a predominantly alphabetical order of authorship, our study found that a considerable percentage of respondents (34.5%) had practiced an order of authorship based on the significance of the authors’ contribution to the work. The relative importance of tasks differed significantly according to whether researchers co-authored as mentors or co-authored as colleagues. Lastly, researchers were found to associate, to varying degrees, with other researchers based on socio-academic parameters, such as nationality, ethnicity, gender, professional position and friendship. The study indicates that Economics authors perceive co-authorship as a rewarding endeavor. Nonetheless, the level of contribution and even the choice of association itself as a co-author depends to a great extent on the type of working relationship and socio-academic factors. [ABSTRACT FROM AUTHOR]

Background: Large cross-sectional household surveys are common for measuring indicators of neglected tropical disease control programs. As an alternative to standard paper-based data collection, we utilized novel paperless technology to collect data electronically from over 12,000 households in Ethiopia. Methodology: We conducted a needs assessment to design an Android-based electronic data collection and management system. We then evaluated the system by reporting results of a pilot trial and from comparisons of two, large-scale surveys; one with traditional paper questionnaires and the other with tablet computers, including accuracy, person-time days, and costs incurred. Principle Findings: The electronic data collection system met core functions in household surveys and overcame constraints identified in the needs assessment. Pilot data recorders took 264 (standard deviation (SD) 152 sec) and 260 sec (SD 122 sec) per person registered to complete household surveys using paper and tablets, respectively (P = 0.77). Data recorders felt a lack of connection with the interviewee during the first days using electronic devices, but preferred to collect data electronically in future surveys. Electronic data collection saved time by giving results immediately, obviating the need for double data entry and cross-correcting. The proportion of identified data entry errors in disease classification did not differ between the two data collection methods. Geographic coordinates collected using the tablets were more accurate than coordinates transcribed on a paper form. Costs of the equipment required for electronic data collection was approximately the same cost incurred for data entry of questionnaires, whereas repeated use of the electronic equipment may increase cost savings. Conclusions/Significance: Conducting a needs assessment and pilot testing allowed the design to specifically match the functionality required for surveys. Electronic data collection using an Android-based technology was suitable for a large-scale health survey, saved time, provided more accurate geo-coordinates, and was preferred by recorders over standard paper-based questionnaires. [ABSTRACT FROM AUTHOR]

Objective: Complementary Health Approaches (CHA) are commonly used by children with cancer; however, a few health care providers (HCPs) inquire about the use of CHA. A standardized questionnaire could facilitate such clinical discussions. We aimed to adapt and determine the face and content validity of the "Which Health Approaches and Treatments are you using?" (WHAT) child and parent-report questionnaires in pediatric oncology. Methods: An electronic Delphi survey that included children with cancer (8–18 years), parents, and HCPs and CHA researchers was conducted to reach consensus on the content of the WHAT questionnaires in pediatric oncology. Children and parents from the Hospital for Sick Children (SickKids), and HCPs and researchers from the International Society of Pediatric Oncology and Pediatric Complementary and Alternative Medicine Research and Education Network completed the survey. To determine the face and content validity of the questionnaires, two iterative cycles of individual interviews were conducted with purposive samples of children (8–18 years), parents, and HCPs from SickKids. Results: Consensus was reached on all domains and items of the original WHAT questionnaires after one Delphi cycle (n = 61). For face and content validity testing, the first cycle of interviews (n = 19) revealed that the questionnaires were mostly comprehensive and relevant. However, the paper-based format of the original WHAT was not user-friendly, and generic items were vague and not aimed at facilitating clinical dialogues about CHA use. The WHAT questionnaires were then modified into electronic cancer-specific self- and proxy-report questionnaires including 13 and 15 items, respectively. The second cycle (n = 21) showed no need for further changes. Conclusions: The modified electronic cancer-specific WHAT questionnaires showed adequate face and content validity. The next step is to determine inter-rater reliability, construct validity, and feasibility of administration of the modified WHAT questionnaires in pediatric oncology. [ABSTRACT FROM AUTHOR]

Objective: Routine measurement of patient safety from the patients' perspective receives increasing attention as an important component of safety measurement systems. The aim of this study was to examine patients' experience with patient safety in ambulatory care and the results' implications for routine patient safety measurement in ambulatory care. Design: Cross-sectional mixed-mode survey. Setting: General practitioner and specialist practices. Participants: Patients aged >18 years seeking care in ambulatory care practices between February and June 2020. Methods: A 22-item-questionnaire was completed in the practice or at home either on paper or online. Multivariate logistic regression was used to analyse the influence of survey mode and patient characteristics on patient experience with patient safety. Results: The overall response rate was 71.1%. Most patients completed the questionnaire on site (76.6%) and on paper (96.1%). Between 30.1% to 68.5% of the respondents report the most positive option for patient experience with the main domains of patient safety. A total of 2.9% of patients reported having experienced a patient-safety event (PSE) during the last 12 months. Patients who filled in the questionnaire off site were more likely to report negative experiences for the scales communication & information (OR 1.2, 95% CI 1.0–1.5), rapport & participation (OR 1.4, 95% CI 1.1–1.7) and access (OR 1.3, 95% CI 0.9–1.4) than those who completed it on site. Those who chose a paper questionnaire were more likely to report negative experiences for all five scales compared to web responders. Conclusion: Routine measurement of patient experience with factors contributing to the occurrence of PSEs can achieve high response rates by offering flexible participation options. Results gained from mixed-mode surveys need to take mode-effects into account when interpreting and using the results. Further research is needed in how to adequately assess number and type of experienced events in routine measurements. [ABSTRACT FROM AUTHOR]

Discrete choice experiments (DCEs) are a way to assess priority-setting in health care provision. This approach allows for the evaluation of individuals’ preferences as a means of adding criteria to traditional quality-adjusted life year analysis. The aim of this systematic literature review was to identify attributes for designing a DCE in order to then develop and validate a framework that supports decision-making on health technologies. Our systematic literature review replicated the methods and search terms used by de Bekker-Grob et al. 2012 and Clark et al. 2014. The Medline database was searched for articles dated between 2008 and 2015. The search was limited to studies in English that reflected general preferences and were choice-based, published as full-text articles and related to health technologies. This study included 72 papers, 52% of which focused on DCEs on drug treatments. The average number of attributes used in all included DCE studies was 5.74 (SD 1.98). The most frequently used attributes in these DCEs were improvements in health (78%), side effects (57%) and cost of treatment (53%). Other, less frequently used attributes included waiting time for treatment or duration of treatment (25%), severity of disease (7%) and value for money (4%). The attributes identified might inform future DCE surveys designed to study societal preferences regarding health technologies in order to better inform decisions in health technology assessment. [ABSTRACT FROM AUTHOR]

Introduction: Non-medical prescribing has the potential to deliver innovative healthcare within limited finances. However, uptake has been slow, and a proportion of non-medical prescribers do not use the qualification. This systematic review aimed to describe the facilitators and barriers to non-medical prescribing in the United Kingdom. Methods: The systematic review and thematic analysis included qualitative and mixed methods papers reporting facilitators and barriers to independent non-medical prescribing in the United Kingdom. The following databases were searched to identify relevant papers: AMED, ASSIA, BNI, CINAHL, EMBASE, ERIC, MEDLINE, Open Grey, Open access theses and dissertations, and Web of Science. Papers published between 2006 and March 2017 were included. Studies were quality assessed using a validated tool (QATSDD), then underwent thematic analysis. The protocol was registered with PROSPERO (CRD42015019786). Results: Of 3991 potentially relevant identified studies, 42 were eligible for inclusion. The studies were generally of moderate quality (83%), and most (71%) were published 2007–2012. The nursing profession dominated the studies (30/42). Thematic analysis identified three overarching themes: non-medical prescriber, human factors, and organisational aspects. Each theme consisted of several sub-themes; the four most highly mentioned were ‘medical professionals’, ‘area of competence’, ‘impact on time’ and ‘service’. Sub-themes were frequently interdependent on each other, having the potential to act as a barrier or facilitator depending on circumstances. Discussion: Addressing the identified themes and subthemes enables strategies to be developed to support and optimise non-medical prescribing. Further research is required to identify if similar themes are encountered by other non-medical prescribing groups than nurses and pharmacists. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to investigate the utilization of Lean & Six Sigma quality initiatives in healthcare sector in India. Methodology: The survey questionnaires were sent to 454 hospitals through registered postal in all the states of India. The survey questionnaire was designed to assess different quality initiatives; currently implemented in Indian hospitals, factors align with organization's objectives, reasons for not implementing Lean & Six Sigma and contribution of Lean & Six Sigma projects in healthcare improvement projects etc. A separate section in the questionnaire provides the feedback on implementation of Lean & Six Sigma in various hospitals. The relationships between Lean & Six Sigma and healthcare performance have also been established in this paper. Findings: It is found that 15 Nos. of hospitals have implemented the Lean tools while 14 Nos. have implemented the Six Sigma tools out of 109 collected responses. This shows the utilization of Lean & Six Sigma in Indian healthcare sector. The 'Lack of knowledge' and 'Availability of resources' are the major reasons for not implementing Lean & Six Sigma. It is also observed that 22% running projects were related to Lean & Six Sigma out of various improvement projects running in various hospitals. Originality: There is lack of evidences of similar studies that determines the utilization of Lean & Six Sigma in Indian healthcare sector at the national level. This paper will provide important breakthrough to academicians and healthcare practitioners, who are involved in Lean & Six Sigma research. Social implications: The present study will create awareness among healthcare practitioners across India for utilization of quality tools that will provide direct benefits to the society. [ABSTRACT FROM AUTHOR]

In some circumstances rule-governed behavior, a behavior that is governed by verbal rules instead of environmental consequences, may be beneficial for human beings. At the same time, rigid rule following is associated with psychopathology. Thus measurement of rule-governed behavior may be of special use in a clinical setting. The aim of this paper is to assess the psychometric properties of Polish adaptations of three questionnaires measuring generalized tendency to engage in various types of rule-governed behaviors: Generalized Pliance Questionnaire (GPQ), Generalized Self-Pliance Questionnaire (GSPQ), Generalized Tracking Questionnaire (GTQ). A forward-backward method was used for translation. Data was collected from two samples: general population (N = 669) and university students (N = 451). To measure the validity of the adapted scales the participants filled in a set of self-assessed questionnaires: Satisfaction with Life Scale (SWLS), Depression, Anxiety, and Stress Scale– 21 (DASS-21), General Self-Efficacy Scale (GSES), Acceptance and Action Questionnaire–II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), Valuing Questionnaire (VQ) and Rumination—Reflection Questionnaire (RRQ). The exploratory and confirmatory analyses confirmed the unidimensional structure of each of the adapted scales. All of those scales presented good reliability (internal consistency measured with Cronbach Alpha) and item-total correlations. The Polish versions of questionnaires presented significant correlations in the expected directions with relevant psychological variables in line with the original studies. The measurement occurred invariant across both samples as well as gender. The results provide evidence that Polish versions of GPQ, GSPQ and GTQ present sufficient validity and reliability to be used in the Polish-speaking population. [ABSTRACT FROM AUTHOR]

Background: Behaviour problems are common in young children with autism spectrum disorder (ASD). There are many different tools used to measure behavior problems but little is known about their validity for the population. Objectives: To evaluate the measurement properties of behaviour problems tools used in evaluation of intervention or observational research studies with children with ASD up to the age of six years. Methods: Behaviour measurement tools were identified as part of a larger, two stage, systematic review. First, sixteen major electronic databases, as well as grey literature and research registers were searched, and tools used listed and categorized. Second, using methodological filters, we searched for articles examining the measurement properties of the tools in use with young children with ASD in ERIC, MEDLINE, EMBASE, CINAHL, and PsycINFO. The quality of these papers was then evaluated using the COSMIN checklist. Results: We identified twelve tools which had been used to measure behaviour problems in young children with ASD, and fifteen studies which investigated the measurement properties of six of these tools. There was no evidence available for the remaining six tools. Two questionnaires were found to be the most robust in their measurement properties, the Child Behavior Checklist and the Home Situations Questionnaire—Pervasive Developmental Disorders version. Conclusions: We found patchy evidence on reliability and validity, for only a few of the tools used to measure behaviour problems in young children with ASD. More systematic research is required on measurement properties of tools for use in this population, in particular to establish responsiveness to change which is essential in measurement of outcomes of intervention. PROSPERO Registration Number: [ABSTRACT FROM AUTHOR]

Classical paper-and-pencil based risk assessment questionnaires are often accompanied by the online versions of the questionnaire to reach a wider population. This study focuses on the loss, especially in risk estimation performance, that can be inflicted by direct transformation from the paper to online versions of risk estimation calculators by ignoring the possibilities of more complex and accurate calculations that can be performed using the online calculators. We empirically compare the risk estimation performance between four major diabetes risk calculators and two, more advanced, predictive models. National Health and Nutrition Examination Survey (NHANES) data from 1999–2012 was used to evaluate the performance of detecting diabetes and pre-diabetes. American Diabetes Association risk test achieved the best predictive performance in category of classical paper-and-pencil based tests with an Area Under the ROC Curve (AUC) of 0.699 for undiagnosed diabetes (0.662 for pre-diabetes) and 47% (47% for pre-diabetes) persons selected for screening. Our results demonstrate a significant difference in performance with additional benefits for a lower number of persons selected for screening when statistical methods are used. The best AUC overall was obtained in diabetes risk prediction using logistic regression with AUC of 0.775 (0.734) and an average 34% (48%) persons selected for screening. However, generalized boosted regression models might be a better option from the economical point of view as the number of selected persons for screening of 30% (47%) lies significantly lower for diabetes risk assessment in comparison to logistic regression (p < 0.001), with a significantly higher AUC (p < 0.001) of 0.774 (0.740) for the pre-diabetes group. Our results demonstrate a serious lack of predictive performance in four major online diabetes risk calculators. Therefore, one should take great care and consider optimizing the online versions of questionnaires that were primarily developed as classical paper questionnaires. [ABSTRACT FROM AUTHOR]

Background: Over the past two decades, the focus of mental health care has shifted from institutionalisation to community-based programs and short hospital stays. This change means that there is an increased role for caregivers, mostly family members, in managing persons with mental illness. Although there is evidence to support the benefits of deinstitutionalisation of mental health care, there are also indications of substantial burden experienced by caregivers; the evidence of which is limited in sub-Saharan Africa. However, knowledge of the nature and extent of this burden can inform the planning of mental health services that will not only benefit patients, but also caregivers and households. Objective: To systematically review the available evidence on the economic burden of severe mental illness on primary family caregivers in sub-Saharan Africa. Methods: A comprehensive search was conducted in Pubmed, CINAHL, Econlit and Web of Science with no date limitations up to September 2016 using keywords such as "burden", "cost of illness" and "economic burden" to identify relevant published literature. Articles were appraised using a standardised data extraction tool covering themes such as physical, psychological and socioeconomic burden. Results: Seven papers were included in the review. Caregivers were mostly family members with a mean age of 46.34, female and unemployed. Five out of seven studies (71%) estimated the full economic burden of severe mental illness on caregivers. The remainder of studies just described the caregiver burden. All seven papers reported moderate to severe caregiver burden characterised by financial constraint, productivity loss and lost employment. The caregiver’s level of income and employment status, severity of patient's condition and duration of mental illness were reported to negatively affect the economic burden experienced by caregivers. Conclusion: There is paucity of studies reporting the burden of severe mental illness on caregivers in sub-Saharan Africa. Further research is needed to present the nature and extent of this burden to inform service planning and policymaking. [ABSTRACT FROM AUTHOR]

Personal motivation is a key factor in the service of foster care, impending both on the welfare of the child and on the satisfaction of the carer. This paper explores the benefits, challenges and dilemmas involved in the job of professional (i.e. state-supported) foster carer in Romania–a country where the issue of child protection has drawn a great deal of international attention over the last thirty years. The principal hypothesis concerns whether the benefits, challenges and dilemmas identified by foster carers are influenced by the factors that led to their taking up this kind of work. Quantitative research was conducted using a questionnaire as the main tool. The paper takes a descriptive, cross-sectional and multifactorial approach. Sampling was carried out by self-selecting method, and the study involved 51 participants. The research project identified a statistically significant variation in the challenges and dilemmas reported by foster carers. Thus, the results of the study show that the majority of the carers indicate a primarily intrinsic motivation for their work. By way of conclusion, it is argued that social workers, operating in collaboration with multidisciplinary teams, can offer carers support in managing more difficult periods in the child–carer relationship, thus enhancing the sustainability of the foster care service. [ABSTRACT FROM AUTHOR]

Executives act based on their experiences, values, personality and personal interpretation of the situations which they face in their companies. Investigations in the field of Behavioral Corporate Finance have determined that there are some relations between CEOs’ personal traits and financial decisions of large companies, but these results are based on indirect personal trait measurements and on public companies. To see whether such relations also exist between CEOs’ personal traits and the financial structure of large private companies, we used psychometric tests to measure their level of optimism, risk attitude and affect heuristic, collected financial data for a period of fourteen years, and considered the economic situation of the country as a key factor in these relations. This paper reports the relationship of executives’ personal traits with the financial structure of large Spanish companies for the period 2001–2014. We observed that executives’ high optimism (and risk aversion attitude) is positively (negatively) related to long-term debt, whilst positive affect is directly associated to the financial leverage and short-term debt. This paper also reports a change of relations when taking into account the country’s economic situation. In effect, by considering this new variable, executives’ risk aversion is seen to be associated to financial leverage and short-term debt, whilst CEOs’ positive affect is linked to long-term debt. These relations are strongly moderated and they become statistically significant in a contracting economic period. In conclusion, the links between CEOs’ personal traits and financial structure of large private Spanish companies make sense when the effect of the economic situation is taken into account. Furthermore, the awareness of these links helps to understand the financial decisions taken within large Spanish companies. [ABSTRACT FROM AUTHOR]

This paper aims to investigate the relationship between women’s social class and their levels of self- and other-objectification. Two online studies comprising of multiple questionnaires were conducted: Study 1 examined the association between the social class (both objective and subjective) of 198 non-student British women and their self-objectification levels, while Study 2 turned towards the relationship between social class and other-objectification among 82 non-student British women. Our results indicated no apparent relationship between social class and each of the relevant objectification measures. As the first paper on the topic of class and objectification, it appears that there is no relationship observed between the two. [ABSTRACT FROM AUTHOR]

This paper investigates the feasibility, from a user perspective, of integrating a heterogeneous information network mining (HINM) technique into SensePlace3 (SP3), a web-based geovisual analytics environment. The core contribution of this paper is a user study that determines whether an analyst with minimal background can comprehend the network data modeling metaphors employed by the resulting system, whether they can employ said metaphors to explore spatial data, and whether they can interpret the results of such spatial analysis correctly. This study confirms that all of the above is, indeed, possible, and provides empirical evidence about the importance of a hands-on tutorial and a graphical approach to explaining data modeling metaphors in the successful adoption of advanced data mining techniques. Analysis of outcomes of data exploration by the study participants also demonstrates the kinds of insights that a visual interface to HINM can enable. A second contribution is a realistic case study that demonstrates that our HINM approach (made accessible through a visual interface that provides immediate visual feedback for user queries), produces a clear and a positive difference in the outcome of spatial analysis. Although this study does not aim to validate HINM as a data modeling approach (there is considerable evidence for this in existing literature), the results of the case study suggest that HINM holds promise in the (geo)visual analytics domain as well, particularly when integrated into geovisual analytics applications. A third contribution is a user study protocol that is based on and improves upon the current methodological state of the art. This protocol includes a hands-on tutorial and a set of realistic data analysis tasks. Detailed evaluation protocols are rare in geovisual analytics (and in visual analytics more broadly), with most studies reviewed in this paper failing to provide sufficient details for study replication or comparison work. [ABSTRACT FROM AUTHOR]

Background: Rhythmic Auditory Stimulation (RAS) is an effective technique to improve gait and reduce freezing episodes for Persons with Parkinson’s Disease (PwPD). The BeatHealth system, which comprises a mobile application, gait sensors, and a website, exploits the potential of the RAS technique. This paper describes the tools used for co-designing and evaluating the system and discusses the results and conclusions. Methods: Personas, interviews, use cases, and ethnographic observations were used to define the functional requirements of the system. Low fidelity prototypes were created for iterative and incremental evaluation with end-users. Field trials were also performed with the final system. The process followed a user centered design methodology defined for this project with the aim of building a useful, usable, and easy-to-use system. Results: Functional requirements of the system were produced as a result of the initial exploration phase. Building upon these, mock-ups for the BeatHealth system were created. The mobile application was iterated twice, with the second version of it achieving a rating of 75 when assessed by participants through the System Usability Scale (SUS). After another iteration field trials were performed and the mobile application was rated with an average 78.6 using SUS. Participants rated two website mock-ups, one for health professionals and another for end-users, as good except from minor issues related to visual design (e.g. font size), which were resolved in the final version. Conclusion: The high ratings obtained in the evaluation of the BeatHealth system demonstrate the benefit of applying a user centered design methodology which involves stakeholders from the very beginning. Other important lessons were learned through the process of design and development of the system, such as the importance of motivational aspects, the techniques which work best, and the extra care that has to be taken when evaluating non-functional mock-ups with end users. [ABSTRACT FROM AUTHOR]

Besides its several threats to health, welfare, social and academic development and performance of kids and teenagers, school bullying remains highlighted as one of the most relevant related challenges for educational, behavioral and legal sciences worldwide. Moreover, the lack of research on the field and the crucial but unattended need to count on psychometrically suitable and valid tools to detect school bullying make difficult understanding its contexts, dynamics and possible solutions. Objective The aim of this study was to thoroughly present in detail the psychometric properties and validity issues of the School Bullying Questionnaire (CIE-A) among secondary students. Methods A regionwide sample of 810 (47.2% girls) secondary students attending to 21 schools across the Valencian Community (Spain), aged M = 14.40 (SD = 1.61) years, responded to a paper-based questionnaire containing the 36-item version of the CIE-A and various scales related to psychosocial health and wellbeing, used as criterion variables. Results The outcomes of this study suggest that the CIE-A has a clear factor structure, an optimal set of item loadings and goodness-of-fit indexes. Further, that CIE-A has shown good internal consistency and reliability indexes, coherent associations with other mental health and academic performance variables, and the possibility to assess gender differences on bullying-related factors among secondary students. Conclusion The CIE-A may represent a suitable tool for assessing bullying in a three-factorial approach (i.e., victimization, symptomatology, and intimidation), offering optimal psychometric properties, validity and reliability insights, and the potentiality of being applied in the school environment. Actions aimed at improving the school coexistence and the well-being of secondary students, targeting potential bullied/bully profiles or seeking to assess demographic and psychosocial correlates of bullying among teenagers, might get benefited from this questionnaire. [ABSTRACT FROM AUTHOR]

Objectives: Parenting is an integral component of obesity treatment in early childhood. However, the link between specific parenting practices and treatment effectiveness remains unclear. This paper introduces and validates a new parenting questionnaire and evaluates mothers' and fathers' parenting practices in relation to child weight status during a 12-month childhood obesity treatment trial. Methods: First, a merged school/clinical sample (n = 558, 82% mothers) was used for the factorial and construct validation of the new parenting questionnaire. Second, changes in parenting were evaluated using clinical data from the More and Less Study, a randomized controlled trial (RCT) with 174 children (mean age = 5 years, mean Body Mass Index Standard Deviation Score (BMI SDS) = 3.0) comparing a parent support program (with and without booster sessions) and standard treatment. Data were collected at four time points over 12 months. We used linear mixed models and mediation models to investigate associations between changes in parenting practices and treatment effects. Findings: The validation of the questionnaire (9 items; responses on a 5-point Likert scale) revealed two dimensions of parenting (Cronbach's alpha ≥0.7): setting limits to the child and regulating one's own emotions when interacting with the child, both of which correlated with feeding practices and parental self-efficacy. We administered the questionnaire to the RCT participants. Fathers in standard treatment increased their emotional regulation compared to fathers in the parenting program (p = 0.03). Mothers increased their limit-setting regardless of treatment allocation (p = 0.01). No treatment effect was found on child weight status through changes in parenting practices. Conclusion: Taken together, the findings demonstrate that the new questionnaire assessing parenting practices proved valid in a 12-month childhood obesity trial. During treatment, paternal and maternal parenting practices followed different trajectories, though they did not mediate treatment effects on child weight status. Future research should address the pathways whereby maternal and paternal parenting practices affect treatment outcomes, such as child eating behaviors and weight status. [ABSTRACT FROM AUTHOR]

Reducing information rents is an important task for government agencies wishing to purchase maximal environmental services with limited budgets. This paper reports on several green auction options for reducing information rents and improving the performance of the “Grain for Green” Payments for environmental services (PES) program implemented in northwestern China. In r experimental auctions and investigations, door-to-door interviews were conducted and bidding envelopes and survey questionnaires were used to determine the offers and the foregone profits of the participants. Three scenarios are analyzed in this paper: a uniform price auction, a discriminatory price auction, and an opportunity-cost system. The results show that compared to the uniform price auction system, the other auction systems can increase the cost-effectiveness of conservation contracting. Competitive bidding can reveal true opportunity costs and can reduce information rents extracted from the government by farmers using private information. The demographics and average bids of these auction types were also analyzed. “Perfect information” in the opportunity-cost offer system has the best performance but is very hard to implement in reality. The results of this research show that the auction is a valuable tool for purchasing conservation contracts in northwestern China, but that in the future, the performance of these auctions should be studied with relaxed model assumptions. [ABSTRACT FROM AUTHOR]

Research utilizing repeated-measures such as daily assessments with self-report and/or objective measures [e.g., physical activity (PA) monitors] are important in understanding health behaviors and informing practice and policy. However, studies that utilize daily assessment often encounter issues with attrition and non-compliance. The current research yielded high levels of retention and adherence with both self-report and objective daily measures. The purpose of this paper is to highlight and discuss strategies utilized in maximizing retention, minimizing missing data, and some lessons learned from the research experience. Fifty community participants took part in a 4-week study utilizing both daily self-report questionnaires and daily use of PA monitors (Fitbit One™). This study focused on typical daily PA and was not an intervention study (e.g., participants were not randomized nor asked to change their PA behavior). Participants completed the study in two waves (wave 1 n = 10, wave 2 n = 40). The research team utilized several retention strategies including automating the data collection process, a prorated incentive structure, having a dedicated and responsive study staff, and utilizing the 2-wave process to optimize data collection during the 2nd wave. The study had 100% retention and generally positive anonymous feedback post-study. Overall, participants completed the vast majority of daily surveys (97%) and wore their Fitbits (for at least part of the day) on almost all days (99.57%) of the study, although there were individual differences. The strategies discussed and lessons learned may be useful to other researchers using daily measurements for whom adherence and retention are important issues. Future research employing these strategies in different populations, with different measurements, and for longer durations is warranted to determine generalizability. [ABSTRACT FROM AUTHOR]

This paper examines how to maximize contribution in public good dilemmas by arranging people into homogeneous or heterogeneous subgroups. Past studies on the effect of homogeneity of efficacy have exclusively manipulated group composition in their experimental designs, which might have imposed a limit on ecological validity because group membership may not be easily changed in reality. In this study, we maintained the same group composition but varied the subgroup composition. We developed a public good dilemmas paradigm in which participants were assigned to one of the four conditions (high- vs. low-efficacy; homogeneous vs. heterogeneous subgroup) to produce their endowments and then to decide how much to contribute. We found that individuals in homogeneous and heterogeneous subgroups produced a similar amount and proportion of contribution, which was due to the two mediating effects that counteracted each other, namely (a) perceived efficacy relative to subgroup and (b) expectation of contribution of other subgroup members. This paper demonstrates both the pros and cons of arranging people into homogeneous and heterogeneous subgroups of efficacy. [ABSTRACT FROM AUTHOR]

The Strength Use and Deficit Correction (SUDCO) Questionnaire has been shown to be a reliable instrument for the measurement of its four dimensions perceived organizational support for strengths use, perceived organizational support for deficit correction, strengths use behavior, and deficit correction behavior in the context of organizations. This paper aims to adapt and validate the SUDCO for the German-speaking population (SUDCO-G). Three studies were conducted. Confirmatory factor analyses and correlations with other psychological constructs on the data of three German samples (N1 = 302; N2 = 243, N3 = 295) were performed. The twenty-four item SUDCO-G exhibits the anticipated factorial structure with four factors and an acceptable model fit in all three studies (CFI =.920-.937, TLI =.911-.929, RMSEA =.063-.079, SRMR = 0.52-.075). The associations of the four dimensions to other constructs concur with previous findings (study 2) and the subscales of the SUDCO-G also show positive relations with general strengths use, meaning of work and Psychological Capital (study 3). We conclude that the SUDCO-G is a reliable and valid instrument for the use in the German-speaking population. [ABSTRACT FROM AUTHOR]

The study investigated two followership behaviors, followers’ active engagement and followers’ independent critical thinking, and their relationship with job satisfaction in a sample of nurses. In addition, the study also considered a number of control variables and classical job demands and job resources—workload and emotional dissonance for job demands, and meaningful work for job resources—which have an impact on well-being at work. A paper-and-pencil questionnaire was administered to 425 nurses in an Italian hospital, and a hierarchical multiple regression was used to test the hypotheses. In addition to the job demands and job resources considered, followers’ active engagement had a significant impact on job satisfaction. Moreover, it showed a significant linear and curvilinear relationship with the outcome variable. Followers’ independent critical thinking has a non significant relationship with job satisfaction, confirming the mixed results obtained in the past for this dimension. These findings bore out the importance of analyzing followers’ behaviors as potential resources that people can use on the job to increase their own well-being. Looking at followers not just as passive recipients but as active and proactive employees can also benefit the organization. [ABSTRACT FROM AUTHOR]

Much of the literature on recovery focuses on the economy, the physical environment and infrastructure at a macro level, which may ignore the personal experiences of affected individuals during recovery. This paper combines internal factors at a micro level and external factors at a macro level to model for understanding perception of recovery (PoR). This study focuses on areas devastated by the 2008 Wenchuan earthquake in China. With respect to three recovery-related aspects (house recovery condition (HRC), family recovery power (FRP) and reconstruction investment (RI)), structural equation modeling (SEM) was applied. It was found that the three aspects (FRP, HRC and RI) effectively explain how earthquake affected households perceive recovery. Internal factors associated with FRP contributed the most to favourable PoR, followed by external factors associated with HRC. Findings identified that for PoR the importance of active recovery within households outweighed an advantageous house recovery condition. At the same time, households trapped in unfavourable external conditions would invest more in housing recovery, which result in wealth accumulation and improved quality of life leading to a high level of PoR. In addition, schooling in households showed a negative effect on improving PoR. This research contributes to current debates around post-disaster permanent housing policy. It is implied that a one-size-fits-all policy in disaster recovery may not be effective and more specific assistance should be provided to those people in need. [ABSTRACT FROM AUTHOR]

It is well known that the outcome of an intervention is affected both by the inherent effects of the intervention and the patient's expectations. For this reason in comparative clinical trials an effort is made to conceal the nature of the administered intervention from the participants in the trial i.e. to blind the trial. Yet, in practice perfect blinding is impossible to ensure or even verify post hoc. The current clinical standard is to follow up the trial with an auxiliary questionnaire, which allows trial participants to express in closed form their belief concerning the intervention, i.e. trial group assignment (treatment or control). Auxiliary questionnaire responses are then used to compute the extent of blinding in the trial in the form of a blinding index. If the estimated extent of blinding exceeds a particular threshold the trial is deemed sufficiently blinded; otherwise, the strength of evidence of the trial is brought into question. This may necessitate that the trial is repeated. In this paper we make several contributions. Firstly, we identify a series of problems of the aforesaid clinical practice and discuss them in context of the most commonly used blinding indexes. Secondly, we formulate a novel approach for handling imperfectly blinded trials. We adopt a feedback questionnaire of the same form as that which is currently in use, but interpret the collected data using a novel statistical method, significantly different from that proposed in the previous work. Unlike the previously proposed approaches, our method is void of any ad hoc free parameters and robust to small changes in the participants' feedback responses. Our method also does not discard any data and is not predicated on any strong assumptions used to interpret participants' feedback. The key idea behind the present method is that it is meaningful to compare only the corresponding treatment and control participant sub-groups, that is, sub-groups matched by their auxiliary responses. A series of experiments on simulated trials is used to demonstrate the effectiveness of the proposed approach and its superiority over those currently in use. [ABSTRACT FROM AUTHOR]

Esports as the competitive play of digital games has gained considerable popularity. However, a comprehensive framework for esport training is still missing. In this paper, a performance model integrating insights from game research and sport science is developed. Based on this model, an online questionnaire was designed and applied to investigate training in different esports regarding relevant competencies and training areas. Overall, 1,835 esports players voluntarily participated in the study. Age ranged from 13 to 47 years (M = 20,9; SD = 4,5), and males clearly dominated (95%). Furthermore, the mean weakly playing time was 20.03 hours (SD = 15.8). Training occupied 38.85% (7.75 h) of the playing time on average. On the one hand, the results reveal game-specific competence and training structures in the five esports selected for the study (Starcraft II, League of Legends, Rocket League, FIFA, and Counter Strike). On the other hand, the factor structure of competencies closely resembles the esports performance model. As a conclusion, esports training methods should always consider the specific competence profile of the respective esports game. [ABSTRACT FROM AUTHOR]

Introduction: The number of cancer survivors is projected to increase to 22.1 million by 2030. Late effects incorporate the full domains of cancer survivorship (e.g., physiologic, psychosocial, economic). They are numerous, complex, and potentially alter the life trajectories of cancer survivors. Currently, research is missing on the impact of late effects (e.g., cardiomyopathy, fertility, lymphedema, anxiety) on cancer survivors. Objective: The goal of this study is to present a systematic review of existing instruments for identifying, diagnosing, and managing late effects within cancer survivors. Methods: Using PRISMA guidelines, a systematic search was conducted using the electronic databases of PubMed and Web of Science to identify relevant papers. Articles considered eligible for this review met the following criteria: 1) written in English, 2) published until September 30, 2019, and 3) containing instruments with questions on late effects. Hypothesis, study design, study sample, questionnaire domains, details of late effects, results, conclusions, and advantages/disadvantages of each article were assessed using a modified version of the NHLBI quality assessment tool. Results: An exhaustive literature review revealed 576 publications in PubMed, 628 in Web of Science, and 260 from additional sources. After removing duplicates, articles without late-effects questionnaires, and publications using identical questionnaires, 11 studies fulfilled the eligibility criteria. Study quality assessment was measured on a scale of 0–6 (0 = poor quality; 6 = highest quality). Only one study was rated with a score of 5 (Rocque). Conclusions: Taken in totality, none of the studies adequately addressed the prevalence, etiology, characteristics, management, and prevention of late effects. There is currently no comprehensive questionnaire that captures all of the relevant details of late effects across the cancer survivorship continuum nor that tracks the interrelatedness of multiple late effects. Hence, it is difficult to identify, diagnose, manage, and ultimately prevent late effects. [ABSTRACT FROM AUTHOR]

Reflective functioning or mentalizing is the capacity to interpret both the self and others in terms of internal mental states such as feelings, wishes, goals, desires, and attitudes. This paper is part of a series of papers outlining the development and psychometric features of a new self-report measure, the Reflective Functioning Questionnaire (RFQ), designed to provide an easy to administer self-report measure of mentalizing. We describe the development and initial validation of the RFQ in three studies. Study 1 focuses on the development of the RFQ, its factor structure and construct validity in a sample of patients with Borderline Personality Disorder (BPD) and Eating Disorder (ED) (n = 108) and normal controls (n = 295). Study 2 aims to replicate these findings in a fresh sample of 129 patients with personality disorder and 281 normal controls. Study 3 addresses the relationship between the RFQ, parental reflective functioning and infant attachment status as assessed with the Strange Situation Procedure (SSP) in a sample of 136 community mothers and their infants. In both Study 1 and 2, confirmatory factor analyses yielded two factors assessing Certainty (RFQ_C) and Uncertainty (RFQ_U) about the mental states of self and others. These two factors were relatively distinct, invariant across clinical and non-clinical samples, had satisfactory internal consistency and test–retest stability, and were largely unrelated to demographic features. The scales discriminated between patients and controls, and were significantly and in theoretically predicted ways correlated with measures of empathy, mindfulness and perspective-taking, and with both self-reported and clinician-reported measures of borderline personality features and other indices of maladaptive personality functioning. Furthermore, the RFQ scales were associated with levels of parental reflective functioning, which in turn predicted infant attachment status in the SSP. Overall, this study lends preliminary support for the RFQ as a screening measure of reflective functioning. Further research is needed, however, to investigate in more detail the psychometric qualities of the RFQ. [ABSTRACT FROM AUTHOR]

Purpose: This paper identifies predictors of recovery trajectories of quality of life (QoL), health status and personal wellbeing in the two years following colorectal cancer surgery. Methods: 872 adults receiving curative intent surgery during November 2010 to March 2012. Questionnaires at baseline, 3, 9, 15, 24 months post-surgery assessed QoL, health status, wellbeing, confidence to manage illness-related problems (self-efficacy), social support, co-morbidities, socio-demographic, clinical and treatment characteristics. Group-based trajectory analyses identified distinct trajectories and predictors for QoL, health status and wellbeing. Results: Four recovery trajectories were identified for each outcome. Groups 1 and 2 fared consistently well (scores above/within normal range); 70.5% of participants for QoL, 33.3% health status, 77.6% wellbeing. Group 3 had some problems (24.2% QoL, 59.3% health, 18.2% wellbeing); Group 4 fared consistently poorly (5.3% QoL, 7.4% health, 4.2% wellbeing). Higher pre-surgery depression and lower self-efficacy were significantly associated with poorer trajectories for all three outcomes after adjusting for other important predictors including disease characteristics, stoma, anxiety and social support. Conclusions: Psychosocial factors including self-efficacy and depression before surgery predict recovery trajectories in QoL, health status and wellbeing following colorectal cancer treatment independent of treatment or disease characteristics. This has significant implications for colorectal cancer management as appropriate support may be improved by early intervention resulting in more positive recovery experiences. [ABSTRACT FROM AUTHOR]

Objectives: Our hospital replaced the format for delivering portable antimicrobial prescribing guidance from a paper-based pocket guide to a smartphone application (app). We used this opportunity to assess the relationship between its use and the attitudes and behaviours of antimicrobial prescribers. Methods: We used 2 structured cross-sectional questionnaires issued just prior to and 3 months following the launch of the smartphone app. Ordinal Likert scale responses to both frequencies of use and agreement statements permitted quantitative assessment of the relationship between variables. Results: The smartphone app was used more frequently than the pocket guide it replaced (p < 0.01), and its increased use was associated with sentiments that the app was useful, easy to navigate and its content relevant. Users who used the app more frequently were more likely to agree that the app encouraged them to challenge inappropriate prescribing by their colleagues (p = 0.001) and were more aware of the importance of antimicrobial stewardship (p = 0.005). Reduced use of the app was associated with agreement that senior physicians’ preferences for antimicrobial prescribing would irrespectively overrule guideline recommendations (p = 0.0002). Conclusions: Smartphone apps are an effective and acceptable format to deliver guidance on antimicrobial prescribing. Our findings suggest that they may empower users to challenge incorrect prescribing, breaking well-established behaviours, and thus supporting vital stewardship efforts in an era of increased antimicrobial resistance. Future work will need to focus on the direct impact on drug prescriptions as well as identifying barriers to implementing smartphone apps in other clinical settings. [ABSTRACT FROM AUTHOR]

Background: Illness perceptions are linked to individual help-seeking and preventive behaviors. Previous illness perception studies have identified five dimensions of illness-related experience and behaviour. The Revised Illness Perception Questionnaire (IPQ-R) for genetic predisposition (IPQ-R-GP) was developed to measure illness perceptions in those genetically-predisposed to blood disease. We adapted the IPQ-R-GP to measure perceptions of generalized cancer predisposition. This paper describes the development and validation of the Cancer Predisposition Perception Scale (CPPS). Methods: The draft CPPS scale was first administered to 167 well Hepatitis B carriers and 123 other healthy individuals and the factor structure was examined using Exploratory Factor Analysis. Then the factor structure was confirmed in a second sample comprising 148 healthy controls, 150 smokers and 152 passive smokers using Confirmatory Factor Analysis (CFA). Results: Six-factors comprising 26 items provided optimal fit by eigen and scree-plot methods, accounting for 58.9% of the total variance. CFA indicated good fit of the six-factor model after further excluding three items. The six factors, Emotional representation (5 items), Illness coherence (4 items), Treatment control (3 items), Consequences (5 items), Internal locus of control (2 items) and External locus of control (4 items) demonstrated adequate-to-good subscale internal consistency (Cronbach’s α = 0.63–0.90). Divergent validity was suggested by low correlations with optimism, self-efficacy, and scales for measuring physical and psychological health symptoms. Conclusion: The CPPS appears to be a valid measure of perceived predisposition to generic cancer risks and can be used to examine cancer-risk-related cognitions in individuals at higher and lower cancer risk. [ABSTRACT FROM AUTHOR]

This study aimed to replicate findings on sensitivity groups, their proportions, and cut-off scores in a South Korean population. Uniquely, it extended the age range to include participants up to 80 years old, representing the first attempt to validate these constructs across such a broad age spectrum in this cultural context. A total of 1773 South Koreans in their 20s to 80s participated in the Highly Sensitive Person Scale (HSPS) questionnaire survey, conducted to establish a cut-off score to be used more conveniently in real-world scenarios. The results showed that 22.0%, 45.3%, and 32.7% belonged to the low-, medium-, and high-sensitivity groups, respectively. The average item scores of 3.81 and 4.73 served as cut-off points distinguishing low- from medium-sensitivity and medium- from high-sensitivity groups, respectively. This study represents applied research on the use of HSPS. Research on HSPS cut-off scores considering cultural or demographic characteristics is still in its early stages, and accumulating data through various surveys is key for in-depth comparative analyses. [ABSTRACT FROM AUTHOR]

Human well-being and functioning depend on two fundamental mental states: Relaxation and sleepiness. Relaxation and sleepiness are both assumed to be states of low physiological arousal and negatively correlated. However, it is still unclear how consistent this negative relationship is across different settings and whether it changes before and after an intervention. Here we investigated this intricate relationship between subjective momentary sleepiness and relaxation states by meta-analytically analyzing several data sets from studies using the Relaxation State Questionnaire. We discovered that subjective sleepiness and relaxation were in fact anti-correlated pre-intervention. This anti-correlation provides a quantitative dissociation between sleepiness and relaxation. Thus, even though sleepiness and relaxation both implicate a low arousal level, the two mental states are subjectively experienced in a qualitatively different fashion, and thus reflect distinct underlying constructs. For the post-intervention relationship, this negative correlation could not be consistently found. This indicates that there are aspects of the experimental setting or intervention that introduce changes in the dynamics of the relationship of the two constructs. [ABSTRACT FROM AUTHOR]

Purpose: Self-regulation is the capacity to regulate attention, emotion, and behaviour to pursue long-term goals. The current study examined the associations between role model presence and self-regulation during early adolescence, controlling for hopefulness, using a large population-based data set from the Tokyo Teen Cohort study. Methods: Adolescents, aged 12 years, identified a role model using a single item on a paper questionnaire: ‘Who is the person you most look up to?’ Level of hopefulness was also assessed using a single question: ‘To what extent do you feel hopeful about the future of your life?’ Trained investigators evaluated self-regulation. Results: Of 2550 adolescents, 2279 (89.4%) identified a role model. After adjusting for level of hopefulness, identifying a role model was associated with higher levels of self-regulation in comparison to indications of no role model. Hopeful future expectations were also associated with higher self-regulation; however, the beta coefficient was smaller than role model presence in the multivariate linear regression analysis. Conclusions: Role model presence was significantly associated with higher self-regulation among early adolescents. Educational environments should focus on support for adolescents with no role models. [ABSTRACT FROM AUTHOR]

Objectives: The Norwegian randomized controlled trial Early Food for Future Health provided parental anticipatory guidance on early protective feeding practices from child age 6 to 12 months through an eHealth intervention. Previously published outcomes at child age 12 months indicated that the eHealth intervention increased daily vegetable/fruit intake and promoted more beneficial mealtime routines. The objective of the current paper is to evaluate the effects of the intervention at child age 24 months, one year after cessation. Methods: Parents of infants aged 3–5 months were recruited via social media and child health clinics during spring 2016. At child age 5.5 months, 715 mothers were randomized to either control (n = 358) or intervention (n = 360) arm. Primary study-outcomes were child eating behaviors, dietary intake, mealtime routines and maternal feeding practices and feeding styles. Secondary outcome was child anthropometry. Results: In total 295 mothers (41%) completed the follow-up questionnaire at child age 24 months. Regarding fruit intake, 54.3% in the intervention group had a high score compared with 48.3% of the control group (p = 0.29). For intake of vegetables, 54.5% in the intervention group had a high score compared with 50.7% in the control group (p = 0.49). A total of 65.7% of the children in the intervention group were eating breakfast together with family ≥ 4 times per week, compared with 57.3% of the children in the control group (p = 0.12). There was no difference between the groups for child anthropometric outcomes at child age 24 months. Conclusions: At child age 24 months, we found no evidence of sustained intervention-effects. Although dietary patterns and mealtime routines at child age 24 months were reasonably consistent and in the same directions as at child age 12 months, the between-group differences were not significant. The large loss to follow-up may have limited power and validity and makes it difficult to draw overall conclusions. Future research is needed to improve knowledge of how short-time effects could be retained over longer term, taking into account that larger samples are necessary when planning longer-term follow-up studies. Trial registration: ISRCTN, . [ABSTRACT FROM AUTHOR]

‘Honour killing’, the murder of women to preserve family reputation, is well recognised but infrequently systematically researched. This paper has three hypotheses. First, in families where women report an ‘honour killing’ there is more violence against women and girls, second these women are more likely to report more patriarchal gender attitudes than others, and third these families are exposed to higher levels of poverty. We asked (n = 1461) women enrolled in a trial in Afghanistan, and (n = 535) in a population-based sample in the occupied Palestinian Territories (oPT) if there had ever been an ‘honour killing’ in their family. In Afghanistan, 2.3% (n = 33), and the oPT 7.7% (n = 41), reported this. We built separate multivariable logistic regression models for each country, and for married and unmarried women in each country. Among Afghan married women, ‘honour killing’ was associated with borrowing because of hunger (adjusted odds ratio [aOR]8.71, 95%CI 2.27–33.40), easier access to money in emergency (aOR11.39, 95%CI 3.05–42.50), and violence within the family; intimate partner violence (IPV) (aOR3.73, 95%CI 1.12–12.36), and IPV and mother-in-law violence (aOR10.52, 2.60–42.56). For unmarried women in Afghanistan, ‘honour killing’ was associated with easier access money in an emergency (aOR4.06, 95%CI 0.85–19.37), household violence (hit by parent or sibling, or parent and sibling [aOR5.47, 95%CI 0.82–36.70; aOR7.37, 95%CI 1.24–43.86, respectively]); more childhood traumas (aOR1.24, 1.11–1.38), and more patriarchal personal gender attitudes (aOR1.24, 1.00–1.54). In the oPT experiencing IPV (aOR3.07, 1.02–9.23) and borrowing and experiencing IPV (aOR5.89, 1.84–18.79) were risks for married women. For unmarried women borrowing because of hunger was associated with higher risk (aOR2.33, 95%CI 1.18–4.85). Despite limitations–specifically the potential women were reporting the same ‘honour killing’—our analysis suggests ‘honour killings’ are associated with violence, patriarchy, and poverty. Research is needed for the prevention of ‘honour killing’, which must address the root causes. Trial Registration: ClinicalTrials.gov . [ABSTRACT FROM AUTHOR]

Previous school-based interventions have produced positive effects upon measures of children’s health and wellbeing but such interventions are often delivered by external experts which result in short-term effects. Thus, upskilling and expanding the resources available to classroom teachers could provide longer-term solutions. This paper presents a feasibility study of an online health resource (Healthy Schools Resource: HSR) developed to assist primary school teachers in the delivery of health-related education. Four schools (n = 2 intervention) participated in this study. Study feasibility was assessed by recruitment, retention and completion rates of several outcomes including height, weight, waist circumference, blood pressure and several metabolic markers including HDL-cholesterol, triglycerides, glucose and dietary knowledge following a 10-12-week intervention period. The process evaluation involved fidelity checks of teachers’ use of the HSR and post-intervention teacher interviews. A total of 614 consent forms were issued and 267 were returned (43%), of which, 201 confirmed consent for blood sampling (75%). Retention of children participating in the study was also high (96%). Of the 13 teachers who delivered the intervention to the children, four teachers were excluded from further analyses as they did not participate in the fidelity checks. Overall, teachers found the online resource facilitative of teaching health and wellbeing and several recommendations regarding the resource were provided to inform further evaluations. Recruitment and retention rates suggest that the teacher led intervention is feasible and acceptable to both teachers, parents and children. Initial findings provide promising evidence that given a greater sample size, a longer intervention exposure period and changes made to the resource, teachers’ use of HSR could enhance measures of health and wellbeing in children. [ABSTRACT FROM AUTHOR]

People with spinal cord injuries (SCI), and particularly with high level lesions, can potentially lose the ability to effectively operate computers. The Multimedia Authoring and Management using your Eyes and Mind (MAMEM) project aims to design and produce a novel assistive device to support computer use by individuals with SCI and other disabilities. The solution harnesses eye tracking and brain waves, as measured by encephalography (EEG), to manipulate common computer functions. This paper describes the first step in the project, during which we defined clinically related requirements of the assistive device. These definitions were based on data from three sources: (1) a narrative review; (2) a focus group of SCI rehabilitation professionals; and (3) structured questionnaires administrated to potential computer users with SCI, addressing computer-use habits, barriers, and needs. We describe both the collection of data from each source and the clinically related requirements extracted. The novel three-source requirement assessment method is discussed, and the advantages and disadvantages of each data source are reported. In conclusion, we suggest that this approach makes it possible to organize, discuss, and prioritize the requirements, and to create a work program while planning the device. This increases our level of certainty that the efficacy and adequacy of the assistive device will be maximized, in terms of the clinical needs of users. [ABSTRACT FROM AUTHOR]

University dropout is a growing problem with considerable academic, social and economic consequences. Conclusions and limitations of previous studies highlight the difficulty of analyzing the phenomenon from a broad perspective and with bigger data sets. This paper proposes a new, machine-learning based method, able to examine the problem using a holistic approach. Advantages of this method include the lack of strong distribution hypothesis, the capacity for handling bigger data sets and the interpretability of the results. Results are consistent with previous research, showing the influence of personal and contextual variables and the importance of academic performance in the first year, but other factors are also highlighted with this model, such as the importance of dedication (part or full time), and the vulnerability of the students with respect to their age. Additionally, a comprehensive graphic output is included to make it easier to interpret the discovered rules. [ABSTRACT FROM AUTHOR]