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Background: Previous studies have documented that disordered eating is associated with a wide range of impaired physical and mental health conditions among children and adolescents. The relationship between disordered eating and health-related quality of life (HRQOL) has been predominantly examined in children and adolescents who are overweight or obese or suffer from chronic illnesses. In the last decade, several studies have been conducted to investigate the relationship between disordered eating and HRQOL among school and community children and adolescents. No systematic review or meta-analysis has synthesized the findings from these population-based studies. The purpose of this systematic review and meta-analysis was to synthesize the relationship between disordered eating and HRQOL among the general population of children and adolescents. Methods: We performed a computer search for the English language literature using the databases PUBMED, EMBASE and PSYCINFO to retrieve eligible studies published between 1946 and August 9, 2018. We also searched the relevant articles using PubMed related article search features and manually examined the reference lists of the retrieved full text articles selected from the database search. The association between disordered eating and HRQOL was synthesized using both a qualitative method and a meta-analysis. The review was conducted adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: We identified eight studies that met the inclusion criteria and were included in the final synthesis. The studies included six cross-sectional studies and two longitudinal studies. The systematic review found that disordered eating attitudes and behaviors were associated with lower HRQOL among children and adolescents. Children and adolescents with bulimia nervosa (BN), binge eating disorder (BED), purging disorder (PD) and other eating disorder symptoms had poorer HRQOL than their healthy peers without the eating disorder conditions. The meta-analysis using four out of the eight studies showed that disordered eating was significantly associated with poor psychosocial health and lower overall HRQOL among children and adolescents. Conclusion: The present review reveals that disordered eating behaviors and eating disorders are associated with decreased HRQOL in children and adolescents. More prospective studies are needed to ascertain the directions in the relationship between disordered eating and HRQOL among children and adolescents. The findings of this review suggest that health programs for promoting healthy eating and reducing disordered eating behaviors among school children and adolescents may help to enhance the HRQOL and overall health status of these individuals. [ABSTRACT FROM AUTHOR]

Human neonates spontaneously associate changes in magnitude across the dimensions of number, length, and duration. Do these particular associations generalize to other pairs of magnitudes in the same way at birth, or do they reflect an early predisposition to expect specific relations between spatial, temporal, and numerical representations? To begin to answer this question, we investigated how strongly newborns associated auditory sequences changing in number/duration with visual objects changing in levels of brightness. We tested forty-eight newborn infants in one of three, bimodal stimulus conditions in which auditory numbers/durations increased or decreased from a familiarization trial to the two test trials. Auditory numbers/durations were paired with visual objects in familiarization that remained the same on one test trial but changed in luminance/contrast or shape on the other. On average, results indicated that newborns looked longer when changes in brightness accompanied the number/duration change as compared to no change, a preference that was most consistent when the brightness change was congruent with the number/duration change. For incongruent changes, this preference depended on trial order. Critically, infants showed no preference for a shape change over no shape change, indicating that infants likely treated brightness differently than a generic feature. Though this performance pattern is somewhat similar to previously documented associations, these findings suggest that cross-magnitude associations among number, length, and duration may be more specialized at birth, rather than emerge gradually from postnatal experience or maturation. [ABSTRACT FROM AUTHOR]

Background: Multi-substance use is accompanied by increased morbidity and mortality and responsible for a large number of emergency department (ED) consultations. To improve the treatment for this vulnerable group of patients, it is important to quantify and break down in detail the ED resources used during the ED treatment of multi-substance users. Methods: This retrospective single centre case-control study included all ED consultations of multi-substance users over a three-year study period at a university hospital in Switzerland. Resource consumption of these patients was compared to an age-matched control group of non-multi-substance users. Results: The analysis includes 867 ED consultations of multi-substance users compared to 4,335 age-matched controls (5:1). Multi-substance users needed more total resources (median tax points [medical currency] (IQR): 762 (459–1226) vs. 462 (196–833), p<0.001), especially physician, radiology, and laboratory resources. This difference persisted in multivariable analysis (geometric mean ratio (GMR) 1.2, 95% CI: 1.1–1.3, p = 0.001) adjusted for sociodemographic parameters, consultation characteristics, and patient comorbidity; the GMR was highest in ED laboratory and radiology resource consumption. Among multi-substance user, indirect and non-drug-related consultations had higher ED resource consumption compared to drug-related consultations. Furthermore, leading discipline as well as urgency were predictors of ED resource consumption. Moreover, multi-substance users had more revisits (55.2% vs. 24.9%, p<0.001) as well as longer ED and in-hospital stays (both: GMR 1.2, 95% CI: 1.1–1.3, p<0.001). Conclusion: ED consultations of multi-substance users are expensive and resource intensive. Multi-substance users visited the ED more often and stayed longer at the ED and in-hospital. The findings of our study underline the importance of this patient group. Additional efforts should be made to improve their ED care. Special interventions should target this patient group in order to decrease the high frequency and costs of emergency consultations caused by multi-substance users. [ABSTRACT FROM AUTHOR]

This study examines the relationship between female representation in different organisational positions and performance using a sample of Spanish secondary schools. These organizations have been usually depicted as ‘feminised environments’ although women in managerial positions are still underrepresented. Based on different theoretical approaches, we separately investigate the relationship between a greater female presence and school performance in three positions: a) as principal; b) on the management team; and c) as teachers. We also investigate if having a female leader exerts a significant mediator role on the relationship between greater female representation on the management team and teachers, respectively, and school performance. Our results reveal a positive and significant relationship between having a woman principal or a greater proportion of women teachers and school performance. However, the relationship between a high proportion of women on the management team and school performance is negative. We also find that a female principal does not play a significant role as mediator in the relationship between having a greater proportion of women on the management team and as teachers and school performance. [ABSTRACT FROM AUTHOR]

The Best Possible Self (BPS) exercise promotes a positive view of oneself in the best possible future, after working hard towards it. Since the first work that attempted to examine the benefits of this intervention in 2001, studies on the BPS have grown exponentially and, currently, this is one of the most widely used Positive Psychology Interventions. However, little is yet known about its overall effectiveness in increasing wellbeing outcomes. Thus, the aim of this meta-analysis is to shed light on this question. A systematic literature search was conducted, and 29 studies (in 26 articles) met the inclusion criteria of empirically testing the intervention and comparing it to a control condition. In addition, BPS was compared to gratitude interventions in some of the included studies. A total of 2,909 participants were involved in the analyses. The outcome measures were wellbeing, optimism, depressive symptoms, and positive and negative affect. Results showed that the BPS is an effective intervention to improve wellbeing (d+ = .325), optimism (d+ = .334) and positive affect (d+ = .511) comparing to controls. Small effect sizes were obtained for negative affect and depressive symptoms. Moderator analyses did not show statistically significant results for wellbeing, except for a trend towards significance in the age of the participants (years) and the magnitude of the intervention (total minutes of practice). In addition, the BPS was found to be more beneficial for positive and negative affect than gratitude interventions (d+ = .326 and d+ = .485, respectively). These results indicate that the BPS can be considered a valuable Positive Psychology Intervention to improve clients’ wellbeing, and it seems that it might be more effective for older participants and with shorter practices (measured as total minutes of practice). [ABSTRACT FROM AUTHOR]

Previous studies suggest theory of mind (ToM) ability declines with age. However, prior tasks not only required ToM competence but also imposed high executive function (EF) demands, so decline in ToM ability could be caused by deterioration in ToM competence, EF, or both. It was predicted that if the elderly have intact ToM competence but compromised EF, then they should perform similarly to younger adults when using ToM tasks that lower executive demands, such as spontaneous-response tasks. Results showed that on tasks with reduced demands, older adults tracked belief to the same extent as younger adults, despite their declining EF. The findings support a model in which age-related decline in ToM ability is primarily caused by compromised EF, not ToM competence, suggesting that underlying ToM mechanisms are still intact in the elderly. We discuss implications of this work for competence-performance issues in ToM processing and the underlying sources of age-related deterioration of ToM. [ABSTRACT FROM AUTHOR]

Background and aim: Prevalence and motives for nipple shield use are not well studied in preterm infants and recommendations of nipple shield use in preterm infants are inconsistent. The aim of this study was to determine the prevalence of nipple shield use, explore the motives for nipple shield use and elucidate the association with exclusive breastfeeding in preterm infants. Methods: The study was part of a prospective survey of a Danish national cohort of preterm infants based on questionnaires answered by the 1221 mothers of 1488 preterm infants with gestational age of 24–36 weeks. Data on nipple shield use was available for 1407 infants. Results: Nipple shields were used by 54% of the mother-infant dyads for many different motives and was more often related to breastfeeding problems associated with the infant than with the mother. The most common motive for nipple shield use was “infant slipped the nipple” (52%). The lower the gestational age, the more frequently nipple shields were used for motives related to the infant. For those using a nipple shield, only the motive “infant fell asleep at the breast” was associated with a higher risk of not breastfeeding exclusively at discharge (OR 1.90 (95% CI 1.15; 3.13), p = 0.012), and “breast too engorged” with a lower risk of not breastfeeding exclusively (OR 0.32 (0.16; 0.63), p = 0.001), but overall nipple shield use was associated with failure of exclusive breastfeeding. Conclusion: The present study does not give justifiable motives for nipple shield use, except for “breast too engorged”. Nipple shields should not be recommended for infants falling asleep at the breast, instead, staff and mothers should be patient, allowing the dyad time skin-to-skin. The results indicate that the use of a nipple shield does not promote exclusive breastfeeding in preterm infants. [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]

Continuous norming methods have seldom been subjected to scientific review. In this simulation study, we compared parametric with semi-parametric continuous norming methods in psychometric tests by constructing a fictitious population model within which a latent ability increases with age across seven age groups. We drew samples of different sizes (n = 50, 75, 100, 150, 250, 500 and 1,000 per age group) and simulated the results of an easy, medium, and difficult test scale based on Item Response Theory (IRT). We subjected the resulting data to different continuous norming methods and compared the data fit under the different test conditions with a representative cross-validation dataset of n = 10,000 per age group. The most significant differences were found in suboptimal (i.e., too easy or too difficult) test scales and in ability levels that were far from the population mean. We discuss the results with regard to the selection of the appropriate modeling techniques in psychometric test construction, the required sample sizes, and the requirement to report appropriate quantitative and qualitative test quality criteria for continuous norming methods in test manuals. [ABSTRACT FROM AUTHOR]

Objectives: Patients with mental health disorders often have to endure the burdens of the condition itself and the stigma that follows. Since no study has been conducted in Lebanon on this topic, our objective was to assess the knowledge, attitude and behaviors towards public stigma of mental health diseases, among a sample of the Lebanese population. Methods: A cross-sectional study, conducted between November 2017 and May 2018, enrolled 2289 participants. The Mental Health Knowledge Schedule (MAKS), the Community Attitudes toward Mental Illness (CAMI) and the Reported and Intended Behavior Scale (RIBS) were used to assess knowledge, attitude and behaviors toward mental illness respectively. The 25th, 50th and 75th percentile of the MAKS, CAMI and RIBS scales scores were considered as cutoff points for low, medium and high scores respectively. Results: A high knowledge score was found in 33.0% of the participants, whereas a high attitude score and a higher behavior score were found in 32.2% and 26.9% of the participants respectively. Living in North Lebanon (Beta = 1.331) and being familiar with a non-close person with mental illness (Beta = 0.811) were associated with higher knowledge of mental illness (higher MAKS score), whereas living in Bekaa (Beta = -8.693) and being 70 years old and above (Beta = -5.060) were associated with lower knowledge toward mental illness (lower MAKS score). Higher knowledge of mental illness (higher MAKS score) (Beta = 0.670), having a high level of education (university (Beta = 8.785), secondary (Beta = 6.084) and technical (Beta = 5.677)) were associated with less stigmatizing attitudes (higher CAMI scale). Being familiar with close people with mental illness (Beta = 0.577), less stigmatizing attitudes (higher CAMI scale) (Beta = 0.077) and higher knowledge of mental illness (higher MAKS score) (Beta = 0.115) were associated with higher favorable behaviors (higher RIBS score), whereas knowing a non-close person who have a mental illness (Beta = -0.720) was associated with lower favorable behaviors (lower RIBS score). Conclusion: A mass media awareness campaigns that could transmit health messages to a wide public audience in the country to fight stigma toward mental illness, seems warranted. [ABSTRACT FROM AUTHOR]

Background: Speaking up behavior is a manifestation the culture of safety in an organization; however, withholding voice is commonly observed. Within one academic teaching hospital, it was the aim to assess students’ speaking up behaviors and perceived culture in order to stimulation of the academic development in terms of patient safety. Methods: Survey amongst medical students using a validated questionnaire. Data were analysed using descriptive statistics. Results: 326 individuals completed the questionnaire (response rate 24%). 37% of responders were in their 5th- 6th clinical term, 32% were in their 7th-8th term and 31% were in the 9th-12th term. 69% of students had a specific safety concern in the past four weeks, 48% had observed an error and 68% noticed the violation of a patient safety rule. Though students perceived specific patient safety concerns, 56% did not speak up in a critical situation. All predefined barriers seemed to play an important role in inhibiting students’ voicing concerns. The scores on the psychological safety scale were overall moderately favourable. Students felt little encouraged by colleagues and, in particular, by supervisors to speak up. Conclusion: Speaking up behaviour of students was assessed for the first time in an Austrian academic teaching hospital. The higher the term the more frequent students reported perceived patient safety concerns or rule violations and withholding voice. These results suggest the need to adapt the curriculum concept of the faculty in order to address patient safety as a relevant topic. [ABSTRACT FROM AUTHOR]

This scoping review presents an overview of cognitive and social congruence in peer assisted learning (PAL), as the positive effects of PAL have been shown to rely on these critical factors. The scoping review followed the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Databases were systematically searched for articles that focus on PAL and cognitive and social congruence. Participants of the studies included were medical, health science, polytechnic, law and paramedic students. Studies that assessed cognitive and social congruence by questionnaires with a 5-point Likert scale were regarded for meta-analytic pooling. Sixteen of 786 identified articles were included in the review, whereof 9 studies were considered for meta-analytic pooling. The meta-analytic pooling showed that tutees tend to see their student tutors as cognitively (Mweighted = 3.84; range of Mweighted = 2.69–4.56) and socially congruent (Mweighted = 3.95; range of Mweighted = 2.33–4.57). Further, characteristics of student tutors are summarized. This scoping review presents an overview and operationalization of cognitive and social congruence in PAL. Based on the presented meta-analytic pooling, cognitive and social congruence were found to represent relevant key factors in the PAL context. Thus, this theoretical background should be acknowledged as a core concept for tutorials within the medical curriculum. [ABSTRACT FROM AUTHOR]

Purpose: The Edinburgh Postnatal Depression Scale (EPDS) aims at detecting postpartum depression. It has been hypothesized that a subscale (items 3, 4, 5) may detect anxiety. The aim of this study is to assess whether this EPDS anxiety subscale is present in a community-based dataset, and if so, to assess its validity and stability during the first six months postpartum. Methods: We obtained EPDS data of a community sample of 1612 women at 1 month, with follow-up at 3 and 6 months, postpartum (Post-Up study). We performed an exploratory factor analysis on the EPDS forcing two- and three-factor solutions. We assessed the correlations of the extracted factor subscales and the total EPDS with the short-form of the STAI (STAI-6). We examined the stability of the identified factors by means of a confirmatory factor analysis (CFA), using the EPDS data collected at 3 and 6 months postpartum. Results: Both the two- and three-factor solutions contained a hypothesized anxiety subscale of items 3,4,5,10, and fitted well with the 3- and 6-months EPDS data, with CFI and TLI values >.99 and RMSEA and SRMR values < .035 and < .45. The subscale’s Pearson correlations with the STAI-6 were moderate: .516, compared to .643 for the total EPDS. Conclusions: The factor structure of the EPDS is stable across the first six months postpartum, and includes the subscale assumed to represent anxiety. However, this subscale as well as the total EPDS correlate only moderately with anxiety criteria. Using the EPDS thus does not imply adequate screening for anxiety. [ABSTRACT FROM AUTHOR]

Personal control relies on the expectation that events are contingent upon one’s own behavior. A common ‘inconsistency compensation approach’ posits that a violation of expectancies in social interaction triggers aversive arousal and compensatory effort. Following this approach, we tested the hypothesis that interventions affecting participants' decisions violate the expected personal control. In a modified version of the established cyberball paradigm, participants were not excluded, but consistently included. However, their decisions regarding the recipient of a ball throw in the virtual game were occasionally overruled (expectancy violation). We hypothesized that this intervention will trigger a P3 response in event-related brain potentials (ERP). Since this component is related to subjective expectancies, its amplitude was assumed to depend on the frequency of interventions (independent factor: loss of control). Further, we manipulated the vertical position of the participants’ avatar on the computer screen (independent factor: verticality). Building on research showing that verticality is related to the self-assigned power and influences the expected level of control, we hypothesized that the ERP effects of intervention should be more pronounced for participants with avatars in superior position. As predicted, both experimental factors interactively affected the expression of the ERP response: In case of low intervention frequency, P3 amplitudes were significantly pronounced if the participants’ avatar was positioned above as compared to below co-players (high > low self-assigned power). The effect of verticality could be traced back to a lack of adaptation of P3 amplitudes to recurring aversive events. By demonstrating that loss of control triggers ERP effects corresponding to those triggered by social exclusion, this study provides further evidence for a common cognitive mechanism in reactions to aversive events based on an inconsistency in expectancy states. [ABSTRACT FROM AUTHOR]

This paper examines whether tobacco expenditure leads to the crowding out or crowding in of different expenditure items in South Africa. We apply genetic matching to expenditure quartiles of the 2010/2011 South African Income and Expenditure Survey. Genetic matching is a more appealing approach for dealing with the endogeneity of tobacco expenditure that often plagues studies using systems of demand equations. Further, genetic matching provides transparent measures of covariate balance giving the analyst objective means of assessing match success. We find that the poorest tobacco consuming households in South Africa consistently allocate smaller budget shares towards food items than non-smoking households. Specifically, we find that dairy, fruits, nuts and oils are displaced in favour of tobacco expenditure in the two poorest quartiles. Unsurprisingly, food items are never displaced for households in the top two quartiles, given these households’ greater access to resources. Like other studies in the literature, we find that tobacco expenditure consistently crowds-in alcohol across all quartiles confirming the strong complementarities between the two. [ABSTRACT FROM AUTHOR]

Background: Patients and clinicians endorse the importance of compassionate healthcare but patients report gaps between its perceived importance and its demonstration. Empathy and compassion have been associated with quality of life and significant health outcomes but these characteristics are not optimally measured or used for performance and organizational improvement. Objective: To address these gaps, we conducted a study with the objective of evaluating the properties of the 12-item Schwartz Center Compassionate Care Scale® using psychometric analysis and cognitive debriefing. Methods: Non-hospitalized patients with multiple chronic conditions were sampled using an on-line platform. Classical test theory and Rasch measurement theory were used to evaluate psychometric properties of the scale. Structured questions elicited cognitive responses regarding clarity of each item. Results: Classical test theory analysis confirmed that the 12-item Schwartz Center Compassionate Care Scale is a unidimensional scale with excellent internal consistency and test-retest reliability. Patients’ ratings of compassionate behaviors using the Schwartz Center Compassionate Care Scale correlated significantly with a related instrument designed to measure empathy, demonstrating convergent validity. Rasch measurement theory showed that reducing the number of response options on 3 items in the scale would improve respondents’ discrimination between responses on these items. Although person-item threshold distribution analysis showed that patients may wish to rate compassionate care at levels both higher and lower than the scale permits, items could be ordered on an interval scale from low to high levels of compassionate care. Conclusions: The current 12-item Schwartz Center Compassionate Care Scale demonstrates excellent psychometric properties by Classical Test Theory and Rasch measurement theory. The 12-item Schwartz Center Compassionate Care Scale adds questions related to understanding and discussing emotional, contextual issues and the needs of the patient and family. Easily completed on-line, it could be used for work-place based assessment and feedback to clinicians and performance or quality improvement. [ABSTRACT FROM AUTHOR]

Similarity between targets and distracters is a key factor in generating distractibility, and exerts a large detrimental effect on aging. The present EEG study tested the role of a new stimulus dimension in generating distractibility in visual Working Memory (vWM), namely numerical similarity. In a change detection paradigm a varying number of relevant and irrelevant stimuli were presented simultaneously in opposite hemifields. Behavioral results indicated that young participants outperformed older individuals; however, in both groups numerical similarity per se did not modulate performance. At the electrophysiological level, in young participants the Contralateral Delay Activity (CDA, a proxy for item maintenance in vWM) was modulated by the numerosity of the relevant items regardless of numerical similarity. In older participants, the CDA was modulated by target numerosity only in the same numerical condition, where the total number of (relevant and irrelevant) items increased with increasing target numerosities. No effect was present in the dissimilar numerical condition, where the total number of items did not vary substantially across target numerosity. This pattern was suggestive of an age-related effect of the total number of (relevant and irrelevant) items on vWM. The additional analyses on alpha-band lateralization measures support this interpretation by revealing that older adults lacked selective deployment of attentional and vWM resources towards the relevant hemifield. Overall, the results indicate that, while numerical similarity does not modulate distractibility, there is an age-related redistribution of vWM resources across the two visual fields, ultimately leading to a general decrease in task performance of older adults. [ABSTRACT FROM AUTHOR]

Introduction: Eating breakfast has been proved to positively influence human health. However, evidence for the association between breakfast consumption and depressive symptoms is lacking, especially among young adults. The aim of this study was to determine whether breakfast consumption is associated with depressive symptoms among Chinese university students. Methods: A cross-sectional study involving 10,174 undergraduate students (6,287 males and 3,887 females) was conducted in 2015. Breakfast consumption was assessed using a self-reported questionnaire. Depressive symptoms were assessed using the Zung self-rating depression scale (SDS) score. Three cut-off values of the SDS score (40, 45, and 50) were used to assess the severity of the depressive symptoms. Logistic regression models were used to analyze the association between the frequency of breakfast consumption and depressive symptoms. Results: The mean SDS score was 37.1±8.0 in present study. In crude model, a higher frequency of breakfast consumption was primarily associated with a lower prevalence of depressive symptoms in all three SDS groups (p = 0.001, < 0.001, = 0.009 for SDS cut-off value 40, 45, and 50 points, respectively). These associations remained significant after adjustment for confounding factors. Conclusions: A higher frequency of breakfast consumption was strongly associated with a lower prevalence of depressive symptoms among Chinese university students. These results corroborate the evidence that the habit of eating breakfast may be beneficial to mental health. [ABSTRACT FROM AUTHOR]

A growing body of evidence has shown that active learning has a considerable advantage over traditional lecture for student learning in undergraduate STEM classes, but there have been few large-scale studies to identify the specific types of activities that have the greatest impact on learning. We therefore undertook a large-scale, curriculum-wide study to investigate the effects of time spent on a variety of classroom activities on learning gains. We quantified classroom practices and related these to student learning, assessed using diagnostic tests written by over 3700 students, across 31 undergraduate biology classes at a research-intensive university in the Pacific Northwest. The most significant positive predictor of learning gains was the use of group work, supporting the findings of previous studies. Strikingly, we found that the addition of worksheets as an active learning tool for in-class group activities had the strongest impact on diagnostic test scores. This particular low-tech activity promotes student collaboration, develops problem solving skills, and can be used to inform the instructor about what students are struggling with, thus providing opportunities for valuable and timely feedback. Overall, our results indicate that group activities with low barriers to entry, such as worksheets, can result in significant learning gains in undergraduate science. [ABSTRACT FROM AUTHOR]

In this study, we assumed that correct functional movements for weightlifting can be learned with the help of a music-based biofeedback system. We compared musical feedback with verbal feedback from experienced trainers using two independent groups. The focus was on one specific movement called deadlift. Physical parameters under considerations were the spine (i.e. loss of midline stability resulting in flexion) and the forward displacement of the barbell during the repetitions relative to the mid-foot. We recruited 31 recreational weight lifters (21-42 years of age). Results revealed that both feedback types are effective in improving the movements for deadlift. No significant differences were found across the two feedback types, neither in terms of movement, nor in terms of clarity and motivation. The results suggest that the proposed feedback system is a valid tool for technology-aided training and self-training practices. [ABSTRACT FROM AUTHOR]

Background: Risky sexual behaviours are not uncommon among young adults particularly those in the higher levels of education. It is known that higher self-efficacy could contribute to better sexual and reproductive health outcomes including the use of condoms. However, there is limited research on the role of socio-demographic, behavioural and parental factors as predictors of condom-use self-efficacy. As a result, this exploratory study was designed to assess the predictors of self-efficacy for condom use among university students in Nigeria Methods: A cross-sectional survey was conducted with 755 university students in Nigeria from February to April 2018. Self-efficacy for condom use was assessed by combining responses to 11-items measures of condom self-efficacy drawn from the work of Barkley and colleagues. We fitted a structural equation model to identify the pathways through which socio-demographic, behavioural and parental factors predict two constructs of condom-use self-efficacy (self-efficacy for condom purchase and use and partner communication self-efficacy) in the sample. Results: Demographic factors such as age (β = -0.29, p<0.05) and sex (β = 0.42, p<0.05), as well as ratings on religious importance (β = -0.08, p<0.05) were directly associated with self-efficacy for condom purchase and use. These factors showed significantly mediated effects through sexual experience which also had a direct positive relationship (β = 0.73, p<0.05) with self-efficacy for condom purchase and use. The receipt of parental support, on the other hand, was directly associated with higher partner communication efficacy for condom use (β = 0.07, p<0.05). We found no evidence that the level of partner communication efficacy was directly associated with any of the behavioural, demographic or parental factors. Conclusion: The findings of this study affirm that sex, or age or having higher ratings on religious importance alone does not increases self-efficacy but also exposure to sexual activity through which these factors affect self-efficacy for condom purchase and use. These findings also highlight the need to address and strengthen condom use self-efficacy among young adults, particularly the sexually inexperienced, highly religious and young adults with limited support from their parent. [ABSTRACT FROM AUTHOR]

Background: In the U.S., non-binary refers to transgender people who have a gender identity not aligned with their assigned sex at birth, and who identify outside of the traditional male-female binary, such as genderqueer, genderfluid, or gender nonconforming. Few data are available to characterize the health of non-binary adults. Methods: The current study sought to fill this gap by conducting a secondary analysis of data from a non-probability sample of transgender and/or gender nonconforming adults in Massachusetts (sample mean age 32.6 years, 63% female assigned sex at birth; 79.4% white non-Hispanic/Latinx). Multivariable models were fit to compare non-binary (e.g., genderqueer) vs. binary (e.g., man/trans man, woman/trans woman) respondents across a range of social and health indicators. Results: Overall, 40.9% identified their gender identity as non-binary. Non-binary respondents significantly differed from binary respondents on (all p<0.05): demographics (younger age, more female assigned sex at birth); gender affirmation (older age of identity recognition, lower current uptake of and future desires for medical gender affirmation); healthcare utilization (lower rates of being up-to-date in annual wellness visit, less mental healthcare utilization in past year); mental health and substance use (higher past-week depressive distress, higher hazardous alcohol use); social history (more unstably housed, more current students), violence victimization (lower rates of lifetime intimate partner violence), and social support (less family support). Conclusion: Gender diversity, including whether people endorse a binary or non-binary gender identity, is a prevalent and an important aspect of transgender health. Demographic measures of gender identity that include binary and non-binary response options are recommended to inform future research and clinical care. [ABSTRACT FROM AUTHOR]

Introduction: School victimization by peers is an important social problem with serious short- and long-term consequences poorly studied at preschool ages, which can lead to school bullying without timely intervention. Longitudinal data was used to determine the prevalence of warning signs of preschool peer victimization and its individual and family risk factors. Methods: Data was obtained from 577 community preschoolers. School victimization was measured using the Strengths and Difficulties Questionnaire (SDQ) administered to parents and teachers of children at ages 4 and 5. Risk factors for the child (demographics, conduct and emotional problems, aggressiveness) and the family (maternal problems during pregnancy and early development, parenting styles, adaptive functioning and parents’ problems) were previously recorded at 3 years old. Results: Combined information from parents and teachers showed that 4.2% of preschoolers presented warning signs of victimization at ages 4 and 5. Low socioeconomic status, poor emotional control, early problems making friends and low level of parenting education in social norms at age 3 predicted later victimization at ages 4 and 5 (AUC = .78). Conclusion: Peer victimization affects a considerable percentage of preschoolers. Early detection may help to reduce the risk of escalation. [ABSTRACT FROM AUTHOR]

China relaxed its family planning policy and adopted a universal two-child policy on January 1, 2016 to actively address the country’s aging trend. However, the policy has failed to have any significant effect on the fertility rate of many provinces. In light of the country having the highest sex ratio at birth in the world and the huge burden of the aging population, improving the fertility rate is an urgent priority in China. This facility-based cross-sectional survey aimed to study determinants of fertility decision-making among couples based on the Theory of Planned Behavior. The study was conducted in Inner Mongolia Autonomous Region of China. A structured self-administered questionnaire was completed by 1,399 couples, consisting of wives aged 20–49 years and their husbands. Based on the structural equation modeling method of analysis, determinants of fertility decision-making were perceived behavior control (perceived importance of having a stable income and cost of raising a child), subjective norms (perceived social pressure about “sex preference of the newborn by themselves and their partner”) and attitudes (only healthy parents can have a child). Other significant factors influencing fertility decision were ethnicity and education level, with ethnic minority couples having less perception of social norm towards fertility and those with higher education having higher perceived control toward having a (further) child. The study reveals the importance of the China’s infrastructure and public facilities to support child-rearing to increase the fertility rate among couples of child-bearing age, which in turn will reduce the burden associated with an aging society. [ABSTRACT FROM AUTHOR]

Background: Autism spectrum disorders (ASD) are a set of neurodevelopmental disorders characterised by behavioural, communication and social impairments. The prevalence of sleep disturbances in children with ASD is 40–80%, with significant effects on quality of life for the children and carers. This systematic review aimed to synthesise evidence of the effects of behavioural interventions to improve sleep among children with ASD. Methods: Databases (MEDLINE, PsycINFO, CINAHL, ScienceDirect, Autism Data, CENTRAL, ClinicalTrials.gov and Current Controlled Trials) were searched for published, unpublished and ongoing randomised controlled trials evaluating the effect of non-pharmacological interventions for insomnia in children with autism spectrum conditions. Results: Three studies met the inclusion criteria, one provided actigraphy data, one Children’s Sleep Habits Questionnaire (CSHQ) data, and one both actigraphy and CSHQ data for use in meta-analyses. There were significant differences between the behavioural intervention and comparison groups (actigraphy data) for total sleep time (24.41 minutes, 95% CI 5.71, 43.11, P = 0.01), sleep latency (-18.31 minutes, 95% CI -30.84, -5.77, P = 0.004) and sleep efficiency (5.59%, 95% CI 0.87, 10.31, P = 0.02). There was also a favourable intervention effect evident for the subjective CSHQ data (-4.71, 95% CI -6.70, -2.73, P<0.00001). Risk of bias was low across several key domains (randomisation, allocation concealment and reporting), with some studies being unclear due to poor reporting. Conclusions: There are very few high quality randomised controlled trials in this area. Here we provide initial synthesised quantitative evidence of the effectiveness of behavioural interventions for treating sleep problems in children with ASD. Trial registration: Protocol was registered () on the International Prospective Register of Systematic Reviews (). [ABSTRACT FROM AUTHOR]

Parenting behavior is a key factor in children’s socio-emotional development. However, little is known about similarities and differences in maternal and paternal parenting behavior, as most studies have focused on mothers. The present study investigated similarities and differences in mothers’ and fathers’ parenting behavior during observed free play with their preschool children, in a Danish well-resourced sample. We examined differences in mean scores and associations between mothers’ and fathers’ sensitivity, intrusiveness and limit-setting assessed with the Coding Interactive Behavior instrument. Additionally, we conducted confirmatory factor analysis to test the model-fit between the measurement model and parental data. Exploratory factor analysis was conducted to investigate if maternal and paternal factor structures replicated the three parenting constructs, and to explore if certain parenting behaviors seemed specifically related to either mothering or fathering. Participants included 52 mothers, 41 fathers and their 5-year old children. Similar mean scores were found for mothers and fathers on all parenting constructs. Maternal and paternal parenting behavior were not correlated. Confirmatory factor analysis revealed a poor model-fit. For both mothers and fathers, latent factors related to sensitivity, intrusiveness and limit-setting emerged, which indicated that the Coding Interactive Behavior instrument was suitable for assessment of both maternal and paternal sensitivity, intrusiveness and limit-setting. However, item loadings suggested that the instrument assessed maternal sensitivity more accurately than paternal sensitivity in our sample. Two additional factors were retrieved for fathers, i.e. paternal performance and challenging behavior, and paternal teaching behavior. This finding may suggest that additional parenting constructs need to be developed for researchers to be able to thoroughly investigate similarities and differences in mothers’ and fathers’ parenting behavior. Despite difference in factor structure, we did not identify behaviors solely related to mothering or to fathering. [ABSTRACT FROM AUTHOR]

In this study, we assessed the factor structure and construct validity of the parent-reported Inventory of Callous-Unemotional Traits (ICU) among school-aged children and adolescents, aged 6 to 15 years, in a community setting in Japan (n = 10,936). We investigated 15 models that have been reported in previous studies and used confirmatory factor analyses to determine a model that might actually be the best-fit among these. We then examined the correlations between the score of ICU and the Strengths and Difficulties Questionnaire (SDQ) in the best fit model and the three-factor bifactor (3FBF) model with the original ICU through cross-sectional and longitudinal analysis to determine the concurrent and predictive validity of the ICU. The results showed that the best-fit model was the two-factor bifactor (2FBF) model with a revised version of the ICU with 12 items, excluding all but one item of unemotional factors. The cross-sectional and longitudinal analysis showed that higher general callous-unemotional factor scores, callousness and uncaring specific factor scores were significantly associated with a higher level of conduct problems and a lower level of prosocial behaviors in the SDQ. These tendencies were shown both in the 2FBF model with the revised version of the ICU and the 3FBF model with the original ICU. We conclude that the 2FBF model was useful for school-aged community samples, as it predicts increases in conduct problems and decreases in prosocial behavior with fewer items than the 3FBF model. [ABSTRACT FROM AUTHOR]

Background: Culture influences personal health habits and behavior, and healthcare personnel possess different views of cultural perspectives. Currently, an appropriate instrument to assess cultural competence in clinical practice is limited. The present study aimed to develop and examine the psychometric properties of the Nursing Cultural Competence Scale (NCCS) for clinical nurses. Methods: Developing and assessing the scale was carried out in two phases: Phase I involved a qualitative research to explore the themes of nurses’ cultural competence and instrument development; Phase II established construct validity of the scale using a sample of 246 nurses in Taiwan. Data from the questionnaire were analyzed using exploratory factor analysis, confirmatory factor analysis, internal consistency and test-retest reliability. Analysis results were used to determine the reliability and validity of the developed scale. Results: The results showed four factors including cultural awareness ability, cultural action ability, cultural resources application ability, and self-learning cultural ability were generated by exploratory factor analysis, and these factors explained 62.0% of total variance. Cronbach’s α of the Nursing Cultural Competence Scale was .88, and test-retest reliability correlation was .70. Conclusions: The establishment of the tool will facilitate accurate monitoring of the cultural competence among nurses and nursing managers, which can inform the construction of nursing policies aimed at pledge cultural competence expansion. [ABSTRACT FROM AUTHOR]

Picture fuzzy sets (PFSs) are comparatively a new extension of fuzzy sets which describe the human opinions that has more answers like acceptance, rejection, neutral and desist, which cannot be correctly presented in fuzzy sets (FSs) and intuitionistic fuzzy sets (IFSs). The PFSs are categorized by three objects, the degree of belonging, the degree of neutral belonging and the degree of non- belonging such that the total of these three degrees must not be more than one. So far, there is no such work presented in the literature which deals with unknown weights of criteria based on PFSs. In the present work, we have developed a linear programming (LP) model to find the exact weights from the given constraints of weights for the criteria and construct a modified distance based on similarity measure between picture fuzzy sets. Then we have utilized this similarity measure to achieve the best option in the multiple criteria decision making (MCDM) problem. Lastly, two practical examples for the selection of alternatives are presented to compare the obtained results with the existing similarity measures. [ABSTRACT FROM AUTHOR]

Background: People with disability (PWD) often rely on others, both for direct support and for the creation of enabling environments to meet their needs. This need makes it crucial for professionals to be willing to work with PWD, and for people to pursue careers that focus on supporting PWD. Objectives: To explore self-other overlap as a unique predictor of willingness to work with PWD as part of one’s career, using three studies. Methods: Studies 1 and 2 used cross-sectional surveys of college undergraduates to explore: 1. whether an association between self-other overlap and willingness to work with PWD exists, and 2. whether self-other overlap is a unique predictor, controlling for attitudes and empathy. Study 3 investigated whether self-other overlap is associated with the groups with whom the students indicated they want (and do not want) to work as part of their career. Results: Across the three studies, self-other overlap was uniquely associated with students’ willingness to work with PWD as part of one’s profession, even when controlling for attitudes and empathy. Conclusions: Self-other overlap may be an important additional factor to take into consideration when developing interventions targeted toward promoting working with PWD. [ABSTRACT FROM AUTHOR]

Aims: Personality traits are suggested to influence adults’ cognitive performance, but little is known about their association with visuo-spatial competence, in terms of those visuo-spatial abilities and inclinations crucial to remaining autonomous, especially with aging. This study newly investigated whether, and to what extent, major traits and narrower facets of personality influence young and older adults’ performance in the so-called objective visuo-spatial abilities (mental rotation and visuo-spatial working memory [VSWM]), and self-assessed visuo-spatial inclinations (pleasure and anxiety in exploring places). Method: Seventy young adults (18–35 years old) and 70 older adults (65–75 years old) completed the Big-Five questionnaire, objective rotation and VSWM tasks, and spatial self-assessments on pleasure and anxiety in exploring places. Results: Hierarchical regression models confirmed that age negatively predicted the variance in objective visuo-spatial tasks, but not in self-assessed visuo-spatial inclinations, while only the latter were slightly influenced by gender (in favor of men). Further, both objective visuo-spatial abilities (albeit modestly) and self-assessed visuo-spatial inclinations were predicted by higher Conscientiousness. The latter were also predicted by higher Emotional Stability. Finally, a better objective visuo-spatial performance was explained (again modestly) by lower Dynamism and Politeness, and higher Emotion Control, while higher Perseverance, Emotion Control and Cooperativeness explained a moderate part of the variance in the positive self-assessed visuo-spatial inclinations. Conclusions: Our findings indicate that, beyond age and gender, some personality traits and facets predict self-assessed visuo-spatial inclinations to a larger extent than objective visuo-spatial performance. These results are discussed within the spatial cognition and aging framework. [ABSTRACT FROM AUTHOR]

Physical education professionals aim to develop quality programmes for physical education. This study aimed to develop and validate a scale using professionals’ perceptions of Quality Physical Education QPE in Asia using twenty-four items regarding QPE quality issues. The items covered status and roles, development of educational elements and supportive features in physical education. A sample of N = 799 sport and physical education professionals from eleven Asian cities participated in this questionnaire survey. Twenty-four items relating to QPE were examined via exploratory factor analysis (EFA) using maximum likelihood extraction and direct oblimin rotation methods. Nevertheless, only 20 items were extracted following the EFA examination. Items 1, 9, 14 and 18 were excluded because of low factor loadings. The remaining items were clustered into four subscales: Development and Supportive Elements for Quality Physical Education in Schools (DSFQPE; α = .918), Core Values of Quality Physical Education (CVPE; α = .908), Curriculum Arrangement of Physical Activities (CAPA; α = .884) and Provision and Norms in Physical Education (PNPE; α = .865). The Cronbach’s alpha coefficient (α = .875) indicated excellent internal consistency for the overall measure. Furthermore, the 4 retained factors from the EFA were assessed via robust confirmatory factor analysis (CFA). The 4-factor model demonstrated a good fit with the data (CMIN/DF = 3.450, CFI = .928, TLI = .916, PCFI = .801, RMSEA = .078). The study identified a 4-factor structure with internal consistency and acceptable interfactor correlations. The structure seemed to be applicable, including the twenty items identified as useful and necessary tools for the framework of analysis in the investigation of diverse settings for the study of quality physical education. [ABSTRACT FROM AUTHOR]

Introduction: Although caring for a child with intellectual and developmental disabilities (IDD) can have positive outcomes, parents may be at a greater risk of depression and anxiety, due to a number of associated stressors, such as increased caregiver demands and financial strain. This systematic review updates previous data, exploring the relationship between parenting a child with IDD and parental depression and anxiety. Methods: Five electronic databases were searched for eligible English-language articles, published between January 2004 and July 2018. All epidemiological study designs were eligible, provided the level of depression and/or anxiety was compared between parents of children (aged <18) with and without IDD. No limit was placed on geographic location. The proportion of positive associations between parenting a child with IDD and depression/anxiety were disaggregated by disability type, geographic region, and sample size. The percentage of parents at risk of moderate depression or anxiety were calculated using recognised clinical cut-off scores for each screening tool. Meta-analyses, in which pooled effect sizes of elevated depression and anxiety symptoms were calculated, were conducted across two IDD conditions, autism and cerebral palsy. Results: Of the 5,839 unique records screened, 19 studies fulfilled the inclusion criteria. The majority of studies were conducted in high-income (n = 8, 42%) or upper-middle income countries (n = 10, 53%). Of the 19 studies, 69% focused on parents of children with cerebral palsy (n = 7, 37%) or autism (n = 6, 32%). Nearly all studies found a positive association between parenting a child with IDD and depression (n = 18, 95%) and anxiety (n = 9, 90%) symptoms. Factors associated with higher levels of depression symptoms amongst parents of children with IDD included disability severity (n = 8, 78%) and lower household income (n = 4, 80%). Approximately one third (31%) of parents of children with IDD reach the clinical cut-off score for moderate depression, compared with 7% of parents of children without IDD. 31% of parents of children with IDD reach the cut-off score for moderate anxiety, compared with 14% of parents of children without IDD. The meta-analyses demonstrated moderate effect sizes for elevated depression amongst parents of children with autism and cerebral palsy. Conclusions: Results indicate elevated levels of depressive symptoms amongst parents of children with IDD. Quality concerns amongst the existing literature support the need for further research, especially in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Objectives: To estimate tobacco use prevalence in healthcare workers (HCW) by country income level, occupation and sex, and compare the estimates with the prevalence in the general population. Methods: We systematically searched five databases; Medline, EMBASE, CINHAL Plus, CAB Abstracts, and LILACS for original studies published between 2000 and March 2016 without language restriction. All primary studies that reported tobacco use in any category of HCW were included. Study extraction and quality assessment were conducted independently by three reviewers, using a standardised data extraction and quality appraisal form. We performed random effect meta-analyses to obtain prevalence estimates by World Bank (WB) country income level, sex, and occupation. Data on prevalence of tobacco use in the general population were obtained from the World Health Organisation (WHO) Global Health Observatory website. The review protocol registration number on PROSPERO is CRD42016041231. Results: 229 studies met our inclusion criteria, representing 457,415 HCW and 63 countries: 29 high-income countries (HIC), 21 upper-middle-income countries (UMIC), and 13 lower-middle-and-low-income countries (LMLIC). The overall pooled prevalence of tobacco use in HCW was 21%, 31% in males and 17% in females. Highest estimates were in male doctors in UMIC and LMLIC, 35% and 45%, and female nurses in HIC and UMIC, 21% and 25%. Heterogeneity was high (I2 > 90%). Country level comparison suggest that in HIC male HCW tend to have lower prevalence compared with males in the general population while in females the estimates were similar. Male and female HCW in UMIC and LMLIC tend to have similar or higher prevalence rates relative to their counterparts in the general population. Conclusions: HCW continue to use tobacco at high rates. Tackling HCW tobacco use requires urgent action as they are at the front line for tackling tobacco use in their patients. [ABSTRACT FROM AUTHOR]

Background: Medication errors have long been associated with low-quality medical care services and significant additional medical costs. Objective: The aim of this study was to culturally adapt and validate the questionnaire on knowledge, attitudes and behaviors in the administration of intravenous medication, as well as to explore these factors in a hospital setting. Methods: The study was divided into two phases: 1) validation and cross-cultural adaptation, and 2) cross-sectional study. A total of 276 hospital-based nursing professionals participated in the study. Results: A Cronbach’s alpha value of 0.849 was found, indicating good internal consistency. In the multivariate analysis, statistically significant differences were found between knowledge and attitudes, demonstrating that having greater suitable knowledge correlates with having a more positive attitude. It was also discovered that having a positive attitude as well as the necessary knowledge increases the possibility of engaging in adequate behaviors. Conclusions: The knowledge, attitudes and behavior questionnaire has a satisfactory internal consistency in order to be applied to the Spanish context. Implications for nursing management: Knowledge acquisition and positive attitude are both factors which promote adequate behavior, which in turn seems to have an impact on medication errors prevention. Health institutions must encourage continuous education for their employees. [ABSTRACT FROM AUTHOR]

Background: Recently we defined a user-friendly tool to assess complexity of patients hospitalized in medical wards. FCS-1 is an average between the Barthel Index and the Exton-Smith score, while FCS-2 is obtained by using the Charlson score. The aim of this paper is to assess the ability of the FCS to predict mortality in-hospital and after 1-3-6-12-months. In this perspective, we performed comparisons with the validated Multidimensional Prognostic Index (MPI). Methods: It is a multicenter, prospective observational study, enrolling patients aged over 40, suffering from at least two chronic diseases and consecutively admitted to Internal Medicine departments. For each patient, data from 13 questionnaires were collected. Survival follow-up was conducted at 1-3-6-12 months after discharge. The relationships between cumulative incidences of death with FCS were investigated with logistic regression analyses. ROC curve analyses were performed in order to compare the predictiveness of the logistic models based on FCS with respect to those with MPI taken as reference. Results: A cohort of 541 patients was evaluated. A 10-point higher value for FCS-1 and FCS-2 leads to an increased risk of 1-year death equal to 25.0% and 27.1%, respectively. In case of in-hospital mortality, the relevant percentages were 63.1% and 15.3%. The logistic model based on FCS is significantly more predictive than the model based on MPI (which requires an almost doubled number of items) for all the time-points considered. Conclusions: Assessment of prognosis of patients has the potential to guide clinical decision-making and lead to better care. We propose a new, efficient and easy-to-use instrument based on FCS, which demonstrated a good predictive power for mortality in patients hospitalized in medical wards. This tool may be of interest for clinical practice, since it well balances feasibility (requiring the compilation of 34 items, taking around 10 minutes) and performance. [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]

Background: High-quality training is required to improve the cardiopulmonary resuscitation (CPR) skills. Although it has been reported that the use of a feedback device is effective, the effects of feedback timing and frequency on CPR training have not been investigated. The aim of this study was to clarify the influence of feedback frequency and timing on the acquisition of CPR skills. Methods: Sixty-eight undergraduates were first divided into female (n = 32) and male (n = 36) groups, and randomly assigned to one of four groups for each sex: concurrent-100%, concurrent-50%, terminal-100%, and terminal-50% feedback groups. The randomization was performed using a lottery method. This study consisted of a pre-test, practice sessions, a post-test, and a follow-up test. In the practice sessions, the participants performed six 2-minute CPR sessions in accordance with the condition assigned using mannequins and feedback devices. The post-test was conducted 24 hours after the completion of the practice sessions and the follow-up test was conducted 3 months after the completion of the practice sessions. The primary outcome of the study was the overall score at the follow-up test. Results: The results of the overall score at the follow-up test for each group were 88.2 ± 9.6% for concurrent-100%, 92.2 ± 6.4% for concurrent-50%, 82.6 ± 16.4% for terminal-100%, and 85.2 ± 16.9% for terminal-50%. We did not find any statistically significant difference for the overall score at the follow-up test among the four groups (p = 0.173). The ANOVA for the test sessions revealed that there were no significant main effects of feedback timing (p = 0.135) or frequency (p = 0.765), and no significant interaction between timing and frequency (p = 0.997). Conclusion: The present study reveals that the use of feedback devices is an important factor for higher quality CPR training, regardless of the timing and frequency with which they are used. [ABSTRACT FROM AUTHOR]

Children aged 2 to 6 years are in a crucial period of growth development, during which it is important for them to attain specific cognition related to concentration and attention so that they can perform well in school later in life. Various factors influence children’s cognition during this crucial period. However, to date, only a limited number of studies have examined the cognitive performance of underprivileged children living in poverty, particularly indigenous children (also known as Orang Asli children in Malaysia). Therefore, this cross-sectional study aimed to determine the associations between sociodemographic factors, nutritional factors (body composition and hemoglobin), and environmental factors (home environment and parasitic infections) with cognitive performance among Orang Asli children in Negeri Sembilan, Malaysia. The participants were 269 children (51% boys, 49% girls) aged 2 to 6 years (M = 4.0, SD = 1.2 years) and their mothers, from 14 Orang Asli villages. Face-to-face interviews were conducted with the mothers, and the children’s cognitive performance, operationalized as working memory index (WMI), processing speed index (PSI), and cognitive proficiency index (CPI), was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV). The children’s weight and height were measured, and their blood and stool samples were collected to assess hemoglobin level and parasitic infections, respectively. Multiple linear regression analysis showed that the father’s years of education (β = 0.262–0.342, p < 0.05), availability of learning materials at home (β = 0.263–0.425, p < 0.05), and responsiveness of the parent to the child (β = 0.192–0.331, p < 0.05) were consistently associated with all three cognitive indices (WMI, PSI, and CPI). A holistic approach involving parents, communities, and government agencies should be established to improve the cognitive performance of these underprivileged children. [ABSTRACT FROM AUTHOR]

Context: Permanent childhood hearing loss (PCHL) can affect speech, language, and wider outcomes. Adverse effects are mitigated through universal newborn hearing screening (UNHS) and early intervention. Objective: We undertook a systematic review and meta-analysis to estimate prevalence of UNHS-detected PCHL (bilateral loss ≥26 dB HL) and its variation by admission to neonatal intensive care unit (NICU). A secondary objective was to report UNHS programme performance (PROSPERO: CRD42016051267). Data sources: Multiple electronic databases were interrogated in January 2017, with further reports identified from article citations and unpublished literature (November 2017). Study selection: UNHS reports from very highly-developed (VHD) countries with relevant prevalence and performance data; no language or date restrictions. Data extraction: Three reviewers independently extracted data and assessed quality. Results: We identified 41 eligible reports from 32 study populations (1799863 screened infants) in 6195 non-duplicate references. Pooled UNHS-detected PCHL prevalence was 1.1 per 1000 screened children (95% confidence interval [CI]: 0.9, 1.3; I2 = 89.2%). This was 6.9 times (95% CI: 3.8, 12.5) higher among those admitted to NICU. Smaller studies were significantly associated with higher prevalences (Egger’s test: p = 0.02). Sensitivity and specificity ranged from 89–100% and 92–100% respectively, positive predictive values from 2–84%, with all negative predictive values 100%. Limitations: Results are generalisable to VHD countries only. Estimates and inferences were limited by available data. Conclusions: In VHD countries, 1 per 1000 screened newborns require referral to clinical services for PCHL. Prevalence is higher in those admitted to NICU. Improved reporting would support further examination of screen performance and child demographics. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the relationship between the ground reaction force-time profile of a countermovement jump (CMJ) and fatigue, specifically focusing on predicting the onset of neuromuscular versus metabolic fatigue using the CMJ. Method: Ten recreational athletes performed 5 CMJs at time points prior to, immediately following, and at 0.5, 1, 3, 6, 24 and 48 h after training, which comprised repeated sprint sessions of low, moderate, or high workloads. Features of the concentric portion of the CMJ force-time signature at the measurement time points were analysed using Principal Components Analysis (PCA) and functional PCA (fPCA) to better understand fatigue onset given training workload. In addition, Linear Mixed Effects (LME) models were developed to predict the onset of fatigue. Results: The first two Principal Components (PCs) using PCA explained 68% of the variation in CMJ features, capturing variation between athletes through weighted combinations of force, concentric time and power. The next two PCs explained 9.9% of the variation and revealed fatigue effects between 6 to 48 h after training for PC3, and contrasting neuromuscular and metabolic fatigue effects in PC4. fPCA supported these findings and further revealed contrasts between metabolic and neuromuscular fatigue effects in the first and second half of the force-time curve in PC3, and a double peak effect in PC4. Subsequently, CMJ measurements up to 0.5 h after training were used to predict relative peak CMJ force, with mean squared errors of 0.013 and 0.015 at 6 and 48 h corresponding to metabolic and neuromuscular fatigue. Conclusion: The CMJ was found to provide a strong predictor of neuromuscular and metabolic fatigue, after accounting for force, concentric time and power. This method can be used to assist coaches to individualise future training based on CMJ response to the immediate session. [ABSTRACT FROM AUTHOR]

Background: English editing services are effective for improving manuscript quality as well as providing learning opportunities for non-native English-speaking authors. Herein, we describe the effects of a combined system of in-house and external editing services for handling large volumes of editing requests and providing personalized editing service in academic hospitals. Methods: We established the Scientific Publications Team (SPT), an in-house editing team in Asan Medical Center in Seoul, Korea. The SPT is composed of two professional editors who manage editing requests sent to external companies while also providing one-on-one in-house editing services. We gathered author satisfaction data from 936 surveys between July 2017 and December 2018 and analyzed the number of editing requests and research publications by segmented regression analysis of interrupted time series data. Results: The SPT processed 3931 editing requests in 2017–2018, which was a marked increase compared with prior to its establishment (P = 0.0097). The authors were generally satisfied with the quality of editing services from both in-house and external editors. Upon conducting regular quality control, overall author satisfaction with one external company gradually increased over the course of one year (P for trend = 0.086). Author satisfaction survey results revealed that overall satisfaction of editing service was most strongly correlated with how well the edits conformed to the authors’ intentions (R = 0.796), and was only weakly correlated with quick turnaround time (R = 0.355). We also observed a significant increase in the trend of the number of research publications (P = 0.0007) at one year after the establishment of the SPT. Conclusion: Providing a combination of in-house and external editing services resulted in high author satisfaction and subsequent hospital-wide increases in manuscript writing and publication. Our model system may be adapted in academic hospitals to better address the editing needs of non-native English-speaking researchers. [ABSTRACT FROM AUTHOR]

The Child Problematic Traits Inventory (CPTI) is a newly developed informant-rated instrument to measure psychopathic traits during early childhood. The aim of this study was to examine the longitudinal measurement invariance of the CPTI in a group of Chinese schoolchildren. Mothers of 585 children aged 8 to 12 years (50% girls) completed the CPTI twice with one-year interval. Confirmatory factor analyses showed that the CPTI had strict invariance (i.e., equality of factor patterns, loadings, intercepts, and item uniqueness) across time. Furthermore, the internal consistencies for the CPTI subscales were good at both time points and the stability coefficients over time were moderate. Findings suggest that, in children aged 8 to 12 years old, changes in CPTI scores across time can be attributed to actual changes in the child’s psychopathic personality. [ABSTRACT FROM AUTHOR]

We investigated what factors may foster or hinder physicians’ cancer screening risk literacy–specifically the ability to understand evidence regarding screening effectiveness and make evidence-based recommendations to patients. In an experiment, physicians in training (interns and residents) read statistical information about outcomes from screening for cancer, and had to decide whether to recommend it to a patient. We manipulated the effectiveness of the screening (effective vs. ineffective at reducing mortality) and the demand of the patient to get screened (demand vs. no demand). We assessed participants’ comprehension of the presented evidence and recommendation to the patient, as well as a-priori screening beliefs (e.g., that screening is always a good choice), numeracy, science literacy, knowledge of screening statistics, statistical education, and demographics. Stronger positive a-priori screening beliefs, lower knowledge of screening statistics, and lower numeracy were related to worse comprehension of the evidence. Physicians recommended against the ineffective screening but only if they showed good comprehension of the evidence. Physicians’ recommendations were further based on the perceived benefits from screening but not on perceived harms, nor the patient’s demands. The current study demonstrates that comprehension of cancer screening statistics and the ability to infer the potential benefits for patients are essential for evidence-based recommendations. However, strong beliefs in favor of screening fostered by promotion campaigns may influence how physicians evaluate evidence about specific screenings. Fostering physician numeracy skills could help counteract such biases and provide evidence-based recommendations to patients. [ABSTRACT FROM AUTHOR]

Introduction: In sports related to low body weight, such as classical ballet, the assessment of body composition is important for monitoring performance and health status. This study aimed to cross-validate anthropometry and bioelectrical impedance (BIA) predictive equations for estimating body composition of non-professional classical ballet dancers, using dual-energy-X-ray absorptiometry (DXA) as a reference method. Materials and methods: Thirty-seven female non-professional classical dancers (median age of 19 years), at intermediate/advanced level, were evaluated in a cross-sectional study. Body composition was evaluated by DXA, anthropometry and tetrapolar BIA. Twenty different predictive equations of anthropometry (n = 8) and BIA (n = 12) were used to estimate Body Fat (BF) and Fat-Free Mass (FFM), testing their validity against DXA using the Bland-Altman statistics. Results: For BF estimated by anthropometry equations, just one equation showed agreement with DXA (r = 0.852, p < 0.0005; p = 0.600 for one sample T-test). According to the Bland-Altman analysis, this equation also showed validity, with the absence of proportional bias. Regarding the predictive BIA equations tested, none were valid for our study group. Conclusion: Only one of the anthropometric equations, the one proposed by Durnin and Womerley (1974), but none of the BIA equations analyzed, was valid for the evaluation of body composition of the studied classical dancers. Our results emphasize the importance of previous cross-validation of existing equations or the development of specific equations for body composition assessment in specific populations. [ABSTRACT FROM AUTHOR]

Background: The relationships between hedonic deficits, type D personality and suicidal ideation were explored in a group of medical students. Methods: In a cross-sectional study, 382 medical students filled out several questionnaires measuring suicide risk, depression (using the Beck Depression Inventory, i.e. BDI), type D personality (using the type D personality scale-14, i.e. DS-14) and anhedonia (using the anhedonia subscale of the BDI, the Snaith Hamilton Pleasure Scale, the Anticipatory and Consummatory subscales of the Physical Anhedonia Scale). Results: State anhedonia and, in particular, recent change of state anhedonia and not trait anhedonia was significantly associated with suicidal ideation, specifically when depression was controlled for. Negative affectivity component of type D personality and anhedonia were independent predictors of suicidal ideation even when depression was controlled for. Loss of pleasure and not loss of interest was a significant predictor of suicidal ideation. Conclusions: Change of state anhedonia and its component of loss of pleasure measuring dissatisfaction in life could be a risk factor of suicidal ideation in medical students. Dissatisfaction, particularly in the medical course, could be a strong predictor of suicidal ideation in medical students. [ABSTRACT FROM AUTHOR]

Objectives: There is limited evidence on the effect of exposure to second hand smoke (SHS) in non-smoking pregnant mothers and infant health. We assessed the effects of maternal antenatal exposure to SHS on infant growth rate, and secondarily, on birth weight, birth length and head circumference at birth. Methods: In this prospective cohort, 305 mother-infant pairs were studied. Mothers filled out questionnaires about exposure to SHS in pregnancy at the 3rd trimester of pregnancy. Infant anthropometry was performed at birth, day 7, and months 1, 2, 4, and 6, postnatally. Linear mixed modeling and linear regression were used to calculate growth rates over the first 6 months. The association between SHS-exposure with growth rate and birth sizes was assessed using multivariate linear regression adjusted for confounders, with SHS as both number of cigarettes and as groups (no exposure, SHS < 23 cigarettes, SHS ≥ 23 cigarettes). Results: Seventy-three mothers were not exposed and 232 were exposed. SHS exposure (per cigarette) was not related to gain in weight, length, head circumference, and weight for length. However, infants born to mothers exposed to ≥ 23 cigarettes/d had lower head circumference gain (-0.32 mm/m, 95% CI -0.60, -0.03) than those born to non-exposed mothers. SHS exposure (per cigarette) was not related to birth weight, length, and head circumference, but exposure to ≥ 23 cigarettes was related to lower head circumference at birth (-11.09 mm, -20.03, -2.16). Conclusions: Heavy antenatal exposure to SHS in non-smoking mothers results in reduced neonatal head circumference at birth and head circumference gain over the first 6 months of life. Our findings show no clear relations between exposure to SHS during pregnancy and other markers of neonatal growth and birth size. [ABSTRACT FROM AUTHOR]

A large proportion of Depression Disorder patients do not receive an effective diagnosis, which makes it necessary to find a more objective assessment to facilitate a more rapid and accurate diagnosis of depression. Speech data is easy to acquire clinically, its association with depression has been studied, although the actual predictive effect of voice features has not been examined. Thus, we do not have a general understanding of the extent to which voice features contribute to the identification of depression. In this study, we investigated the significance of the association between voice features and depression using binary logistic regression, and the actual classification effect of voice features on depression was re-examined through classification modeling. Nearly 1000 Chinese females participated in this study. Several different datasets was included as test set. We found that 4 voice features (PC1, PC6, PC17, PC24, P<0.05, corrected) made significant contribution to depression, and that the contribution effect of the voice features alone reached 35.65% (Nagelkerke's R2). In classification modeling, voice data based model has consistently higher predicting accuracy(F-measure) than the baseline model of demographic data when tested on different datasets, even across different emotion context. F-measure of voice features alone reached 81%, consistent with existing data. These results demonstrate that voice features are effective in predicting depression and indicate that more sophisticated models based on voice features can be built to help in clinical diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Research has demonstrated benefits of social capital on depression, but variations in this relationship by geographic characteristics such as urbanicity have rarely been investigated. Methods: Using survey data on 4,209 Ghanaian and 3,148 South African adults aged 50 and above from the World Health Organization (WHO) Study on Global AGEing and Adult Health (SAGE), exploratory and confirmatory factor analyses were conducted to extract dimensions of social capital from survey items. Structural equation models with the extracted factors were then used to estimate the associations between social capital and depression in each sample and assess differences between urban and rural settings with measurement and structural invariance tests. Results: Factor analyses suggested three dimensions of social capital representing community engagement, sociability, and trust. Urbanicity did not substantially modify the effects of social capital on depression in either setting, but urban-rural differences in the measurement and level of social capital were observed. Urban Ghanaian older adults were less socially integrated and trusting than older rural residents (standardized mean difference: -0.28, -0.24, and -0.38 for community engagement, sociability, and trust, respectively) while urban South African older adults appeared less engaged in community activities but significantly more trusting and socially active informally than older rural residents (standardized mean difference: -0.33, 0.30, and 0.17 for community engagement, sociability, and trust, respectively). Moreover, while trust was associated with a lower risk of depression in South Africa overall, sociability and trust were associated with an increased risk of depression in Ghana. Conclusions: Results indicate that the composition and average levels of social capital differ between urban and rural older adult residents in Ghana and South Africa although urban-rural differences in the strength of the association between social capital and depression were not substantial. Furthermore, the associations between social capital and depression are context-specific and are not uniformly beneficial. [ABSTRACT FROM AUTHOR]

Background: The Lower Extremity Functional Scale evaluates the functional status of patients that have lower extremity conditions of musculoskeletal origin. Regional Arabic dialects often create barriers to clear communication and comparative research. We aimed to cross-culturally adapt the Lower Extremity Functional Scale in modern standard Arabic that is widely used and understood in the Middle East and North Africa region, and assess its psychometric properties. Methods: Cross-cultural adaptation followed a combination of recommended guidelines. For psychometric evaluation 150 patients with anterior cruciate ligament injury and 65 asymptomatic individuals were recruited. All measurement properties as indicated by the Consensus-based Standards for the selection of health status Measurement Instruments recommendations were evaluated, including content-relevance analysis, structural validity, longitudinal reproducibility, anchor- and distribution-based methods of responsiveness, as well as the longitudinal pattern of change of Lower Extremity Functional Scale in anterior cruciate ligament injured patients’ functional status. Results: The questionnaire presented excellent internal consistency (α = 0.96), reliability (0.80–0.98), and good convergent validity (ρ = 0.85). For reproducibility testing: minimal detectable change was 9.26 points; for responsiveness assessment: minimal clinically important difference was 9 points and presented moderate effect sizes (Glass’Δ = 0.71, Cohen’s d = 0.81). Its unidimensionality was not confirmed and an exploratory factor analysis indicated a 2-factor solution explaining 78.1% of the variance. Conclusion: The Arabic Lower Extremity Functional Scale presented acceptable psychometric properties comparable to the original version. The Arabic version of Lower Extremity Functional Scale can be used in research and clinical practice to assess the functional status of Arabic-patients suffering an anterior cruciate ligament injury. [ABSTRACT FROM AUTHOR]