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In recent years, nutrition has become increasingly important in treating and managing gestational diabetes mellitus. The Health Belief Model (HBM) is a conceptual framework in health behavior research used in some medical research. The present study aimed to evaluate the effect of glycemic index training based on the HBM on metabolic indicators and pregnant women's health-related quality of life. In this open-label, parallel-controlled randomized trial, 90 pregnant women from primary health centers in Iran were recruited and randomly assigned to either the intervention group or the control group, using a block randomization method with a block size of six. The intervention group underwent 12 weeks of nutritional education on the glycemic index and load of foodstuff. The control group only received routine health care. Valid and reliable questionnaires included demographic and prenatal information, physical activity, three days of food records, quality of life (SF-12), and HBM constructs. Fasting blood samples were taken at baseline and end of the study, to assess fasting blood glucose (FBS), fasting insulin, hs-CRP, and lipids. Eighty-four pregnant women with an age mean of 30.12 ± 4.35 completed 12 weeks of intervention. At baseline, there were no significant differences between groups in the HBM subscales (P > 0.05). However, within the intervention group, there was an increase in perceived susceptibilities (mean change 1.45 ± 4.21; P = 0.03) and cue to action (mean change: 1.22 ± 3.38; P = 0.02). In the adjusted model, the General Health subscale of Quality of Life showed a significant increase in the comparison between groups (mean change 13.69 ± 29.83 vs. 0.00 ± 29.58; P = 0.04). Additionally, the adjusted model revealed a notable difference between the groups in serum hs-CRP level, (mean change -0.877 ± 3.47 vs. -0.067 ± 3.40; P = 0.01) and triglyceride level (mean change − 55.24 ± 111.21 vs. 40.92 ± 142.01; P = 0.001). However, in the adjusted model, the total cholesterol levels increased between groups (mean change 22.75 ± 66.17 vs. 30.12 ± 61.33; P = 0.01) at the end of the study. There was no significant difference in glycemic indices (P > 0.05). Participation in a nutrition education program might positively impact nutritional beliefs, behaviors, and some biochemical indicators among pregnant women. Future studies with larger sample sizes and longer follow-ups are warranted. Trial registration number: IRCTID: IRCT20190227042858N1. Registration date: 2019-07-18. [ABSTRACT FROM AUTHOR]

Background: Previous studies have shown that the Gaming Disorder Test (GDT) and Gaming Disorder Scale for Adolescents (GADIS-A) have promising validity and reliability when assessing symptoms of gaming disorder among young adults. However, validity and reliability properties of the two scales have not been established among a Vietnamese population. Objective: The present study translated the GDT and GADIS-A into Vietnamese and examined their factor structures, measurement invariance, convergent validity, concurrent validity, and divergent validity among university students. Methods: A total of 610 young adults (mean age = 21.09 years; 63.4% females) were recruited using convenience sampling and who completed a paper-and-pencil survey between April and June 2023. All participants completed a demographic questionnaire, GDT, GADIS-A, and six standardized scales related to gaming disorder, social media addiction, smartphone addiction, and psychological distress. Confirmatory factor analysis (CFA), internal consistency testing, and Pearson's correlations were performed. Results: CFA showed that the GDT had a one-factor structure and the GADIS-A had a two-factor structure. The internal consistency was excellent for both scales among this population. Moreover, both GDT and GADIS-A showed convergent, concurrent, and divergent validity with other standardized scales. Conclusion: The Vietnamese versions of the GDT and GADIS-A have good psychometrics, which may be utilized in future research regarding gaming disorder among Vietnamese populations. [ABSTRACT FROM AUTHOR]

Amid escalating global drought concerns and the imperative of water-saving practices, this 2022 methodological study in the southwest and central regions of Iran, involving 287 participants, employed structural equation modeling to investigate correlates of pro-water conservation behaviors using a validated TPB questionnaire. Findings revealed that attitudes positively influenced intentions (p < 0.05), subjective norms had dual effects on intentions and perceived control (p < 0.05), and perceived behavioral control positively impacted both intentions and behavior (p < 0.05), yet intentions did not significantly predict behavior (p > 0.05). Confirmatory factor analysis demonstrated favorable fit indices for TPB (CMin/df = 1.59, RMSEA = 0.04, CFI = 0.96, TLI = 0.95) and SEM models (CMin/df = 1.58, RMSEA = 0.04, CFI = 0.92, TLI = 0.91), reaffirming the model's validity. The Theory of Planned Behavior offers a potent framework for shaping water-conservation efforts, emphasizing attitudes, subjective norms, and perceived control. Further research is needed to gain a deeper understanding of the disparities that may exist between intentions and actual behaviors in conserving water. [ABSTRACT FROM AUTHOR]

The present study's aim is to find the prevalence of two of the common indicators of mental health - depression and anxiety – and any correlation with socio-demographic indicators in the Pakistani population during the lockdown from 5 May to 25 July 2020. A cross-sectional survey was conducted using an online questionnaire sent to volunteer participants. A total of 1047 participants over 18 were recruited through convenience sampling. The survey targeted depression and anxiety levels, which were measured using a 14 item self-reporting Hospital Anxiety and Depression Scale (HADS). Out of the total sample population (N=354), 39.9% suffered from depression and 57.7% from anxiety. Binary logistical regressions indicated significant predictive associations of gender (OR=1.410), education (OR=9.311), residence (OR=0.370), household income (OR=0.579), previous psychiatric problems (OR=1.671), and previous psychiatric medication (OR=2.641). These were the key factors e associated with a significant increase in depression. Increases in anxiety levels were significantly linked to gender (OR=2.427), residence (OR=0.619), previous psychiatric problems (OR=1.166), and previous psychiatric medication (OR=7.330). These results suggest depression and anxiety were prevalent among the Pakistani population during the lockdown. Along with other measures to contain the spread of COVID-19, citizens' mental health needs the Pakistani government's urgent attention as well as that of mental health experts. Further large-scale, such as healthcare practitioners, should be undertaken to identify other mental health indicators that need to be monitored. [ABSTRACT FROM AUTHOR]

Exercise addiction is a morbid-compulsive behavioral pattern characterized by a loss of control over exercise and which results in major detrimental consequences in the affected individual's life. Although the condition is not formally recognized in official psychiatric texts, exercise addiction can lead to clinical impairment of everyday activities just like other more traditional addictions. This has led to the development of many instruments to assess exercise addiction. One of the most widely used instruments is the Exercise Addiction Inventory (EAI) which has been translated into a number of languages and has separate versions of the scale for adults and adolescents (i.e., the EAI-Y for youth). However, there are currently no Persian versions. Therefore, the present study translated the EAI into Persian and assessed its psychometric properties using Rasch analysis among both Iranian adults (n = 745, age range = 19–30 years, 60.53% female) and Iranian adolescents (n = 562, age range = 13–18 years, 62.45% female). An online survey was used to collect data from September to November 2021. Confirmatory factor analyses and the Rasch analyses confirmed the unidimensional structure of the EAIs and good reliability using the Omega coefficient (.71 to.72). Also, separation reliability on item, scale, and person-level was established, along with supported measurement invariance, demonstrating that EAI can discriminate individuals on a high or low level of exercise addiction independent of their age and gender. Overall, the Persian EAI demonstrated sound psychometrics in screening for exercise addiction among Iranian adults and adolescents. [ABSTRACT FROM AUTHOR]

The Internet Disorder Scale–Short Form (IDS9-SF) is a validated instrument assessing internet disorder which modified the internet gaming disorder criteria proposed in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the relationships between the nine items in the IDS9-SF are rarely investigated. The present study used network analysis to investigate the features of the IDS9-SF among three populations in Bangladesh, Iran, and Pakistan. Data were collected (N = 1901; 957 [50.3%] females; 666 [35.0%] Pakistani, 533 [28.1%] Bangladesh, and 702 [36.9%] Iranians) using an online survey platform (e.g., Google Forms). All the participants completed the IDS9-SF. The central-stability-coefficients of the nine IDS9-SF items were 0.71, 0.89, 0.96, 0.98, 0.98, 1.00, 0.67, 0.79, and 0.91, respectively. The node centrality was stable and interpretable in the network. The Network Comparison Test (NCT) showed that the network structure had no significant differences among Pakistani, Bangladeshi, and Iranian participants (p-values = 0.172 to 0.371). Researchers may also use the IDS9-SF to estimate underlying internet addiction for their target participants and further explore and investigate the phenomenon related to internet addiction. [ABSTRACT FROM AUTHOR]

Serious games (SGs), are gaining prominence as a tool for early education at home as well as in school settings. Given the mixed effects of gamification on various aspects of users' lives, it is pertinent to study its broader effects on a child's pre-school and school years. Given the lack of consensus on a comprehensive measure that encapsulates these effects on an individual's routine functioning, the present study examined whether various engagement states in SGs use influence a relatively broader measure of users' functioning across significant life domains such as Quality of Life (QoL). It is argued that it would serve scholars, teachers, and parents better to understand the broader implications of SGs on children's overall QoL rather than isolated physiological and behavioral effects. Consequently, utilizing structural equation modeling, results from 335 parents of 2–10-year-olds in a developing country showed that cognitive and behavioral engagement in gamified applications appear to influence the child's QoL, but not affective engagement. Results are discussed in terms of the consequences of using game-based technology for a child's development, with far-reaching academic, personal, physical, and social implications not only for the school-going ages, but also for early teenage years. The results are promising in relation to QoL. The findings indicate the role modern technology plays in improving individuals' lives. The findings provide scholars, parents, and creators of SGs important information for their plan of action regarding children's exposure to SGs and making SGs a frequent aspect of the learning experience early in life. [ABSTRACT FROM AUTHOR]

Utilizing a large-scale cross-sectional survey, the present study tested the advanced psychometric properties of Fear of COVID-19 Scale (FCV-19S) in specific populations (i.e., primary and middle schoolteachers, and their students). The present study also examined the association between perceived fear of COVID-19 and psychological distress among home-room teachers (i.e., teachers who teach all their students in one classroom all day) and their students. The results among participants (11,134 teachers and 4,335 students) indicated good internal reliability of FCV-19S and excellent factorial validity with a two-factor structure utilizing these specific populations. Furthermore, the multilevel analysis showed that home-room teachers' psychological distress, but not fear of COVID-19, was positively associated with their students. In sum, the FCV-19S is a useful tool to assess the fear of COVID-19 on potentially vulnerable populations (i.e., primary/middle schoolteachers and their students). Future studies are encouraged to use the present study's findings to investigate possible underlying mechanisms for developing effective coping strategies and interventions. [ABSTRACT FROM AUTHOR]

The Fear of COVID-19 Scale (FCV-19S) assesses the fear of the novel coronavirus disease 2019 (COVID-19) and has been translated and validated into over 20 languages. The present study conducted confirmatory factor analysis (CFA) and item response theory (IRT) analyses on the FCV-19S among a sample of 937 Pakistani adults (mean [SD] age of 25.83 [11.80] years; 537 [57.3%] females). The CFA and IRT confirmed the unidimensionality of the FCV-19S. The Likert-type scale used in the FCV-19S was supported by the proper threshold orderings. Additionally, no DIF contrast had an absolute value larger than 0.5 regarding the participants' characteristics of gender, age, living status, and education in the IRT findings. The FCV-19S was found to be valid and reliable with strong psychometric properties among the Pakistani adult population. [ABSTRACT FROM AUTHOR]

Although several studies have been conducted in Bangladesh regarding sleep problems during the COVID-19 pandemic, none have utilized a large nationwide sample or presented their findings based on nationwide geographical distribution. Therefore, the aim of the present study was to explore the total sleep duration, night-time sleep, and daily naptime and their associated factors as well as geographic information system (GIS) distribution. A cross-sectional survey was carried out among 9730 people in April 2020, including questions relating to socio-demographic variables, behavioral and health factors, lockdown, depression, suicidal ideation, night sleep duration, and naptime duration. Descriptive and inferential statistics, both linear and multivariate regression, and spatial distribution were performed using Microsoft Excel, SPSS, Stata, and ArcGIS software. The results indicated that 64.7% reported sleeping 7–9 h a night, while 29.6% slept less than 7 h nightly, and 5.7% slept more than 9 h nightly. 43.7% reported 30–60 min of daily nap duration, whereas 20.9% napped for more than 1 h daily. Significant predictors of total daily sleep duration were being aged 18–25 years, being unemployed, being married, self-isolating 4 days or more, economic hardship, and depression. For nap duration, being aged 18–25 years, retired, a smoker, and a social media user were at relatively higher risk. The GIS distribution showed that regional division areas with high COVID-19 exposure had higher rates of non-normal sleep duration. Sleep duration showed a regional heterogeneity across the regional divisions of the country that exhibited significant associations with a multitude of socioeconomic and health factors. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has many individuals around the world fearing for their lives. The constant news coverage, rapid transmission, and relatively high mortality rate, make fearfulness a natural response. To assess the fear of COVID-19, the Fear of COVID-19 Scale (FCV-19S) was developed. The primary aim of the present study was to conduct the first psychometric assessment and validation of the English version of the FCV-19S. Two samples were collected in New Zealand. Sample 1 comprised 1624 participants of which 1397 completed all questions and were used in the analyses. Sample 2 comprised 1111 participants of which 1023 completed all questions and were used in the analyses. Several psychometric tests were conducted to ascertain the scale's reliability and validity. Across both samples, the FCV-19S had high internal consistency. Consistent with the earlier validation studies, the FCV-19S displayed a moderately strong relationship with the perceived infectability and germ aversion subscales of the perceived vulnerability to disease scale (PVDS). Furthermore, FCV-19S scores were negatively correlated with the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) scores. With respect to the motivating role of fear, there was a significant relationship between FCV-19S scores and adherence to the lockdown rules that were implemented in New Zealand. Finally, consistent with recent reports on the politicization of the COVID-19 pandemic, an exploratory question found that participants who rated themselves as more conservative tended to report lower FCV-19S scores. The English version of the COVID-19S is a sound unidimensional scale with robust psychometric properties and can be used with confidence among English-speaking populations. [ABSTRACT FROM AUTHOR]

The recently developed Fear of COVID-19 Scale (FCV-19S) is a seven-item uni-dimensional scale that assesses the severity of fears of COVID-19. Given the rapid increase of COVID-19 cases in Bangladesh, we aimed to translate and validate the FCV-19S in Bangla. The forward-backward translation method was used to translate the English version of the questionnaire into Bangla. The reliability and validity properties of the Bangla FCV-19S were rigorously psychometrically evaluated (utilizing both confirmatory factor analysis and Rasch analysis) in relation to socio-demographic variables, national lockdown variables, and response to the Bangla Health Patient Questionnaire. The sample comprised 8550 Bangladeshi participants. The Cronbach α value for the Bangla FCV-19S was 0.871 indicating very good internal reliability. The results of the confirmatory factor analysis showed that the uni-dimensional factor structure of the FCV-19S fitted well with the data. The FCV-19S was significantly correlated with the nine-item Bangla Patient Health Questionnaire (PHQ-90) (r = 0.406, p < 0.001). FCV-19S scores were significantly associated with higher worries concerning lockdown. Measurement invariance of the FCV-19S showed no differences with respect to age or gender. The Bangla version of FCV-19S is a valid and reliable tool with robust psychometric properties which will be useful for researchers carrying out studies among the Bangla speaking population in assessing the psychological impact of fear from COVID-19 infection during this pandemic. [ABSTRACT FROM AUTHOR]

Dear Editor, The emergence and development of the COVID-19 pandemic is having a toll on the mental health of the general population, and healthcare workers around the world, often manifested in depression, fear, stress, trauma, and anxiety (Ahorsu et al. [1]; Mamun and Ullah [10]; Lee et al, [9]). We searched PubMed using the keywords "COVID-19" or "SARS-CoV-2" or "Coronavirus disease" and "Fear Scale" or "FCV-19S" or "Fear of COVID-19 Scale" till 30 August 2020. The Fear of COVID-19 Scale (FCV-19S) is a 7-item scale that assesses the severity of COVID-19-related fear (Ahorsu et al. [1]). [Extracted from the article]

Background: The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases. Methods: The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results: After panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α =.82) and test–retest reliability (ICC =.72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459). Conclusion: The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals. [ABSTRACT FROM AUTHOR]

A paper reporting the psychometric properties of the Spanish Fear of COVID-19 Scale (FCV-19S) among Colombian physicians was recently published in the International Journal of Mental Health and Addiction. Although we welcome the translation and validation of our seven-item scale, this commentary outlines some major concerns we have with the study especially the removal of two items in developing a five-item FCV-19S. Based on these concerns, we strongly recommend that healthcare providers and researchers should use the five-item FCV-19S with caution. [ABSTRACT FROM AUTHOR]

Selfitis—which started off as a hoax but has now been investigated empirically—has been defined as the obsessive–compulsive desire to take photos of oneself and post them on social media. Furthermore, a scale to assess selfitis, the Selfitis Behavior Scale (SBS), has been developed. This study applied advanced psychometric testing methods, including confirmatory factor analysis (utilizing classical test theory) and the Rasch model (utilizing modern test theory), to examine the psychometric properties among Persian speakers (in Iran and Afghanistan). The participants (3163 Iranians and 1100 Afghanistani) completed an online survey posted on Instagram pages. The SBS showed promising properties, including satisfactory reliability (e.g., internal consistency and test–retest reliability), excellent construct validity (e.g., good fit in the CFA and Rasch models), and acceptable measurement invariance across Iranian and Afghan samples. Consequently, the SBS is a valid and reliable instrument for assessing selfitis among Persian-speaking samples. [ABSTRACT FROM AUTHOR]

Workload has long been considered as one of the important factors for personal functions and malfunctions, particularly in complex systems. Undertaking operations in workstations of such systems usually entails complex tasks and poor cognitive performance of their operators may contribute to human error and critical subsequent consequences. Although many studies have investigated the effects of workload on the cognitive performance, there is a gap for specific jobs and operations such as control room operation. This paper then aims to determine that what dimensions of the workload has more impact on cognitive performance of a combined cycle power plant (CCPP) Control room operators. Control room operators from two CCPPs participated (n = 95) in this study. Hierarchical task analysis (HTA) was employed to perform the job analysis. To assess the perceived workload, NASA Task Load Index (NASA-TLX) was performed at the end of the work shift. The participants were subjected to three cognitive performance tests including sustained attention, simple reaction and working memory at the beginning and end of the work shift. The values of mental demand on check and control tasks (92.17 ± 4.38), decisions about abnormal conditions (90.16 ± 5.71) and reporting (85.09 ± 3.25) were high. The task of communication and coordination in terms of temporal demand (71.66 ± 7.3) and performance (68.04 ± 4.92) had higher values compared to other tasks. The highest weighted workload (84.27 ± 6.48) was also attributed to the task of checking and controlling. Sustained attention and working memory were more susceptible to excessive workload among CCPP control room operators. [ABSTRACT FROM AUTHOR]

Fear of novel coronavirus 2019 (COVID-19) may result in psychological health problems among different populations. Moreover, believing COVID-19 information and preventive COVID-19 infection behaviors are relevant constructs associated with fear of COVID-19. Therefore, the present study validated three instruments assessing fear, beliefs, and preventive behaviors related to COVID-19 among individuals with mental illness. Moreover, relationships between the three constructs were examined. Individuals with mental illness (N = 400; 178 females; mean age = 46.91 years) completed the Fear of COVID-19 Scale (FCV-19S), Believing COVID-19 Information Scale (BCIS), Preventive COVID-19 Infection Behaviors Scale (PCIBS), and Depression Anxiety Stress Scale-21 (DASS-21). The FCV-19S, BCIS, and PCIBS demonstrated a single-factor structure with satisfactory fit indices. Moreover, believing COVID-19 information positively and significantly associated with fear of COVID-19, and fear of COVID-19 negatively and significantly associated with preventive behaviors and positively and significantly associated with psychological distress. The FCV-19S, BCIS, and PCIBS may assist healthcare providers in assessing COVID-19-related information among individuals with mental illness. Consequently, relevant programs may be designed to help individuals with mental illness going through the period of crisis. [ABSTRACT FROM AUTHOR]

Given the high stress and unfriendly environment caused by imprisonment, prisoners are at risk of developing insomnia. It is important to understand potential intervention (in this case, mindfulness) in improving insomnia for this population. The present study investigated whether dispositional mindfulness can be beneficial in helping relieve insomnia among Iranian prisoners. It also investigated whether psychological distress and perceived stress are potential mediators. Male prisoners (N = 208) aged 39.08 years (SD = 7.85) completed questionnaires and reported their demographic information and mindfulness (at baseline); psychological distress and sleep quality (at 1 month after baseline assessment); sleep quality and insomnia (at 3 months after baseline assessment). The mediation models using 10,000 bootstrapping resamples showed that sleep quality and insomnia significantly improved when mindfulness increased. Moreover, psychological distress and stress partially mediated the aforementioned association between dispositional mindfulness and sleep quality/insomnia. Using mindfulness to improve sleep quality/insomnia may be a promising psychological intervention for prisoners. [ABSTRACT FROM AUTHOR]

The present cross-sectional study examined the actor-partner interdependence effect of fear of COVID-19 among Iranian pregnant women and their husbands and its association with their mental health and preventive behaviours during the first wave of the COVID-19 pandemic in 2020. A total of 290 pregnant women and their husbands (N = 580) were randomly selected from a list of pregnant women in the Iranian Integrated Health System and were invited to respond to psychometric scales assessing fear of COVID-19, depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. The findings demonstrated significant dyadic relationships between husbands and their pregnant wives' fear of COVID-19, mental health, and preventive behaviours. Pregnant wives' actor effect of fear of COVID-19 was significantly associated with depression, suicidal intention, mental quality of life, and COVID-19 preventive behaviours but not anxiety. Moreover, a husband actor effect of fear of COVID-19 was significantly associated with depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. Additionally, there were significant partner effects observed for both the pregnant wives and their husbands concerning all outcomes. The present study used a cross-sectional design and so is unable to determine the mechanism or causal ordering of the effects. Also, the data are mainly based on self-reported measures which have some limitations due to its potential for social desirability and recall biases. Based on the findings, couples may benefit from psychoeducation that focuses on the effect of mental health problems on pregnant women and the foetus. [ABSTRACT FROM AUTHOR]

More specifically, Taylor et al. ([17]) developed the COVID Stress Scales (CSS) and we developed the Fear of COVID-19 Scale (FCV-19S; Ahorsu et al. [1]). In short, there are benefits of both unidimensional and multidimensional instruments for COVID-19 (e.g., the FCV-19S [Ahorsu et al. [1]] and the CSS [Taylor et al. [17]]). To conclude, we believe that both the CSS and FCV-19S are potential useful instruments that can be used by healthcare providers to help understand the psychological responses such as fear and anxiety of individuals during the COVID-19 pandemic. [Extracted from the article]

There are at least eight COVID-19 suicide cases in Bangladesh (seven reported here and one previously reported by Mamun and Griffiths [18]) and all but one was due to the economic-related issues. Cases The first published case study of COVID-19-related suicide in Bangladesh raised the possibility of further suicides (Mamun and Griffiths [18]). First COVID-19 suicide case in Bangladesh due to fear of COVID-19 and xenophobia: Possible suicide prevention strategies. The incidence and mortality of the coronavirus-2019 disease (COVID-19) have increased dramatically around the world. [Extracted from the article]

The psychometric properties of the Generalized Trust Scale (GTS) are well established. Furthermore, previous studies have found that the GTS is positively associated with better mental health and lower distress, and the literature finds that trust is good for mental health. However, current literature does not have any psychometric evidence concerning the Persian GTS. This study translated the GTS into Persian and validated its psychometric properties. After translating the GTS into Persian using robust and standardized translation procedure, 1200 Iranians (mean age = 34.83 years; 583 [48.6%] males) completed the GTS, along with the Hospital Anxiety and Depression Scale (HADS), Short Form-12 (SF-12), and Oxford Happiness Questionnaire Short Form (OHQ-SF). The factor structure of Persian GTS was confirmed by a unidimensional model with a method factor (comparative fit index = 0.998; Tucker-Lewis index = 0.992). The unidimensional model was also supported by Rasch analysis (mean square = 0.75 to 1.31). Other properties of the Persian GTS were satisfactory. More specifically, test-retest reliability was good (intraclass correlational coefficient = 0.865), internal consistency was good (α = 0.881), and concurrent validity was supported (standardized β = − 0.086 with depression in the HADS [p = 0.045]; = − 0.162 with anxiety in the HADS [p < 0.001]; = 0.077 with mental component score in the SF-12 [p = 0.044]; = 0.624 with OHQ-SF [p < 0.001]). The six-item Persian GTS has promising psychometric properties and can be an effective measure to assess trust among Iranians. [ABSTRACT FROM AUTHOR]

The average variance extracted (AVE) and composite reliability (CR) were then corrected as follows: AVE value was marginal (AVE = 0.49) and CR value was above the acceptable threshold level (CR = 0.87). B Correction to: Int J Ment Health Addiction b https://doi.org/10.1007/s11469-020-00289-x While carrying out some pooled analyses on various datasets concerning the psychometric properties of the Fear of COVID-19 Scale (FCV-19S; Ahorsu et al. [1]), we found some errors reported in the original publication of the Bangla version (Sakib et al. [3]). [Extracted from the article]

Introduction/objectives: Adherence to prescribed medication regimens is fundamental to the improvement and maintenance of the health of patients with rheumatoid arthritis. It is therefore important that interventions are developed to address this important health behavior issue. The aim of the present study was to design and evaluate a theory-based intervention to improve the medication adherence (primary outcome) among rheumatoid arthritis patients. Methods: The study adopted a pre-registered randomized controlled trial design. Rheumatoid arthritis patients were recruited from two University teaching hospitals in Qazvin, Iran from June 2018 to May 2019 and randomly assigned to either an intervention group (n = 100) or a treatment-as-usual group (n = 100). The intervention group received a theory-based intervention designed based on the theoretical underpinnings of the health action process approach (HAPA). More specifically, action planning (making detailed plans to follow medication regimen), coping planning (constructing plans to overcome potential obstacles that may arise in medication adherence), and self-monitoring (using a calendar to record medication adherence) of the HAPA has been used for the treatment. The treatment-as-usual group received standard care. Results: Data analysis was conducted based on the principle of intention to treat. Using a linear mixed-effects model (adjusted for age, sex, medication prescribed, and body mass index), the results showed improved medication adherence scores in the intervention group (loss to follow-up = 16) compared to the treatment-as-usual group (loss to follow-up = 12) at the 3-month (coefficient = 3.9; SE = 0.8) and 6-month (coefficient = 4.5; SE = 0.8) follow-up. Intervention effects on medication adherence scores were found to be mediated by some of the theory-based HAPA variables that guided the study. Conclusion: The results of the present study support the use of a theory-based intervention for improving medication adherence among rheumatoid arthritis patients, a group at-risk of not adhering to medication regimens. Trial registration (in Iranian Registry of Clinical Trials): irct.ir, IRCT20180108038271N1 Key Points • Theoretical underpinnings of the health action process approach are useful to improve medication adherence for RA patients. [ABSTRACT FROM AUTHOR]

Purpose: To examine the psychometric properties of the Sleep Condition Indicator (SCI) using different psychometric approaches [including classical test theory, Rasch models, and receiver operating characteristics (ROC) curve] among patients with advanced cancer. Methods: Through convenience sampling, patients with cancer at stage III or IV (n = 859; 511 males; mean ± SD age = 67.4 ± 7.5 years) were recruited from several oncology units of university hospitals in Iran. All the participants completed the SCI, Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), General Health Questionnaire (GHQ), and Edmonton Symptom Assessment Scale (ESAS). In addition, 491 participants wore an actigraph device to capture objective sleep. Results: Classical test theory [factor loadings from confirmatory factor analysis = 0.76–0.89; test–retest reliability = 0.80–0.93] and Rasch analysis [infit mean square (MnSq) = 0.63–1.31; outfit MnSq = 0.61–1.23] both support the construct validity of the SCI. The SCI had significant associations with ISI, PSQI, ESS, HADS, GHQ, and ESAS. In addition, the SCI has satisfactory area under ROC curve (0.92) when comparing a gold standard of insomnia diagnosis. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on the SCI score defined by ROC. Conclusion: With the promising psychometric properties shown in the SCI, healthcare providers can use this simple assessment tool to target the patients with advanced cancer who are at risk of insomnia and subsequently provide personalized care efficiently. [ABSTRACT FROM AUTHOR]

Purpose: Type 2 diabetes is a major public health issue particularly in the elderly. Religion may affect the Health Related Quality of Life (HRQoL) in such patients, mediated by factors such as religious coping and social support. This study aimed to investigate the impact of religiosity on medication adherence and HRQoL.Methods: 793 adults (> 65 years old, 45% females) were recruited from 4 diabetes care centers and followed for 1 year. Duke University Religion Index, Spiritual Coping Strategies, Multidimensional Perceived Social Support, Medication Adherence Report Scale, WHOQOL-BREF and Diabetes-specific Quality of Life Questionnaire Module were used for assessment, as well as HbA1c and fasting blood glucose level. Using structural equation modeling, the potential paths were tested between religiosity, medication adherence and HRQoL; social support, religious coping and medication adherence served as the mediators.Results: Religious coping and social support were recognized as the significant mediators between religiosity and medication adherence (CFI = 0.983, TLI = 0.985, and RMSEA = 0.021). The relationships between religiosity and HRQoL were considerably mediated by social support, religious coping and medication adherence and these variables explained 12% and 33% of variances of generic and specific HRQoL, respectively. There was no significant direct effect of religiosity on HRQoL. HbA1c and fasting blood glucose level were successfully loaded on the latent construct of medication adherence (factor loading = 0.51 and 0.44, respectively).Conclusions: The impact of religiosity on medication adherence and HRQoL occurs through the mediators such as religious coping and social support. Therefore, to improve the adherence to treatment and quality of life, interventions may be designed based on these mediators. [ABSTRACT FROM AUTHOR]

The Smartphone Application-Based Addiction Scale (SABAS) can be used in screening for the risk of smartphone addiction. This study aimed to validate a Persian version of the SABAS using confirmatory factor analysis (CFA), Rasch analysis, and latent class analysis (LCA). In a sample of 3807 Iranian adolescents, CFAs were used to confirm the factor structure of SABAS, Rasch models were used to examine the unidimensionality of SABAS, and LCAs were used to classify the adolescents in terms of application preferences and smartphone application-based addiction. The unidimensional structure of SABAS was supported by CFA and Rasch model. LCA classified the sample into three subgroups (i.e., low, medium, high) in terms of risk of smartphone addiction. This study showed the unidimensionality of the Persian SABAS with robust psychometric properties. It can be used by healthcare providers in screening for risk of addiction to smartphone applications and provide early intervention if necessary. [ABSTRACT FROM AUTHOR]

Given that there is a lack of instruments assessing internet-related addictions among Chinese population, this study aimed to validate the Chinese version of the nine-item Internet Gaming Disorder Scales- Short Form (IGDS-SF9), Bergen Social Media Addiction Scale (BSMAS), and Smartphone Application-Based Addiction Scale (SABAS) among Hong Kong university students. Participants aged between 17 and 30 years participated in the present study (n = 307; 32.4% males; mean [SD] age = 21.64 [8.11]). All the participants completed the IGDS-SF9, BSMAS, SABAS, and the Hospital Anxiety and Depression Scale (HADS). Confirmatory factor analyses (CFAs) were used to examine the factorial structures and the unidimensionality for IGDS-SF9, BSMAS, and SABAS. CFAs demonstrated that the three scales were all unidimensional with satisfactory fit indices: comparative fit index = 0.969 to 0.992. In addition, the IGDS-SF9 and BSMAS were slightly modified based on the modification index in CFA. The Chinese IGDS-SF9, BSMAS, and SABAS are valid instruments to assess the addiction levels of internet-related activities for Hong Kong university students. [ABSTRACT FROM AUTHOR]

Technological advances have created the environment for Internet addiction (IA). A specific form of IA is social media addiction. Moreover, social media addiction may be further classified into general or specific social media addiction, with YouTube addiction among the latter because YouTube is viewed as a video streaming application. The present study aimed to design an instrument assessing YouTube addiction (named as the YouTube Addiction Scale, YAS) for psychometric testing. Guided by the component model of addiction, the YAS included six items corresponding to salience, mood modification, tolerance, withdrawal, conflict, and relapse. Through an online survey, the first sample (N = 530; 50.6% female) completed the YAS together with other measures assessing general social media addiction, psychological distress, and demographic information. Afterward, a second sample (N = 512; 45.5% female) completed the YAS in another period of time. The YAS was found to be unidimensional with strong factor loadings in both exploratory factor analysis (the first sample) and confirmatory factor analysis (the second sample). Internal consistency of the YAS was acceptable for both samples. Using the first sample’s data, Rasch models suggested that the six items in the YAS all fit well in the embedded construct of YouTube addiction. No differential item functioning was displayed for all YAS items across age, gender, and weekly time spent using YouTube. Network analysis results showed that the YAS items grouped together and had a clear distance from all items assessing general social media addiction. In addition, participants with higher levels of YouTube addiction had significantly greater general social media addiction, psychological distress, and time spent on YouTube. The YAS has promising psychometric properties for healthcare providers and researchers to assess individuals’ YouTube addiction levels. Future studies should examine the extent to which with the use of YAS, healthcare providers may monitor the severity of individuals’ YouTube addiction and provide early intervention, if needed. [ABSTRACT FROM AUTHOR]

Health-related quality of life (HRQoL) among patients with diabetes mellitus is often poorer than in those with other chronic medical conditions. Appropriate disease specific measures are needed to measure HRQoL in these patients. This study sought to validate a culturally adapted version of the Diabetes-Mellitus Specific Quality of Life (DMQoL) questionnaire module in Persian. Concurrent validity of the scale was assessed by the Diabetes Quality of Life (DQOL) questionnaire. Convergent and discriminative validity of the DMQoL was determined using a brief version of World Health Organization's Quality of Life Scale Brief version (WHOQOL-BREF), Hospital Anxiety and Depression Scales (HADS), and Medication Adherence Report Scale (MARS). Construct validity was examined using confirmatory factor analysis. Rasch analysis was also performed to examine the unidimensionality of the DMQoL. Known-group method was used to examine the ability of the scale to differentiate between different categories of patients. A sample of 824 patients (512 females) with diabetes mellitus was recruited from diabetic care centers located in Qazvin, Iran. The mean age of participants was 54.1 (SD 6.3) and 27% were smokers. All items loaded on a single factor (factor loadings ≥ 0.6) and internal consistency of the scale was acceptable (α = 0.89). Significant associations were found between the scale and DQOL, indicating concurrent validity (p < 0.001). The DMQoL was able to differentiate subgroups of patients with hypertension, HbA1c, cholesterol, and diabetic diet. All items were appropriate with regard to difficulty level and confirmatory factor analysis verified the scale's single dimension (CFI = 0.927; RMSEA = 0.067). Persian DMQoL is a reliable and valid measure of HRQoL in a Persian-speaking population with type II diabetes. Further assessment is needed to confirm the psychometric properties of the scale in other cultures and languages. Future studies are needed to determine the sensitivity of the scale to change over time in response to treatment. [ABSTRACT FROM AUTHOR]

Osteoarthritis (OA) is a common chronic disorder among elderly people that affects joints such as the knee and hip in particular. The objective of the current study was to examine the efficacy of an intervention based on a theory of planned behavior (TPB) in improving health-related quality of life in middle-age and older adults with this condition. One hundred twenty patients diagnosed with knee/hip OA were recruited from a general hospital. Measures administered at baseline were the SF-12, EuroQol (EQ-5D), Osteoarthritis Knee and Hip Quality of Life (OAKHQoL), and TPB questionnaire. Also assessed were body mass index (BMI), Kellgren-Lawrence Scale, six-minute walk test (SMWT), muscle strength, range of motion (ROM), and joint tenderness and swelling. Participants were randomly assigned to either the intervention (n = 60) or the control group (n = 60). The intervention group received an educational program based on TPB that was administered over 1 month. The control group did not receive this treatment. Three months after the intervention, both groups were reevaluated and comparisons made. Compared to the no-treatment control group, those in the intervention group scored higher on HRQoL, both general and specific, at 3-month follow-up (p < 0.01). The only exception was the vitality domain. Significant differences were also found on the TPB questionnaire, the SMWT, and muscle strength in the expected direction (p < 0.05). While those in the intervention group improved significantly on all clinical measures from pre-test to post-test, those in the control group showed improvement only on BMI and joint tenderness. This TPB-based intervention was found to be efficacious in improving HRQoL and several clinical parameters in patients with knee/hip OA. Studies are needed to examine the effectiveness of this intervention in patients with other chronic medical conditions. [ABSTRACT FROM AUTHOR]

Purpose: To assess the reliability, validity, and factor structure of the Persian Brief Quality of Life in Bipolar Disorder (QoL.BD) in Iranian patients with bipolar disorder (BD).Methods: After translation and cross-cultural adaptation of the Brief QoL.BD, we administered the questionnaire to 184 patients diagnosed with BD. To determine factor structure, we performed both exploratory and confirmatory factor analyses. To investigate the reliability, we assessed internal consistency, reproducibility and agreement. Construct validity was assessed by calculating correlations between the Brief QoL.BD and the Short Form-36 (SF-36), Positive And Negative Affect Schedule (PANAS), Hamilton Depression Rating Scale, Young Mania Rating Scale (YMRS) and Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF). We also investigated gender differences in interpretations of QoL.BD items.Results: The results obtained from reliability analysis confirmed internal consistency (Cronbach's alpha was 0.87 and 0.89 for two assessments) and reproducibility and agreement (the intraclass correlation coefficient ranged between 0.74 and 0.94). Validity analyses showed that the items loaded on a single-factor structure. The inter-item correlations varied from 0.31 to 0.68. Significantly lower scores on the Brief QoL.BD were observed in people diagnosed with BD I compared to BD II. Significant correlations were observed between the Brief QoL.BD and SF-36 summary measures, HAMD, YMRS, Q-LES-Q-SF and PANAS subscales. Items in the Brief QoL.BD were interpreted similarly by men and women.Conclusions: The Brief Persian QoL.BD is a psychometrically sound measure with acceptable validity and reliability and provides a rapid assessment tool for measuring QoL in patients with BD. [ABSTRACT FROM AUTHOR]

Understanding language as a social action draws attention to the ways in which fat stigmatizing discourses do social harm. Drawing on interviews and experiences situated in Osaka, Japan and north Georgia, US, this paper looks closely at the ways in which fat stigma is expressed across the two sites, both blatantly and through more subtle language use. We identified four key themes in people's narratives around localized ideas about fatness. These themes are: (1) expressed pity or concern for fat people; (2) reported experiences of indirect stigma in public settings; (3) reported experiences of direct stigma in private settings; and (4) robust and repeated associations between fat and other conditions that had locally relevant negative connotations in each site. We further identify the expressed concern and pity articulated in the first theme as a form of cloaked, "dressed up" stigma and as such, we argue that it enacts social harm, especially when it co-occurs with more blatant forms of stigma. Linguistic niceties around caring actually, at least in these contexts, reify symbolic connections between fat bodies and their social failure. [ABSTRACT FROM AUTHOR]

The present study aimed to use a novel method (i.e., network analysis) to examine if the Internet Gaming Disorder Scale–Short-Form (IGDS9-SF) has its unidimensional structure supported across different subgroups, including gender groups, continent groups, and age groups. Participants from five continents (n = 545 in Africa; n = 27,910 in Americas; n = 4640 in Asia; n = 88,835 in Europe; and n = 1633 in Oceania) completed the IGDS9-SF. The IGDS9-SF items showed a positively correlated network with moderate-to-high predictability (mean of R2 = 0.338, SD = 0.068). Moreover, the network analysis results suggested that the IGDS9-SF is very likely to have a one-factor model. This one-factor model was further found to be invariant across gender groups (men vs. women), continent groups (Africa, Americas, Asian, Europe, and Oceania), and age groups (minor aged under 18 years, young adults aged between 18 and 30 years, and adults aged 30 years or above). [ABSTRACT FROM AUTHOR]

Objective: To prospectively compare the prevalence and frequency of subchondral bone marrow edema (BME) in the lumbar facet joints of low back pain patients and healthy subjects.Materials and Methods: Lumbar magnetic resonance imaging (MRI) examinations were performed on 55 asymptomatic participants (18 men; age range 21-63; mean 36 ± 12 years; body mass index (BMI) range 16-31; mean 22.6 ± 3.2 kg/m2) and 79 low back pain patients (36 men; age range 18-77; mean 47 ± 14 years; BMI range 18-40; mean 27.8 ± 4.4 kg/m2). In both groups, facet joint subchondral BME signal was evaluated using T2-weighted STIR imaging, and facet joint osteoarthritis was characterized as mild, moderate, and severe.Results: The BME signal was found in seven asymptomatic participants (12.7%) and 28 low back pain patients (35.4%) (P = 0.003). A significant portion of the patients (15.2%) presented more than one BME signal (P = 0.011). By pooling the ten facet joints of all subjects in each group, a significant difference in osteoarthritis grade distribution was observed between the two groups (P < 0.001). When adjusted for low back pain status, age, BMI, Modic type 1, disk herniation, and facet joint osteoarthritis maximal grade, only the latter was significantly associated with the facet joint BME signal (P < 0.001).Conclusion: Despite the higher prevalence and frequency of the BME signal in facet joints of low back pain patients compared to that in healthy subjects, the signal was found to be associated with the severity of the patients' osteoarthritis and not with their low back pain status. [ABSTRACT FROM AUTHOR]

To investigate the prevalence and new onset of depression and anxiety among subjects with age-related macular degeneration (AMD) and its association with AMD in a large European cohort with relatively good visual acuity. 11,834 participants enrolled in the German population-based Gutenberg Health Study were studied. AMD was diagnosed by grading of fundus photographs. Depression and anxiety were assessed with the Patient Health Questionnaire and the Generalized Anxiety Disorder-2 Scale, respectively. Logistic regression analyses were performed and adjusted for several parameters. 1,089 (9.2%) participants were diagnosed having AMD. Prevalence of depression in AMD and non-AMD participants was 7.2% and 8.0%, respectively and prevalence of anxiety was 4.2% and 7.0%, respectively. New onset of depression and anxiety at 5-year follow-up in AMD subjects was 2.6% and 3.6%, respectively. AMD was not associated with depression (OR 0.93; CI 95% 0.70–1.20; p = 0.62). AMD was associated with less anxiety (OR 0.67; CI 95% 0.47–0.93; p = 0.02). This is the first study analyzing both prevalence and new onset of depression and anxiety in AMD subjects. AMD- and non-AMD participants had a similar prevalence and new onset of depression in our population-based sample. Participants without AMD had a higher prevalence of anxiety. AMD was not associated with depression. [ABSTRACT FROM AUTHOR]

Aerosol emissions from vehicles have been linked to changes in heart rate variability (HRV) parameters of the susceptible population in developed countries. In the present study, the effects of vehicular emission and resuspended road dust on HRV parameters in healthy adults (18–43 years of age) were assessed at Delhi, India, a metro city where the world's largest youth population 356 million of age group 10–24 years resides as per census report of 2011. The study presents personal exposure concentration of fine particulate matter (PM1 and PM2.5) at a road site in Delhi and its link with the changes in HRV parameters. The mixed effect model treated particulate matter (PM) mass concentration, age of participants, body mass index, and climatic parameters (ambient temperature and relative humidity) as independent variables and HRV parameters as dependent variables. The observed data showed that per inter quartile range (IQR) increase in PM1 resulted in a considerable decrease in the HRV indices: percentage of successive NN-intervals that differ from each other by greater than 50 ms (pNN50) [− 26.6% (− 40.52, − 1.29)], root mean square of differences between successive NN-intervals (r-MSSD) [− 9.8% (− 17.53, 1.32)] and high-frequency power (HF) [− 15.6% (− 27.61, 2.89)], and considerable increase in low frequency (LF) by HF ratio [24.0% (0.95, 45.39)]. Greater changes were seen in most of the HRV parameters for PM2.5 as compared to PM1, probably due to the presence of fine dust along with vehicle emissions which aggravate the effect. The change in HRV parameters is considered as a powerful and independent predictor of changes in cardiac autonomic nervous system. The trend observed in the present study was in congruence with that observed in previous studies except for LF, and the reductions in HRV indices were well within the range when compared with literature. But still the impact on HRV was significant which raises a concern for the healthy population which forms a large portion of the society. Also, in light of the limited evidence on the effect of PM1 on cardiac health, the present study summarized that PM1 has a significant impact on HRV too which is of concern due to its high contribution to total PM. [ABSTRACT FROM AUTHOR]

The Assessment of Criteria for Specific Internet-use Disorder (ACSID-11) is a psychometric instrument assessing different types of problematic internet use. The aim of the present study was to assess the psychometric properties of the traditional Chinese version and evaluate whether the traditional Chinese version showed similar and robust psychometric evidence to that of original ACSID-11 using a German sample. The present study was longitudinal and comprised 1257 university students in the first study and 409 university students in the follow-up study. Cronbach’s α and McDonald’s ω were used for testing internal consistency of the ACSID-11. A confirmatory factor analysis (CFA) was conducted to examine construct validity. Multi-group CFA was performed to assess the invariance of the factor structure across region and sex. Moreover, Pearson correlations were conducted to examine the test–retest reliability and concurrent validity of ACSID-11. The results suggested satisfactory levels of test–retest reliability, internal consistency, and validity of the ACSID-11. The four-factor structure of the ACSID-11 was replicated and confirmed in both Taiwan and Hong Kong samples. The study findings demonstrated that the traditional Chinese version of the ACSID-11 is reliable and valid for assessing and distinguishing specific internet-use disorders and is applicable across regions and sexes among emerging adults in Taiwan and Hong Kong. [ABSTRACT FROM AUTHOR]

Background: With driving while impaired by alcohol (DWI) representing a persistent burden on global health, better understanding and prevention of recidivism following a first-time DWI conviction are needed. Progress towards these goals is challenged by the marked heterogeneity in offender characteristics and a traffic safety literature that relies on subjective self-report measures and cross-sectional study designs. The present study tested the hypothesis that an objective neurobiological marker of behavioural maladjustment, the cortisol stress response (CSR), predicts future DWI and other traffic convictions over a 9-year follow-up period. Methods: One hundred thirty-two male first-time DWI offenders and 31 non-offender comparators were recruited and assessed at intake for their substance use, psychosocial and psychological characteristics and CSR. Traffic conviction data were obtained from provincial driving records. Survival analysis estimated the association between CSR and risk of a traffic conviction over time. Results: In support of our hypothesis, blunted CSR predicted traffic convictions during the follow-up duration. This effect generalized to both DWI offenders and non-DWI drivers. While CSR was lower in DWI offenders compared to non-offenders, it did not specifically predict recidivism in DWI offenders. Modelling results indicated that blunted CSR, along with DWI offender group membership, experience seeking and drug use frequency, may demarcate a high-risk driver phenotype. Conclusions: CSR is a neurobiological marker of a driver phenotype with elevated generalized driving risk. For drivers with characteristics consistent with this phenotype, expanding the focus of intervention to address multiple forms of risky driving may be necessary to curb their overall threat to traffic safety. [ABSTRACT FROM AUTHOR]

Purpose of Review: This review discusses the mortality and morbidity of hypertensive disorders of pregnancy (HDP) and the current diagnostic thresholds. It then explores measurement of variability in blood pressure (BP) during pregnancy as an opportunity to identify women at high risk of cardiovascular disease (CVD) later in life. Recent Findings: HDP is known to be associated with increased risk of long-term CVD. Current CVD prognostic tools do not incorporate a history of HDP given a lack of improved risk discrimination. However, HDP diagnostic criteria are currently based on a binary threshold, and there is some evidence for the use of variability in BP throughout gestation as a marker of CVD risk. Summary: HDP increases long-term risk of CVD. Future studies investigating changes in diagnostic criteria, including the use of BP variability, may improve long-term CVD risk prediction and be incorporated into future risk assessment tools. [ABSTRACT FROM AUTHOR]

Purpose of Review To review the evidence supporting the use ofmobile health (mHealth) apps to improve resistant hypertension self-assessment, treatment and control. Recent Findings mHealth apps have been used to directly measure blood pressure (BP) levels, either using the oscillometric method with automated inflatable cuffs or using pulse wave signals detected by smartphone technology without the need for cuffs. These app-based BP monitors tend to over or underestimate BP levels when compared to a gold standard aneroid sphygmomanometer. However, the differences in BP measurements are within the acceptable range of 5 mmHg pre-defined by the European Society of Hypertension International Protocol Revision 2010. mHealth apps are also used as tools to support physicians in improving hypertension treatment. App-based clinical decision support systems are innovative solutions, in which patient information is entered in the app and management algorithms provide recommendations for hypertension treatment. The use of these apps has been shown to be feasible and easily integrated into the workflow of healthcare professionals, and, therefore particularly useful in resource-limited settings. In addition, apps can be used to improve hypertension control by facilitating regular BP monitoring, communication between patients and health professionals, and patient education; as well as by reinforcing behaviours through reminders, including medication-taking and appointment reminders. Several studies provided evidence supporting the use of apps for hypertension control. Although some of the results are promising, there is still limited evidence on the benefits of using such mHealth tools, as these studies are relatively small and with a short-term duration. Summary Recent research has shown that mHealth apps can be beneficial in terms of improving hypertension self-assessment, treatment and control, being especially useful to help differentiate and manage true and pseudo-resistant hypertension. However, future research, including large-scale randomised clinical trialswith user-centred design, is crucial to further evaluate the potential scalability and effectiveness of such mHealth apps in the resistant hypertension context. [ABSTRACT FROM AUTHOR]