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Shaping off-job life is becoming increasingly important for workers to increase and maintain their optimal functioning (i.e., feeling and performing well). Proactively shaping the job domain (referred to as job crafting) has been extensively studied, but crafting in the off-job domain has received markedly less research attention. Based on the Integrative Needs Model of Crafting , needs-based off-job crafting is defined as workers' proactive and self-initiated changes in their off-job lives, which target psychological needs satisfaction. Off-job crafting is posited as a possible means for workers to fulfill their needs and enhance well-being and performance over time. We developed a new scale to measure off-job crafting and examined its relationships to optimal functioning in different work contexts in different regions around the world (the United States, Germany, Austria, Switzerland, Finland, Japan, and the United Kingdom). Furthermore, we examined the criterion, convergent, incremental, discriminant, and structural validity evidence of the Needs-based Off-job Crafting Scale using multiple methods (longitudinal and cross-sectional survey studies, an "example generation"-task). The results showed that off-job crafting was related to optimal functioning over time, especially in the off-job domain but also in the job domain. Moreover, the novel off-job crafting scale had good convergent and discriminant validity, internal consistency, and test-retest reliability. To conclude, our series of studies in various countries show that off-job crafting can enhance optimal functioning in different life domains and support people in performing their duties sustainably. Therefore, shaping off-job life may be beneficial in an intensified and continually changing and challenging working life., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Kujanpää, Syrek, Tay, Kinnunen, Mäkikangas, Shimazu, Wiese, Brauchli, Bauer, Kerksieck, Toyama and de Bloom.)

Objectives: Slow gait speed and sit-to-stand performance are associated with adverse clinical outcomes in older adults. Identifying older adults with functional performance "below norms" is the first step toward prevention. We aimed to (1) examine the associations of age, body height, and gender with gait speed and sit-to-stand performance and (2) develop subgroup-specific reference ranges in older adults with no self-reported mobility limitations., Design: Cross-sectional study., Setting and Participants: This study analyzed data from 775 community-dwelling older adults who reported no difficulty walking 100 m, climbing stairs, and rising from the chair., Methods: Gait speed and sit-to-stand performance were measured by the 10-m gait speed test and 5-times sit-to-stand test, respectively. Bayesian linear regression was used to derive 95% reference ranges for gait speed and sit-to-stand performance, defined by different levels of age, body height, and gender., Results: Overall, 95% reference range was 0.89-1.79 m/s for habitual gait speed and 7.4-27.9 stands/30 s for sit-to-stand pace. Age had the highest posterior probability (>99%) of a meaningful association with both functional outcomes. Additionally, height was strongly associated with gait speed: a 10-cm increase in height was associated with 0.07 m/s (95% credible interval, 0.05-0.10) faster gait speed. For sit-to-stand test, the lower 95% reference range limits tended to be similar across gender and gender-specific height subgroups, owing to the associations of faster sit-to-stand pace with shorter height and male gender. Because extensive tables of reference ranges are impractical, a web-based application (https://sghpt.shinyapps.io/ippts/) is created to provide subgroup-specific reference ranges., Conclusions and Implications: In a large sample of mobile-intact older adults, reference ranges for gait speed and sit-to-stand performance differed meaningfully by age. Furthermore, gait speed was stature dependent. Although requiring validation, our findings may be used to define subgroup-specific "below-range" values and to complement existing universal clinical cut points for gait speed and sit-to-stand performance., (Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Surgery is recommended within 48 hours of hip fractures for better perioperative outcomes. Yet, such targets still commonly remain a challenge. Our institution is no exception.As part of a hospital-wide initiative, our anaesthesia department focused on improving perioperative processes with aims to reduce the time to first anaesthesia consult and surgery for hip fracture patients. Acknowledging multiple causes for surgical delay, we decided first to address anaesthesia-specific factors-(a) first anaesthetist contact usually happens after surgery is offered which leaves a short runway for preoptimisation, (b) this is compounded by varying degrees of anaesthetist involvement for follow-up thereafter. (c) There is a need to calibrate our perioperative care standards and (d) enforce more consistent auditing in quality assurance. This project was conducted in a 1000-bed hospital serving eastern Singapore., Intervention: We created an integrated anaesthesia consultant-led outreach service for hip fracture patients, based on a perioperative workflow system to provide proactive anaesthetist consults within 24 hours of admission in advance of surgical decision. This was streamlined with a coordinated follow-up system for preoptimisation until surgery., Methods: Our quality improvement project applied the iterative Plan-Do-Study-Act model from pilot to sustainability stage. We collected data at baseline followed by 6-monthly audits from electronic databases.Primary outcomes measured were time to first anaesthesia consult and surgery. Secondary outcomes included rate of critical care reviews and admission, mortality rate, length of stay and time to nerve blocks., Results: Post implementation, our service reviewed >600 hip fracture patients. Median time to anaesthesia consult reduced significantly from 35.3 hours (2019) to 21.5 hours (2021) (p=0.029). Median time to surgery was reduced from 61.5 hours (2019) to 50 hours (2021) (p=0.897) with a 13.6% increase in patients operated <48 hours. Critical care admissions, 6-monthly and 12-monthly mortality rates and time to nerve block were reduced with a greater percentage of patients discharged within 10 days., Conclusion: Our project focused on improving anaesthesia perioperative processes to address surgical delays in hip fracture patients. Our consultant-led anaesthesia service ensured that proactive anaesthesia care was delivered to provide sufficient time for preoptimisation with greater standardisation to follow-up, better communication and quality assurance., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Organizations are increasingly adopting automated video interviews (AVIs) to screen job applicants despite a paucity of research on their reliability, validity, and generalizability. In this study, we address this gap by developing AVIs that use verbal, paraverbal, and nonverbal behaviors extracted from video interviews to assess Big Five personality traits. We developed and validated machine learning models within (using nested cross-validation) and across three separate samples of mock video interviews (total N = 1,073). Also, we examined their test-retest reliability in a fourth sample ( N = 99). In general, we found that the AVI personality assessments exhibited stronger evidence of validity when they were trained on interviewer-reports rather than self-reports. When cross-validated in the other samples, AVI personality assessments trained on interviewer-reports had mixed evidence of reliability, exhibited consistent convergent and discriminant relations, used predictors that appear to be conceptually relevant to the focal traits, and predicted academic outcomes. On the other hand, there was little evidence of reliability or validity for the AVIs trained on self-reports. We discuss the implications for future work on AVIs and personality theory, and provide practical recommendations for the vendors marketing such approaches and organizations considering adopting them. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Aim: In order to account for the variability in gait speed due to demographic factors, an observed gait speed value can be compared with its predicted value based on age, sex, and body height (observed gait speed divided by predicted gait speed, termed "GS%predicted" henceforth). This study aimed to examine the screening accuracy of an optimal GS%predicted threshold for prefrailty/frailty., Methods: This cross-sectional study included 998 community-dwelling ambulant participants aged >50 years (mean age = 68 years). Participants completed a multi-domain geriatric screen and a physical fitness assessment, from which the 10-m habitual gait speed, GS%predicted, Physical Frailty Phenotype (PFP) index, and 36-item Frailty Index (FI) were computed., Results: Based on the FI, ~49% of participants had pre-frailty or frailty. The optimal threshold of GS%predicted (0.93) had greater screening accuracy than the 1.0 m/s fixed threshold for gait speed (AUC, 0.65 vs. 0.60; DeLong's P < 0.001). Replacing gait speed with GS%predicted in the PFP improved its overall discrimination (AUC, 0.70 vs. 0.67 of original PFP; DeLong's P < 0.001)., Conclusions: Defining a "slow" gait speed by a GS%predicted value of <0.93 provided greater screening accuracy than the traditional 1.0 m/s threshold for gait speed. Our results also support the use of GS%predicted-derived PFP to identify older adults at risk of prefrailty/frailty. Geriatr Gerontol Int 2022; 22: 575-580., (© 2022 Japan Geriatrics Society.)

The Boarder Program is a unique, family-centered program designed to keep a mother and her infant together when the mother has been discharged, but her infant requires additional medical attention and hospitalization. The hospital-sponsored program includes a room in the obstetric department, meals, and services. This provides the mother and second caregiver the opportunity to participate in their infant's physical care and engage in the decision-making process. The program is designed to support families with infants in an intermediate care nursery and has been expanded to include infants experiencing neonatal abstinence syndrome (NAS). The purpose of this article is to describe the Boarder Program at a community medical center, share its history, and provide evidence-based support for the effectiveness of this model., (© Copyright 2022 Springer Publishing Company, LLC.)

Background: There are concerns that Asian patients respond differently to some medications. This study evaluated the efficacy and safety of evolocumab among Asian vs. other subjects in the FOURIER trial, which randomized stable atherosclerosis patients to receive either evolocumab or placebo., Methods and results: Effects of adding evolocumab vs. placebo to background statin therapy on low-density lipoprotein cholesterol (LDL-C) reductions, cardiovascular outcomes, and adverse events were compared among 27,564 participants with atherosclerotic disease, according to self-reported Asian (n=2,723) vs. other (n=24,841) races followed for a median of 2.2 years in the FOURIER trial. The primary endpoint was a composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. At randomization, Asians had slightly lower LDL-C (median 89 [IQR 78-104] mg/dL vs. 92 [80-109] mg/dL; P<0.001) and were much less likely to be on a high-intensity statin (33.3% vs. 73.3%; P<0.001). Evolocumab lowered LDL-C more in Asians than in others (66% vs. 58%; P<0.001). The effect of evolocumab on the primary endpoint was similar in Asians (HR, 0.79; 95% CI, 0.61-1.03) and others (HR, 0.86; 95% CI, 0.79-0.93; P interaction=0.55). There was no excess of serious adverse events with evolocumab among Asians over others., Conclusions: Use of evolocumab robustly lowers LDL-C and is equally efficacious in lowering the risk of cardiovascular events and safe in Asians as it is in others.

Background: While sarcopenia and frailty independently contribute to functional impairment and disability, the combined impact resulting from their interplay is unclear. We investigated if functional, physical, cognitive, and nutritional measures were more adversely affected in community-dwelling older adults who were screened positive for both frailty and sarcopenia., Methods: Using the FRAIL (≥1) and SARC-F (Strength, Assistance with walking, Rising from a chair, Climbing stairs, and Falls) (≥1) scales for screening, we categorized 200 participants (age, 67.9±7.9 years) as combined (both positive, 12.5%), intermediate (either positive, 25.5%), or robust (both negative, 62%)., Results: Comparisons of the three groups showed that the combined group had significantly worse functional ability (Frenchay Activities Index and Modified Barthel Index), physical performance (knee extension, gait speed, and Short Physical Performance Battery score), cognition/mood (Chinese Mini-Mental State Examination [CMMSE] score and Geriatric Depression Scale), and nutrition (Mini Nutritional Assessment [MNA] score) (p&lt;0.05, one-way analysis of variance). Post-hoc comparisons revealed similar findings between the combined and robust groups, except for knee extension and CMMSE scores. Only MNA scores were significantly lower between the intermediate and robust groups., Conclusion: Functional ability, physical performance, and nutrition were more adversely affected in our study population of community-dwelling older adults who screened positive for both frailty and sarcopenia than in those who screened positive for either or neither, supporting the use of community screening for early detection and intervention for both frailty and sarcopenia as opposed to either alone.

Aim: To evaluate the influence of different enamel etching times on the bond strength of two self-adhesive resin cements (RCs) with and without thermocycling (TMC)., Methods: One hundred twenty bovine teeth were used. Blocks of enamel (8×4×2mm) were obtained, polished, and randomly divided into two groups, according to the RC used: MaxCem Elite or RelyX U200. Groups were subdivided into four groups (n=16), according to the etching time: Control (0 seconds), 5 seconds, 10 seconds, and 20 seconds. Three RC cylinders (1-mm diameter) were built on each enamel block. The specimens were submitted to two storage conditions: 24 hours in distilled water or TMC (5000 cycles/5°C-55°C). Afterward, the specimens were submitted to the shear bond strength (SBS) test. The failure modes and adhesive interfaces were analyzed by scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). Data were analyzed with three-way analysis of variance (ANOVA) and Tukey test (α=0.05)., Results: Etching increased the SBS for both the RCs,especially forthe groups etched for 5 and 10 seconds. TMC affected negatively the SBS of the control groups (p<0.05). No resin tags were observed in control groups, and the formation of tags was time dependent., Conclusion: The 10 seconds etching time was more effective in increasing the enamel-resin bond strength. TMC negatively affected bond strength in specimens without acid etching., (©Operative Dentistry, 2021.)

Developing self-report Likert scales is an essential part of modern psychology. However, it is hard for psychologists to remain apprised of best practices as methodological developments accumulate. To address this, this current paper offers a selective review of advances in Likert scale development that have occurred over the past 25 years. We reviewed six major measurement journals (e.g., Psychological Methods , Educational , and Psychological Measurement ) between the years 1995-2019 and identified key advances, ultimately including 40 papers and offering written summaries of each. We supplemented this review with an in-depth discussion of five particular advances: (1) conceptions of construct validity, (2) creating better construct definitions, (3) readability tests for generating items, (4) alternative measures of precision [e.g., coefficient omega and item response theory (IRT) information], and (5) ant colony optimization (ACO) for creating short forms. The Supplementary Material provides further technical details on these advances and offers guidance on software implementation. This paper is intended to be a resource for psychological researchers to be informed about more recent psychometric progress in Likert scale creation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Jebb, Ng and Tay.)

Effective ways to measure employee job satisfaction are fraught with problems of scale, misrepresentation, and timeliness. Current methodologies are limited in capturing subjective differences in expectations, needs, and values at work, and they do not lay emphasis on demographic differences, which may impact people's perceptions of job satisfaction. This study proposes an approach to assess job satisfaction by leveraging large-scale social media data. Starting with an initial Twitter dataset of 1.5M posts, we examine two facets of job satisfaction, pay and supervision . By adopting a theory-driven approach, we first build machine learning classifiers to assess perceived job satisfaction with an average AUC of 0.84. We then study demographic differences in perceived job satisfaction by geography, sex, and race in the U.S. For geography, we find that job satisfaction on Twitter exhibits insightful relationships with macroeconomic indicators such as financial wellbeing and unemployment rates. For sex and race, we find that females express greater pay satisfaction but lower supervision satisfaction than males, whereas Whites express the least pay and supervision satisfaction. Unpacking linguistic differences, we find contrasts in different groups' underlying priorities and concerns, e.g., under-represented groups saliently express about basic livelihood, whereas the majority groups saliently express about self-actualization. We discuss the role of frame of reference and the "job satisfaction paradox", conceptualized by organizational psychologists, in explaining our observed differences. We conclude with theoretical and sociotechnical implications of our work for understanding and improving worker wellbeing.

Objective: We aim to determine the association of monocyte chemotactic protein-1 (MCP-1) and dickkopft-1 (DKK-1) as potential biomarkers that may predict changes in body composition and physical performance in healthy older adults from Singapore., Methods: Two-hundred community-dwelling older adults (mean age: 67.9 years; 68.5% females) were classified into elevated versus non-elevated groups based on quintile cut-offs of MCP-1 and DKK-1 levels (156.02 pg/mL and 606.31 pg/mL, respectively). Multiple linear regression was performed to examine the relationship between MCP-1 and DKK-1 with body composition and physical performance, adjusted for age, gender and ethnicity., Results: MCP-1 was significantly associated with higher fat mass, fat mass index, percentage body fat, waist circumference and trunk-limb ratio for fat mass (all p<0.01), and repeated chair stand (p=0.004). DKK-1 was not associated with body composition and physical performance measures. Utilising the Asian Working Group for Sarcopenia (AWGS) 2019 criteria, there were 39 (19.5%) sarcopenia and 161 (80.5%) non-sarcopenia participants respectively, with MCP-1 levels significantly higher in sarcopenia compared with non-sarcopenia (p=0.046), but not for DKK-1 (p=0.525)., Conclusions: Elevated MCP-1 are associated with changes in fat composition, physical performance and sarcopenia, suggesting its usefulness in identifying at-risk group with sarcopenic obesity., (Copyright: © 2021 Hylonome Publications.)

There has been reemerging interest within psychology in the construct of character, yet assessing it can be difficult due to social desirability of character traits. Forced-choice formats offer one way to address response bias, but traditional scoring methods (i.e., ipsative) associated with this format makes comparing scores between people problematic. Nevertheless, recent advances in modeling item responding (Thurstonian IRT) enable scoring that recovers absolute standing on latent traits and allows for score comparisons between people. Based on recent work in character measurement (CIVIC), we developed a multidimensional forced-choice measure of character (CIVIC-MFC) and scored it using Thurstonian IRT. Initial validation using a sample of 798 participants demonstrated good support for factorial, convergent, and concurrent validity for scores on the CIVIC-MFC, although they did not demonstrate more faking resistance than scores on a Likert-type format version. Potential explanations are discussed.

Policy Points Several intergovernmental organizations (Organisation for Economic Co-operation and Development, World Health Organization, United Nations) are urging countries to use well-being indicators (e.g., life satisfaction) in addition to traditional economic indicators when making important policy decisions. As the number of governments implementing this new approach grows, so does the need to continue evaluating the health and well-being outcomes we might observe from policies aimed at improving life satisfaction. The results of this study suggest that life satisfaction is a valuable target for policies aiming to enhance several indicators of psychosocial well-being, health behaviors, and physical health outcomes., Context: Several intergovernmental organizations (Organisation for Economic Co-operation and Development, World Health Organization, United Nations) are urging countries to use well-being indicators (e.g., life satisfaction) in addition to traditional economic indicators when making important policy decisions. As the number of governments implementing this new approach grows, so does the need to continue evaluating the health and well-being outcomes we might observe from policies aimed at improving life satisfaction., Methods: We evaluated whether positive change in life satisfaction (between t 0 ;2006/2008 and t 1 ;2010/2012) was associated with better outcomes on 35 indicators of physical, behavioral, and psychosocial health and well-being (in t 2 ;2014/2016). Data were from 12,998 participants in the University of Michigan's Health and Retirement Study-a prospective and nationally representative cohort of US adults over age 50., Findings: Participants with the highest (versus lowest) life satisfaction had better subsequent outcomes on some physical health indicators (lower risk of pain, physical functioning limitations, and mortality; lower number of chronic conditions; and higher self-rated health) and health behaviors (lower risk of sleep problems and more frequent physical activity), and nearly all psychosocial indicators (higher positive affect, optimism, purpose in life, mastery, health mastery, financial mastery, and likelihood of living with spouse/partner; and lower depression, depressive symptoms, hopelessness, negative affect, perceived constraints, and loneliness) over the 4-year follow-up period. However, life satisfaction was not subsequently associated with many specific health conditions (i.e., diabetes, hypertension, stroke, cancer, heart disease, lung disease, arthritis, overweight/obesity, or cognitive impairment), other health behaviors (i.e., binge drinking or smoking), or frequency of contact with children, family, or friends., Conclusions: These results suggest that life satisfaction is a valuable target for policies aiming to enhance several indicators of psychosocial well-being, health behaviors, and physical health outcomes., (© 2021 Milbank Memorial Fund.)

Objectives: To determine the safety of urological admissions and procedures during the height of the COVID-19 pandemic using "hot" and "cold" sites. The secondary objective is to determine risk factors of contracting COVID-19 within our cohort., Patients and Methods: A retrospective cohort study of all consecutive patients admitted from March 1 to May 31, 2020 at a high-volume tertiary urology department in London, United Kingdom. Elective surgery was carried out at a "cold" site requiring a negative COVID-19 swab 72-hours prior to admission and patients were required to self-isolate for 14-days preoperatively, while all acute admissions were admitted to the "hot" site.Complications related to COVID-19 were presented as percentages. Risk factors for developing COVID-19 infection were determined using multivariate logistic regression analysis., Results: A total of 611 patients, 451 (73.8%) male and 160 (26.2%) female, with a median age of 57 (interquartile range 44-70) were admitted under the urology team; 101 (16.5%) on the "cold" site and 510 (83.5%) on the "hot" site. Procedures were performed in 495 patients of which eight (1.6%) contracted COVID-19 postoperatively with one (0.2%) postoperative mortality due to COVID-19. Overall, COVID-19 was detected in 20 (3.3%) patients with two (0.3%) deaths. Length of stay was associated with contracting COVID-19 in our cohort (OR 1.25, 95% CI 1.13-1.39)., Conclusions: Continuation of urological procedures using "hot" and "cold" sites throughout the COVID-19 pandemic was safe practice, although the risk of COVID-19 remained and is underlined by a postoperative mortality., Competing Interests: The Authors do not declare any conflict of interest. Funding has been provided the department of Life Sciences and Medicine, King’s College London., (© 2021 The Authors. BJUI Compass published by John Wiley & Sons Ltd on behalf of BJU International Company.)

This article describes some potential uses of Bayesian estimation for time-series and panel data models by incorporating information from prior probabilities (i.e., priors) in addition to observed data. Drawing on econometrics and other literatures we illustrate the use of informative "shrinkage" or "small variance" priors (including so-called "Minnesota priors") while extending prior work on the general cross-lagged panel model (GCLM). Using a panel dataset of national income and subjective well-being (SWB) we describe three key benefits of these priors. First, they shrink parameter estimates toward zero or toward each other for time-varying parameters, which lends additional support for an income → SWB effect that is not supported with maximum likelihood (ML). This is useful because, second, these priors increase model parsimony and the stability of estimates (keeping them within more reasonable bounds) and thus improve out-of-sample predictions and interpretability, which means estimated effect should also be more trustworthy than under ML. Third, these priors allow estimating otherwise under-identified models under ML, allowing higher-order lagged effects and time-varying parameters that are otherwise impossible to estimate using observed data alone. In conclusion we note some of the responsibilities that come with the use of priors which, departing from typical commentaries on their scientific applications, we describe as involving reflection on how best to apply modeling tools to address matters of worldly concern., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Zyphur, Hamaker, Tay, Voelkle, Preacher, Zhang, Allison, Pierides, Koval and Diener.)

Background: Preventing frailty is important to avoid adverse health outcomes. Intervention studies have largely focused on frail elderly, although the intermediate pre-frail state may be more amenable to improvement., Objectives: This study aims to assess how physical performance may change among pre-frail elderly enrolled in a pragmatic non-controlled exercise and nutritional intervention programme., Methods: This is a non-controlled study involving a 4-month exercise and nutritional intervention for community dwelling pre-frail older adults. Pre-frailty was defined as the presence of 1 or 2 positive responses on the FRAIL questionnaire, or evidence of weak grip strength (<26kg for males; <18kg for females) or slow gait speed (<0.8m/s) amongst participants who were asymptomatic on FRAIL. Physical performance in flexibility, grip and lower limb strength, endurance, balance, and Short Physical Performance Battery were measured at 3 time-points: baseline, 3-month from recruitment (without intervention), and immediate post-intervention. Repeated measures mixed model analysis was performed to compare physical performance measures across the 3 time-points., Results: 94 pre-frail participants were eligible for intervention, of whom 59 (mean age = 70.9±7.2 years) were ready for the post-intervention review. 21 (35.6%) transitioned to robust phenotype while 32 (54.2%) remained as pre-frail. Significant improvement post-intervention was observed in lower limb strength and power, evident on reduction in time taken for 5 sit-to-stand repetitions (0.46±0.20s, p=0.03). There was no significant change to the other physical performance measures examined., Conclusion: We observed reversibility of pre-frailty, and the benefit of multi-component intervention in improving physical performance of pre-frail older adults. The findings in this non-controlled study will need to be corroborated with future controlled trials., Competing Interests: The authors have no conflicts of interest to declare, financial or otherwise., (© 2021 - JARLIFE.)

Background: The sit-to-stand (STS) test has been deployed as surrogate measures of strength or physical performance in sarcopenia diagnosis. This study examines the relationship of two common STS variants - Five Times Sit-to-Stand Test (5TSTS) and 30 s Chair Stand Test (30CST) - with grip strength, muscle mass and functional measures, and their impact on sarcopenia prevalence in community-dwelling older adults., Methods: This is a cross-sectional analysis of 887 community-dwelling adults aged ≥50 years. Participants completed a battery of physical fitness tests - 5TSTS, 30CST, grip strength, gait speed, Timed-Up-and-Go (TUG) for dynamic balance and six-minute walk test (6MWT) for cardiorespiratory endurance. Muscle mass was measured using multi-frequency segmental bioelectrical impedance analysis (BIA). We performed correlation analysis between STS performance and other fitness measures and muscle mass, followed by multiple linear regression for the independent determinants of STS performance., Results: Mean participant age was 67.3±7 years, with female predominance (72.9%). STS tests exhibited weak correlations with grip strength (30CST, r = 0.290; 5TSTS, r = - 0.242; both p< 0.01), and stronger correlations with gait speed (30CST, r = 0.517; 5TSTS, r = - 0.533; both p< 0.01), endurance (30CST, r = 0.558; 5TSTS, r = - 0.531; both p < 0.01) and dynamic balance (30CST, r = - 0.501; 5TSTS, r = 0.646; both p< 0.01). Muscle mass correlated with grip strength but not STS. In multiple regression analysis, all fitness measures were independently associated with 30CST performance. Performance in both STS tests remained independent of muscle mass. There was no significant difference in prevalence of possible sarcopenia diagnosis using grip strength or STS (30CST, 25.0%; 5TSTS, 22.1%; grip strength, 22.3%; p = 0.276). When both measures are used, prevalence is significantly higher (42.0%; p = 0.276). Prevalence of confirmed sarcopenia with inclusion of muscle mass was significantly lower using STS compared with grip strength (30CST, 4.6%; 5TSTS, 4.1% vs. grip strength, 7.1%; p< 0.05)., Conclusion: In the sarcopenia construct, STS tests better represents muscle physical performance rather than muscle strength. Different subsets of population with possible sarcopenia are identified depending on the test used. The lack of association of STS performance with muscle mass results in a lower prevalence of confirmed sarcopenia compared with grip strength, but may better reflect changes in muscle quality.

Background: Asthma is a chronic condition that results in the inflammation and narrowing of airways, often clinically presenting as wheeze and shortness of breath. Little is known of the mechanisms of action (MOA) of herbs used to treat asthma. The aim of this study is to review existing data regarding known MOA of traditional Chinese medicine which will aid in the understanding of possible interactions between Western drugs and Chinese herbs as well as the standardization of management via a proposed guideline to improve patient safety and possible synergism in the long term., Methods: We searched through 5 databases for commonly prescribed herbs and formulas for asthma and narrowed down the search to identify the underlying MOA of individual herbs that could specifically target asthma symptoms. We included studies that stated the MOA of individual herbs when used for treating symptoms of asthma, excluding them if they are described as part of a formula., Results: A total of 26 herbs commonly prescribed for asthma with known mechanism of action were identified. Herbs used for asthma were found to have similar MOA as that for drugs. Based on existing GINA guidelines, a guideline is proposed which includes a total of 5 steps depending on the severity of asthma and the herbs' MOA. 16 formulas were subsequently identified for the management of asthma, which consist of 12 "stand-alone" and 4 "add-on" formulas. "Stand-alone" formulas used independently for asthma generally follow the GINA guidelines but do not proceed beyond step 3. These formulas consist mainly of beta-agonist and steroid-like effects. "Add-on" formulas added as adjunct to "stand-alone" formulas, however, mainly act on T helper cells or have steroid-like effects., Conclusion: Through the understanding of MOA of herbs and their respective formulas, it will ensue greater patient safety and outcomes., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2021 Lin Ho Wong et al.)

In recent years, there has been heightened interest in the active role of employees in shaping activities and experiences in their pursuit of optimal functioning (i.e., feeling and performing well), referred to as job-, leisure-, home-, and work-life balance crafting. Various perspectives have emphasized distinct dimensions within the crafting process (i.e., motives, behaviors, life domains, and outcomes), yielding a rich but fragmented theoretical account. With psychological needs satisfaction as the underlying process, we propose an integrative model to account for past conceptualizations of crafting motives and efforts across a person's various role identities. This integration highlights the importance of recognizing unfulfilled needs, matching needs and crafting efforts, within- and between-level temporal dynamics of the crafting process, and possibilities for spillover and compensation processes across identity domains. Accordingly, the Integrative Needs Model of Crafting explains (1) why and how people craft, (2) when and why crafting efforts may (not) be effective in achieving optimal functioning, (3) the sequential process of crafting over time, and (4) how crafting processes unfold across different identity domains. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

The United Nations described the Syrian conflict as the worst man-made disaster since World War II. We adopted a global perspective in examining the impact of the Syrian conflict on Syrians' physical, mental, and social well-being using the Gallup World Poll. Face-to-face interview data of 11,452 Syrian participants from 2008 to 2015 show that Syrians' physical (e.g., access to shelter), mental (e.g., life satisfaction), and social (e.g., social support) well-being decline substantially. Syrians who reported being exposed to the conflict are similarly affected compared to those without direct exposure, suggesting country-wide spillover effects. Global data covering 1.7 million participants across 163 countries from 2006 to 2016 show during the conflict, Syria's precipitous decline in well-being is unparalleled in the world, even when compared to countries similarly experiencing war, protests, and disasters. Our findings reinforce the vital importance of an accelerated peace process to restore well-being in Syria.

In light of increasing rates of overweight and obesity worldwide, there is a critical need for accurate self-report measures of disinhibited and restrained eating behaviors across the weight spectrum. Item response theory was used to determine whether differences in disinhibited and restrained eating between healthy weight and overweight or obese individuals were due to item bias (i.e., differential item functioning). Study 1 participants were healthy weight ( n = 510) or overweight or obese ( n = 304) adults recruited from the community. Study 2 participants were healthy weight ( n = 778) or overweight or obese ( n = 320) college students. Study 1 participants completed the Eating Disorder Examination-Questionnaire (EDE-Q), Eating Disorder Inventory-3, Dutch Eating Behaviors Questionnaire, Restraint Scale, and Three-Factor Eating Questionnaire. Study 2 participants completed the Eating Pathology Symptoms Inventory (EPSI). Items on the Restraint Scale demonstrated the most evidence for bias (60% of items), whereas the majority of other scales demonstrated low to moderate levels of item bias (17-38% of items). However, EDE-Q Restraint and EPSI Binge Eating, Cognitive Restraint, Excessive Exercise, Muscle Building, and Negative Attitudes Toward Obesity scales did not show any evidence of differential item functioning among weight groups. Participants with the same level of disordered eating responded differently to certain eating disorder self-report items due to weight-bias, rather than true between-groups differences. Nevertheless, EDE-Q Restraint, EPSI Cognitive Restraint, and EPSI Binge Eating did not exhibit any evidence of bias and are ideal for assessing restrained and disinhibited eating across the weight spectrum in both research and clinical settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Affect inductions have become essential for testing theories of affect and for conducting experimental research on the effects of mood and emotion. The current review takes stock of the vast body of existing literature on affect induction procedures (AIPs; also referred to as mood inductions) to evaluate the effectiveness of affect inductions as research tools and to test theories of affect (e.g., the bipolarity hypothesis, negativity bias, positivity offset, and theories of emotionality and gender) using meta-analytic data. In doing so, we seek to address whether AIPs are effective for inducing affective states, what conditions maximize their effectiveness, for which emotions they are most effective, for whom they are most effective, and whether affect induction findings can provide insight into theories of affect. A meta-analysis of 874 samples and 53,509 participants suggests that affect inductions are effective on average (δ = 1.32), but this effectiveness varies with the type of affect induction, the emotion being induced, and the gender of the participants. Further, results indicate coupled activation where the induction of positive (negative) emotions leads to a corresponding reduction in negative (positive) emotions, which provides support for the bipolar continuum of positive and negative affect. Results also revealed a negativity bias in which individuals display stronger reactions to negative stimuli than positive stimuli. A practical guide in the choice of affect induction procedures for researchers is presented and implications for emotion theory are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Using representative cross-sections from 166 nations (more than 1.7 million respondents), we examined differences in three measures of subjective well-being over the life span. Globally, and in the individual regions of the world, we found only very small differences in life satisfaction and negative affect. By contrast, decreases in positive affect were larger. We then examined four important predictors of subjective well-being and how their associations changed: marriage, employment, prosociality, and life meaning. These predictors were typically associated with higher subjective well-being over the life span in every world region. Marriage showed only very small associations for the three outcomes, whereas employment had larger effects that peaked around age 50 years. Prosociality had practically significant associations only with positive affect, and life meaning had strong, consistent associations with all subjective-well-being measures across regions and ages. These findings enhance our understanding of subjective-well-being patterns and what matters for subjective well-being across the life span.

A seemingly universal lesson is that anything taken to its extreme is detrimental. Indeed, there has been growing interest in testing this idea within psychology. These studies have often been framed in terms of Aristotle's doctrine of the golden mean or the idea that virtue lies between the vices of deficiency and excess. Recent explicit reviews of this hypothesis in the psychological literature have led to the paradoxical conclusion that one can have too much virtue (i.e., the too-much-of-a-good-thing effect) despite virtue being identified by the golden mean. We argue in this article that this conclusion is due to a reductionist account of virtues in psychology and the resultant measurement of virtues as general dispositional tendencies in behavior. We review philosophical theory on the golden mean to show that the relationship between virtue and relevant behavior is fundamentally about situation-specific optimality . Using schematic models, we contrast the former measurement approach against the latter to explain the too-much-of-a-good-thing effect and further demonstrate why virtues cannot be properly measured as general tendencies in behavior. We conclude with methodological implications of our theory-informed approach to virtue measurement for research design, evaluation, and conceptualization.

Measures of well-being have proliferated over the past decades. Very little guidance has been available as to which measures to use in what contexts. This paper provides a series of recommendations, based on the present state of knowledge and the existing measures available, of what measures might be preferred in which contexts. The recommendations came out of an interdisciplinary workshop on the measurement of well-being. The recommendations are shaped around the number of items that can be included in a survey, and also based on the differing potential contexts and purposes of data collection such as, for example, government surveys, or multi-use cohort studies, or studies specifically about psychological well-being. The recommendations are not intended to be definitive, but to stimulate discussion and refinement, and to provide guidance to those relatively new to the study of well-being., Competing Interests: Declaration of competing interest Tyler J. VanderWeele and Eileen McNeely report having previously received consulting fees from Aetna Inc., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Bifurcation percutaneous coronary intervention (PCI) remains a challenging frontier in interventional cardiology, especially in the setting of ST-elevation myocardial infarction (STEMI). We examined the procedural and clinical outcomes of this patient subset., Methods: We conducted a retrospective case-control study. Between February 2006 and March 2011, 129 patients with STEMI underwent bifurcation PCI at our institution. One hundred and twenty-nine (129) control STEMI patients with non-bifurcation PCI were selected from the institutional database, matched for age, gender, culprit vessel, and lesion location. Patients with cardiac arrest, cardiogenic shock, or who required mechanical ventilation were excluded. Twelve (12)-month follow-up data were collected by telephone calls and examination of the medical records., Results: The average age of patients presenting with STEMI was 61.6 ± 13.1 in the bifurcation group and 61.5 + 31.1 in the non-bifurcation group. There was no difference in lesion type, use of thrombus aspiration catheters, or glycoprotein inhibitors (GPI) among them. Also, the use of drug eluting stent (DES), total cumulative length of stent used, and diameter of the post-dilation balloon were similar. Final kissing balloon post-dilation was performed in 40.3% of bifurcation PCI cases. The incidence of procedural failure (TIMI 0 flow) was 1.5% vs. 0%; p = 0.478. At 12-months follow-up, the bifurcation PCI group had higher incidence of target lesion revascularisation (TLR) (10.9% vs. 3.9%, p = 0.050), mortality (10.1% vs. 2.3%, p = 0.020), and stent thrombosis (9.3% vs. 1.6%; p = 0.013); comprising one acute, nine subacute, and two late vs. two subacute stent thromboses., Conclusions: During acute STEMI, bifurcation PCI has excellent acute procedural outcomes, but significantly increased incidence of TLR, stent thrombosis and mortality at 12 months., (Copyright © 2019 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.)

Background: Sarcopenic obesity (SO) is associated with poorer physical performance in the elderly and will increase in relevance with population ageing and the obesity epidemic. The lack of a consensus definition for SO has resulted in variability in its reported prevalence, poor inter-definitional agreement, and disagreement on its impact on physical performance, impeding further development in the field. While sarcopenia definitions have been compared, the impact of obesity definitions in SO has been less well-studied., Objectives: To compare 3 widely-adopted definitions of obesity in terms of SO prevalence, inter-definitional agreement, and association with muscle function., Design: Cross-sectional., Setting: GERILABS study, Singapore Participants: 200 community-dwelling, functionally-independent older adults., Measurements: We utilized three commonly-used definitions of obesity: body mass index (BMI), waist circumference (WC) and DXA-derived fat mass percentage (FM%). Sarcopenia was defined using Asian Working Group for Sarcopenia criteria. For muscle function, we assessed handgrip strength, gait speed and Short Physical Performance Battery (SPPB). Subjects were classified into 4 body composition phenotypes (normal, obese, sarcopenic and SO), and outcomes were compared between groups., Results: The prevalence rate for SO was lowest for BMI (0.5%) compared to FM% (10.0%) and WC (10.5%). Inter-definitional agreement was lowest between BMI and WC (κ=0.364), and at best moderate between FM% and WC (κ=0.583). SO performed the worst amongst body composition phenotypes in handgrip strength, gait speed and SPPB (all p<0.01) only when defined using WC. In regression analyses, SO was associated with decreased SPPB scores (β=-0.261, p=0.001) only for the WC definition., Conclusion: There is large variation in the prevalence of SO across different obesity definitions, with low-to-moderate agreement between them. Our results corroborate recent evidence that WC, and thus central obesity, is best associated with poorer muscle function in SO. Thus, WC should be further explored in defining obesity for accurate and early characterization of SO among older adults in Asian populations., Competing Interests: The authors report no conflicts of interest in this work.

Importance: Muscle strength has been elevated to the forefront of sarcopenia diagnosis, with handgrip strength the preferred measure. Extant handgrip protocols adopt different handgrip strength (HGS) criteria. Paucity of direct comparison studies assessing the impact of HGS criterion on prevalence of sarcopenia and predictive validity on physical performance contributes to the lack of standardisation of HGS criteria in sarcopenia diagnosis., Objectives: Our study aims to compare the effect of average (HGSave) versus maximum (HGSmax) HGS criterion on: (1) prevalence of low HGS and sarcopenia; and (2) association with physical performance at baseline and at 2 years., Methods: We recruited 200 community dwelling, cognitively intact, and functionally independent older adults. Muscle strength, physical performance measures, cognitive tests and nutritional assessments were performed. Short Physical Performance Battery (SPPB) was administered at baseline and at 2 years. We compared HGSave and HGSmax to assess the prevalence of low HGS and sarcopenia. Univariate analysis was performed comparing baseline characteristics between low and normal groups for each HGS criterion. Significantly different variables were included in logistic regression analysis to examine association of low HGS and SPPB at baseline. Predictive validity of low HGS for SPPB<10 at 2 years was examined by performing logistic regression analysis for HGSave and HGSmax., Results: The prevalence of low HGS and sarcopenia incorporating HGSave criterion is 40% and 33% respectively, whereas that of HGSmax criterion is 21% and 19.5% respectively. There is moderate agreement between the 2 HGS criteria for sarcopenia diagnosis (kappa=0.604) and poorer agreement for low HGS (kappa=0.570). There was no significant association with baseline SPPB for both HGS criteria. At 2 years, only low HGSmax was significantly associated with low SPPB (adjusted OR 3.91, 95% CI 1.24 - 12.33)., Conclusion: Our study demonstrates that HGS criteria matters in diagnosis of sarcopenia and we support extant HGS protocols using HGSmax criterion in view of better predictive validity for poor physical performance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest

Objectives: Compare the diagnostic performance of FRAIL against Fried Phenotype and Frailty Index (FI), and identify clinical factors associated with pre-frailty/frailty., Design: Cross-sectional analysis., Setting: Community-based screenings in Senior Activity Centres, Residents' Corners and Community Centres in northeast Singapore., Participants: 517 community dwelling participants aged >55 years and ambulant independently (with/ without walking aids) were included in this study. Residents of sheltered or nursing homes, and seniors unable to ambulate at least four meters independently were excluded., Measurements: The multidomain geriatric screen included assessments for social vulnerability, mood, cognition, sarcopenia and nutrition. Participants completed a battery of physical fitness tests for grip strength, gait speed, lower limb strength and power, flexibility, balance and endurance, with overall physical performance represented by Short Physical Performance Battery (SPPB). Frailty status was assigned on FRAIL, Fried and 35-item FI., Results: Prevalence of frailty was 1.3% (FRAIL) to 3.1% (FI). Pre-frailty prevalence ranged from 17.0% (FRAIL) to 51.2% (FI). FRAIL demonstrated poor agreement with FI (kappa=0.171, p<0.0001), and Fried (kappa=0.194, p<0.0001). A lower FRAIL cut-off ≥1 yielded significantly improved AUC of 0.70 (95%CI 0.55 to 0.86, p=0.009) against Fried, and 0.71 (95%CI 0.55 to 0.86, p=0.008) against FI. All 3 frailty measures were diagnostic of impaired physical performance on SPPB, with AUCs ranging from 0.69 on FRAIL to 0.77 on Fried (all p values <0.01). Prevalence of low socio-economic status, depression, malnutrition and sarcopenia increased significantly, while fitness measures of gait speed, balance, and endurance declined progressively across robust, pre-frail and frail on all 3 frailty instruments (p <0.05)., Conclusions: Our results suggest that different frailty instruments may capture over-lapping albeit distinct constructs, and thus may not be used interchangeably. FRAIL has utility for quick screening, and any positive response should trigger further assessment, including evaluation for depression, social vulnerability and malnutrition., Competing Interests: All the authors have no conflict of interest or financial disclosure of note.

Background: EWGSOP2 criteria for sarcopenia recommends the use of either handgrip strength (GS) or 5-times repeated chair stand test (RCS) as a muscle strength measure. We aim to compare the impact of different muscle strength definitions on sarcopenia prevalence and predictive validity for 2-year outcomes, using the EWGSOP2 clinical algorithm., Methods: We studied 200 community-dwelling older adults, comparing sarcopenia prevalence using three muscle strength definitions: 1) maximum GS (Asian Working Group cutoffs); 2) RCS-1 (standard cutoff >15s); and 3) RCS-2 (ROC-derived cutoff >12.5s). Two-year outcomes include: 1) Incident frailty (modified Fried criteria); 2) Physical performance [Short Physical Performance Battery (SPPB) score <10]; and 3) Quality of life [EuroQol-5 dimension (EQ-5D) <25th percentile]. We performed logistic regression on 2-year outcomes adjusted for age, gender, cognition and mood., Results: Prevalence of confirmed sarcopenia was 14.5%, 4% and 9% for GS, RCS-1 and RCS-2 respectively. For 2-year outcomes (N=183), RCS-2 predicted incident frailty (OR: 5.7, 95% CI 1.4-22.8, p=0.013), low SPPB (OR: 4.4, 95% CI 1.4-13.1, p=0.009), and trended towards predicting low QOL (OR: 2.1, 95% CI 0.9-4.9, p=0.095). In contrast, GS and RCS-1 did not predict frailty nor low QOL, but predicted low SPPB only (GS: OR 3.8, 95% CI 1.3-10.6, p=0.01; RCS-1: OR: 8.8, 95% CI 2.2-35.0, p=0.002)., Conclusions: Sarcopenia prevalence varies with muscle strength definitions, with GS being significantly higher vis-à-vis RCS definitions. Our results also support the use of population-specific over standard cutoffs for RCS to obtain intermediate estimates of sarcopenia prevalence and the best predictive validity for two-year outcomes., Competing Interests: The authors have no conflicts of interest to disclose

A growing volume of research has used polynomial regression analysis (PRA) to examine congruence effects in a broad range of organizational phenomena. However, conclusions from congruence studies, even ones using the same theoretical framework, vary substantially. We argue that conflicting findings from congruence research can be attributable to several methodological artifacts, including measurement error, collinearity among predictors, and sampling error. These methodological artifacts can significantly affect the estimation accuracy of PRA and undermine the validity of conclusions from primary studies as well as meta-analytic reviews of congruence research. We introduce two alternative methods that address this concern by modeling congruence within a latent variable framework: latent moderated structural equations (LMS) and reliability-corrected single-indicator LMS (SI-LMS). Using a large-scale simulation study with 6,322 conditions and close to 1.9 million replications, we showed how methodological artifacts affected the performance of PRA, specifically, its (un)biasedness, precision, Type I error rate, and power in estimating linear, quadratic, and interaction effects. We also demonstrated the substantial advantages of LMS and SI-LMS compared with PRA in providing accurate and precise estimates, particularly under undesirable conditions. Based on these findings, we discuss how these new methods can help researchers find more consistent effects and draw more meaningful theoretical conclusions in future research. We offer practical recommendations regarding study design, model selection, and sample size planning. In addition, we provide example syntax to facilitate the application of LMS and SI-LMS in congruence research. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Background: Disruption of Wnt signaling has been implicated in dysfunctional synaptic plasticity, the degree of which correlates with Alzheimer's disease severity. We sought to examine whether serum levels of Dickkopf-1 (Dkk-1), a Wnt antagonist, are associated with global disease progression in older adults with mild cognitive impairment (MCI) and mild-to-moderate AD. Methods: We prospectively followed 88 older adults with MCI and mild-to-moderate AD attending a Memory Clinic. Cognitive performance, functional performance and neuropsychological symptoms were assessed at baseline and after 1 year. We reviewed neuroimaging for white matter changes and medial temporal atrophy, and performed ApoE genotyping at baseline. Serum Dkk-1 was assayed at baseline and 1 year, along with blood biomarkers of inflammation and endocrine dysfunction. We defined global disease progression ("progressors") as an increase in Clinical Dementia Rating Sum-of-Boxes (CDR-SB) score by >2 points at 1 year. Results: Fifteen (17.0%) participants had global disease progression. At baseline, there was no difference in cognitive performance and neuropsychiatric symptoms between groups, although progressors were more impaired in instrumental activities of daily living ( p = 0.008). Progressors had significantly greater deterioration in cognitive performance ( p = 0.002), with significantly worse functional performance and more severe neuropsychiatric symptoms ( p = 0.042) at follow-up. Serum inflammatory and endocrine biomarkers at baseline and 1 year were similar between progressors and non-progressors. Serum Dkk-1 had increased significantly from baseline amongst progressors, while non-progressors exhibited decremental Dkk-1 over time (Dkk-1 change : 354.304 ± 670.467 vs. -173.582 ± 535.676 ng/ml, p = 0.001). Adjusting for age, gender and baseline cognitive performance, incremental Dkk-1 independently predicted global cognitive decline ( p = 0.012). Conclusion: Our results suggest progressively dysfunctional Wnt signaling through Dkk-1 antagonism contributes to disease progression amongst older adults with MCI and mild-moderate AD., (Copyright © 2019 Tay, Leung, Yeo, Chan and Lim.)

Background: While previous studies have investigated the interplay between affect and health (1) over an extended period of time, (2) in a representative population, and (3) while modelling positive and negative affect simultaneously, no single study has done all three at once., Methods: The present study accomplishes this by sampling adults from the Midlife Development in the US study who completed affect (Mroczek & Kolarz, 1998) and health measures (chronic conditions, Charlson, Szatrowski, Peterson, & Gold, 1994; functional limitations, McHorney, Ware, Lu, & Sherbourne, 1994; self-reported health) measured three times over 20 years. We ran three (one per health metric) random-intercept cross-lagged panel models, where positive and negative affect were modelled simultaneously., Results: Results indicated that positive and negative affect significantly predicted future heath (functional limitations/self-reported health) and that this relationship was reciprocal (i.e. health measures predicted future affect). However, there were no significant cross-lagged relations between affect and chronic conditions., Conclusion: Our results suggest that both positive and negative affect play an equal role in predicting future health for functional limitations and self-reported health as well as highlight the bi-directionality of this relationship. Additionally, the degree to which affect predicts future health may be moderated by the type of health outcome., (© 2018 The International Association of Applied Psychology.)

Background: When patient safety information is communicated across a regulatory jurisdiction or country, the potential to enhance the safety of community pharmacy practice is significant. While there currently exists a number of sources for patient safety information (e.g., websites, safety bulletins, online tools), knowledge of the barriers that may inhibit the use of such information sources within community pharmacies is limited., Objective: This research explores community pharmacy manager use of Canadian patient safety information sources and the barriers that may limit the use of such sources., Methods: A qualitative research study design using semi-structured interviews was conducted with 15 community pharmacy managers in the Halifax Regional Municipality of Nova Scotia, Canada. The study explored how pharmacists access and engage a variety of information sources, including corporate intranets, websites, and tools provided by third party data base repositories. Interview data were analyzed using thematic analysis., Results: Five general barriers were identified: lack of time to access information sources and its contents; too many sources of available information; too much information not relevant to community pharmacy practice; complexity navigating online information sources; and lack of community pharmacy involvement in source design., Conclusion: While pharmacies do use safety information sources to enhance practice safety, their ability to incorporate this information is inhibited by their general lack of time available to access and read safety information, lack of knowledge about where to get this information, and lack of tailored information for the community pharmacy context. Future initiatives should address increasing information awareness of available sources, consolidating and reducing information overload of such sources, and packaging information to better fit with pharmacists' needs., (Copyright © 2019 Elsevier Inc. All rights reserved.)

The 'Treatment for Adolescents with Depression Study' (TADS, ClinicalTrials.gov, identifier: NCT00006286) was a cornerstone, randomized controlled trial evaluating the effectiveness of standard treatment options for major depression in adolescents. Whereas previous TADS analyses examined primarily effect modifications of treatment-placebo differences by various patient characteristics, less is known about the modification of inter-treatment differences, and hence, patient characteristics that might guide treatment selection. We sought to fill this gap by estimating patient-specific inter-treatment differences as a function of patients' baseline characteristics. We did so by applying the 'model-based random forest', a recently-introduced machine learning-based method for evaluating effect heterogeneity that allows for the estimation of patient-specific treatment effects as a function of arbitrary baseline characteristics. Treatment conditions were cognitive-behavioural therapy (CBT) alone, fluoxetine (FLX) alone, and the combination of CBT and fluoxetine (COMB). All inter-treatment differences (CBT vs. FLX; CBT vs. COMB; FLX vs. COMB) were evaluated across 23 potential effect modifiers extracted from previous studies. Overall, FLX was superior to CBT, while COMB was superior to both CBT and FLX. Evidence for effect heterogeneity was found for the CBT-FLX difference and the FLX-COMB difference, but not for the CBT-COMB difference. Baseline depression severity modified the CBT-FLX difference; whereas baseline depression severity, patients' treatment expectations, and childhood trauma modified the FLX-COMB difference. All modifications were quantitative rather than qualitative, however, meaning that the differences varied only in magnitude, but not direction. These findings imply that combining CBT with fluoxetine may be superior to either therapy used alone across a broad range of patients., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Growing evidence on the predictive validity of vocational interests for job performance calls for greater consideration of interest assessment in organizations. However, a consensus on the fundamental dimensions of interests that are aligned with the contemporary world of work is still lacking. In the current research, we developed an organizing framework of vocational interests and empirically validated an 8-dimension model (SETPOINT: Health Science, Creative E xpression, T echnology, P eople, O rganization, I nfluence, N ature, and T hings). We propose that interests are structured hierarchically, with preferences for specific work activities at the lowest level (assessed using interest items), basic interests for homogeneous classes of activities at the intermediate level (assessed using basic interest scales), and broad-band interest dimensions describing general tendencies of individuals to be drawn to or motivated by broad types of work environments at the top. To derive broad-band interest dimensions, it is necessary to base it on a comprehensive range of content-specific basic interest constructs. In Study 1, we conducted an extensive review of existing basic interest scales and developed a new assessment of basic interests with 41 homogeneous scales across two samples. In Study 2, we demonstrated the structural validity of the proposed dimensional model using second-order confirmatory factor analysis and exploratory structural equation modeling with a large, diverse sample of working adults and supported its predictive validity for occupational membership in new and traditional sectors of work. We discuss implications from the current findings for building interest theory, using interest assessment for organizational research, and evaluating interest structure with appropriate methods. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Objective: Regulation of cortisol under resting conditions is widely used to assess physical and psychological status, but due to the diversity of possible assessments (e.g., cumulative levels; diurnal patterns), considering one or a few at a time hampers understanding and interpretation. Moreover, most studies of cortisol regulation focus on negatively-valanced experiences. This study examined the inter-correlations among cortisol indices and their relative contribution to the explained variance in diverse psychosocial and health factors, including positive functioning., Methods: Data are from midlife and older adults (N = 513; 47.2% male). Cortisol was assessed in urine (overnight) and saliva (at rest and over 4 consecutive days). Positive and negative psychosocial and health factors were assessed by self-report. In addition to examining associations among cortisol indices, relative weight analysis was used to determine which indices were most robustly linked to specific psychosocial factors., Results: Inter-correlations among indices were weak-to-moderate, suggesting that they measure different aspects of hypothalamic-pituitary-axis activity. Overall variance in psychosocial and health factors (R2) explained by the cortisol indices ranged from 0.01 to 0.07. Of this explained variance, relative weight analysis showed that waking cortisol contributed most to the variance in hedonic well-being (32.1%-38.2%), bedtime cortisol to depression-related factors (32.1%-46.9%), the cortisol awakening response to eudaimonic well-being (35.8%-50.5%), cortisol slope to perceived stress (29.2%), and urinary cortisol to physical factors (38.5% and 62.7%)., Conclusions: Positive and negative factors were related to largely non-overlapping cortisol indices. This study illuminates nuanced associations among cortisol indices and diverse aspects of mental and physical health, facilitating thoughtful examination of the complex role of hypothalamic-pituitary-axis activity in health., Competing Interests: The authors have declared that no competing interests exist.

Background: The presence of concomitant sarcopenia and obesity in sarcopenic obesity (SO) confers worse functional, morbidity and mortality outcomes compared to either alone. Excess adiposity and central redistribution of fats are associated with systemic inflammation and ectopic tissue fat infiltration in forms of Intermuscular adipose tissue (IMAT). Our study examines the profile of IMAT across a spectrum of body compositions and associations with physical performance and inflammatory biomarkers including Monocyte Chemoattractant Protein-1 (MCP-1), a novel biomarker of adipose tissue inflammation., Methods: 187 community dwelling elderly participants were recruited and classified into 4 subgroups: normal, obese, sarcopenia and SO, using validated criteria for sarcopenia and waist circumference to define central obesity. We performed magnetic resonance imaging of mid-thigh sections to segment IMAT and muscle. Participants were assessed for muscle strength, physical performance and blood inflammatory biomarkers of interleukin-6, C-Reactive Protein and MCP-1. We examined correlation of IMAT(ratio) with muscle function measures and blood biomarkers. Multiple regression analyses were used to examine the association of body composition types and IMAT(ratio) with muscle function., Results: IMAT(ratio) was highest in SO and obese groups. Overall, higher IMAT(ratio) is significantly associated with raised MCP-1, lower gait speed and muscle strength. SO had lowest scores in Short Physical Performance Battery (SPPB), gait speed, hand-grip and knee extension strength. IMAT(ratio) is independently associated with SPPB and handgrip strength, whilst SO is independently associated with muscle strength., Conclusion: Our results suggest the possible role of IMAT as a candidate imaging biomarker for adipose tissue inflammation and associated poorer functional outcomes in SO., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objectives: (i) To investigate serum myostatin (absolute and normalized for total body lean mass (TBLM)) and IGF-1 as biomarkers of frailty and low relative appendicular skeletal muscle mass (RASM) in older adults, and; (ii) to examine gender differences in the association of serum myostatin and IGF-1 levels with frailty and low RASM., Design: Cross-sectional study., Setting: The "Longitudinal Assessment of Biomarkers for characterization of early Sarcopenia and predicting frailty and functional decline in community-dwelling Asian older adults Study" (GERI-LABS) study in Singapore., Participants: 200 subjects aged 50 years and older residing in the community., Measurements: Frailty was assessed using the modified Fried criteria. Low RASM was defined using cutoffs for height-adjusted appendicular skeletal muscle mass measured by dual-energy X-ray absorptiometry as recommended by the Asian Working Group for Sarcopenia. Comorbidities, cognitive and functional performance, physical activity and nutritional status were assessed. Blood samples collected included serum myostatin, insulin-like growth factor 1 (IGF-1) and markers of inflammation (total white cell count, CRP, IL-6 and TNFaR1). Subjects were classified into 4 groups: Frail/Prefrail with low RASM (Frail/Low RASM), Frail/Prefrail with normal RASM (Frail/Normal RASM), Robust with low RASM (Robust/Low RASM) and Robust with normal RASM (Robust/Normal RASM)., Results: 63 (32%) subjects were classified as Frail/Low RASM, 53 (27%) Frail/Normal RASM, 28 (14%) Robust/Low RASM and 56 (28%) Robust/Normal RASM respectively. Frail/Low RASM subjects were older and had lower BMI compared to Frail/Normal RASM and robust subjects. Mean (SE) normalized myostatin levels were higher in Frail/Low RASM compared to Frail/Normal RASM subjects (1.0 (0.04) versus 0.84 (0.05) ng/ml/kg, P=0.01). Median (IQR) IGF-1 level was lower amongst Frail/Low RASM subjects compared to Frail/Normal RASM subjects (102.3, (77.7, 102.5) vs 119.7 (82.7, 146.0) ng/ml, P=0.046). No differences in myostatin or IGF-1 were observed among robust individuals with or without low muscle mass. In adjusted multinomial logistic regression models with Robust/Normal RASM as the reference group, myostatin (P=0.05) and IGF-1 (P=0.043) were associated with Frail/Low RASM status in the whole cohort. When stratified by gender, myostatin was significantly associated with Frail/Low RASM status in men only (P=0.03). In women, serum IGF-1 was associated with Frail/Low RASM status (P=0.046), but not myostatin (P=0.53)., Conclusion: Serum myostatin, normalized for TBLM in men and IGF-1 in women are potential biomarkers for frail individuals with low RASM, and may identify a target group for intervention., Competing Interests: The authors have no conflicts of interest to disclose.

Most psychological measurement models assume a monotonically increasing relation between the latent trait and the probability of responding. These models have historically been based on the measurement of abilities (e.g., cognitive), which have dominance properties. However, they are less appropriate for the measurement of non-cognitive constructs, or self-reported typical behaviors (e.g., attitudes, emotions, interests, personality), which have historically been assumed to have ideal point properties, or a nonmonotonic relation between the latent trait and the probability of responding. In this paper, we review the literature on ideal point modeling of non-cognitive constructs to present a theoretical framework that can help guide researchers on pertinent factors that may influence ideal point responding when assessing non-cognitive constructs. We also review the practical implications of not using ideal point response models for non-cognitive constructs and propose areas for research in non-cognitive construct assessment.

Despite global gender inequalities, findings on gender differences in subjective well-being have been inconsistent. We conducted a meta-analysis on gender differences in subjective well-being to account for the type of subjective-well-being measure, sampling variability, and levels of national gender inequality from which samples are gathered. Based on 281 effect sizes for life satisfaction ( N = 1,001,802) and 264 for job satisfaction ( N = 341,949), results showed no significant gender differences in both types of subjective well-being. Supplementary meta-analyses found significantly lower job satisfaction, but not life satisfaction, in women for studies that used both life-satisfaction and job-satisfaction measures, and studies that relied on measures that previously demonstrated measurement equivalence. Using the Gender Inequality Index, we found that greater national gender inequality significantly predicts greater gender differences in job satisfaction, but not life satisfaction. We discuss the implications of these findings and the use of subjective well-being as a measure of societal progress.

Objective: Can having too much self-control make people unhappy? Researchers have increasingly questioned the unilateral goodness of self-control and proposed that it is beneficial only up to a certain point, after which it becomes detrimental. The little empirical research on the issue shows mixed results. Hence, we tested whether a curvilinear relationship between self-control and subjective well-being exists., Method: We used multiple metrics (questionnaires, behavioral ratings), sources (self-report, other-report), and methods (cross-sectional measurement, dayreconstruction method, experience sampling method) across six studies (N total  = 5,318)., Results: We found that self-control positively predicted subjective well-being (cognitive and affective), but there was little evidence for an inverted U-shaped curve. The results held after statistically controlling for demographics and other psychological confounds., Conclusion: Our main finding is that self-control enhances subjective well-being with little to no apparent downside of too much self-control., (© 2017 Wiley Periodicals, Inc.)

Background: To test a population health program which could, through the application of process redesign, implement multiple evidence-based practices across the continuum of care in a functionally integrated health delivery system and deliver highly reliable and consistent evidence-based surgical care for patients with fragility hip fractures in an acute tertiary general hospital., Methods: The ValuedCare (VC) program was developed in three distinct phases as an ongoing collaboration between the Geisinger Health System (GHS), USA, and Changi General Hospital (CGH), Singapore, modelled after the GHS ProvenCare® Fragile Hip Fracture Program. Clinical outcome data on consecutive hip fracture patients seen in 12 months pre-intervention were then compared with the post-intervention group. Both pre- and post-intervention groups were followed up across the continuum of care for a period of 12 months., Results: VC patients showed significant improvement in median time to surgery (97 to 50.5 h), as well as proportion of patients operated within 48 h from hospital admission (48% from 18.8%) as compared to baseline pre-intervention data. These patients also had significant reduction (p value < 0.001) of acute inpatient complications such as delirium, pneumonia, urinary tract infections, and pressure sores. VC program has shown significant reduction in median length of stay for acute hospital (13 to 9 days) as well as median combined length of stay for acute and sub-acute rehabilitation hospital (46 to 39 days), thus reducing the total duration of hospitalization and saving total hospital bed days. Operative and inpatient mortality, together with readmission rates, remained low and comparable to international Geriatric Fracture Centers (GFCs)., Conclusion: The implementation of VC methodology has enabled consistent delivery of high-quality, reliable and comprehensive evidence-based care for hip fracture patients at Changi General Hospital. This has also reflected successful change management and interdisciplinary collaboration within the organization through the program. There is potential for testing this methodology as a quality improvement framework replicable to other disease groups in a functionally integrated healthcare system.