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Background Cyclothymic-hypersensitive temperament (CHT) has been related to both depression and bipolarity, as well as to suicidality. Recently, a psychometrically sound way of assessment has been validated in youth (Cyclothymic-Hypersensitive Temperament Questionnaire, CHTQ), but data on clinical populations are still scant. Aim of our study is to further explore the structure and other psychometric properties of the revised version of CHTQ and its clinical implications in clinical samples. Methods The study is based on a dataset of patients with unipolar depression, bipolar disorder and attention deficit and hyperactivity disorder (ADHD) (243 patients, 135 males, mean age 14.22 ± 2.16 years, age range 9–18 years), compared to a community sample of adolescents (398 subjects, 95 boys, mean age 15.47 ± 1.96 years, age range 10–18 years) Results The two-correlated factor structure of CHT has been confirmed, with a moodiness/hypersensitiveness factor, correlated with internalizing symptoms, and an impulsiveness/emotional dysregulation factor, correlated with externalizing symptoms. All CHTQ scores correlate with global functioning. CHTQ total scores discriminate patients from healthy controls. Only CHTQ impulsiveness/emotional dysregulation subscale score is higher in bipolar patients, compared to unipolar depression and ADHD, whereas neither CHTQ moodiness/hypersensitiveness subscale score nor CHTQ total score discriminate between clinical groups. Limitation Data on current mood states are unavailable. Patients were recruited in a third level clinic. The unipolar depression group is relatively small. Conclusion CHT may be a rapid and reliable screening and diagnostic tool in the clinical practice with youth, exploring the cyclothymic dimension in different psychiatric disorders.

We sought to evaluate the religious coping styles of adolescents during the coronavirus disease 2019 (COVID-19) pandemic and its restrictions. The study was conducted online during the 2020 academic year among students in three randomly selected high schools in a city center located in Eastern Turkey. The students studying in the chosen high schools who agreed to participate were included in the study (n = 514). We found that most adolescents were anxious, had been affected in terms of health and life satisfaction, and felt sad due to isolation. Almost all subjects attached importance to their religious beliefs. The adolescents' mean Religious Coping Scale score was 2.23 ± 0.50, their mean Positive Religious Coping subscale score was 2.91 ± 0.73, and their mean Negative Religious Coping subscale score was 1.54 ± 0.52. Specifically, male adolescents of ages 15-17 whose incomes were less than their expenditures and who lived in a broken family had the highest level of negative religious coping. In light of these findings, adolescents can be supported by teaching them to develop positive religious coping styles during the COVID-19 pandemic.

Yue Liu,1 Nina Liu,2 Wenwen Shen,1 Longhui Li,1 Wenhua Zhou,1 Leiting Xu3 1Department of Academic Research, Ningbo Kangning Hospital, Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, 315201, People’s Republic of China; 2Department of Basic Medicine, Ningbo College of Health Sciences, Ningbo, 315100, People’s Republic of China; 3Department of Basic Medicine, Ningbo University School of Medicine, Ningbo, 315211, People’s Republic of ChinaCorrespondence: Leiting XuDepartment of Basic Medicine, Ningbo University School of Medicine, Ningbo, 315211, People’s Republic of ChinaTel +86 18267417969Email leitingxu@yeah.netWenhua ZhouDepartment of Academic Research, Ningbo Kangning Hospital, Key Laboratory of Addiction Research of Zhejiang Province, Ningbo, 315201, People’s Republic of ChinaTel +86 13777113984Email wenhuazhou@yeah.netObjective: The purpose of this study was to retrospectively investigate the abuse characteristics of amphetamine-type stimulants (ATS) in patients receiving methadone maintenance treatment (MMT) and buprenorphine maintenance treatment (BMT).Methods: A total of 58 MMT and 51 BMT patients abusing ATS were recruited from the drug maintenance treatment clinic of Ningbo Addiction Research and Treatment Center from January 2018 to December 2019. They were assessed using the amphetamine abuse questionnaire (AAQ), addiction severity index (ASI) and Barratt impulsiveness scale (BIS). Moreover, 40 MMT control patients, 40 BMT control patients and 20 healthy controls were also assessed using the BIS. All information was collected using the amphetamine abuse questionnaire (AAQ), Chinese version of addiction severity index (ASI-C) and Chinese version of Barratt impulsiveness scale (BIS-C) conducted by qualified psychologists.Results: The interval of amphetamine use in the MMT group was shorter than the BMT group (P < 0.05). The drug use subscale score of ASI was higher in the MMT group than the BMT group (P < 0.05). The respective and total scores of attentional impulsiveness, motor impulsiveness and non-planning impulsiveness in BIS in the MMT group were all higher than the MMT control group (P < 0.05). The scores of motor impulsiveness and non-planning impulsiveness in the BMT group were higher than the BMT control group (P < 0.05). The respective and total scores in BIS in the MMT control group and the BMT control group were all higher than those in the healthy controls.Conclusion: The patients showing amphetamine abuse in maintenance therapy had a greater impulsiveness than those having other simple maintenance treatments, and patients under MMT may be more addicted to amphetamines in comparison with those having BMT.Keywords: methadone maintenance treatment, buprenorphine maintenance treatment, amphetamine-type stimulants, impulsiveness, addiction

Objective To explore the association between sleep disorders and subfoveal choroidal thickness (SFCT) in preschool children. Methods In this population-based cross-sectional study, children aged 60–72 months were measured for SFCT using spectral-domain optical coherence tomography (SD-OCT) and for sleep disorders using the Chinese version of Children’s Sleep Habits Questionnaire (CSHQ). Multiple linear regression analyses were performed to assess the association between sleep disorders and SFCT. Results A total of 1337 children (mean (SD) age: 66.88 (3.41) months) were included in the analyses. In multivariable linear analysis, a higher total CSHQ score (indicating higher likelihood of sleep disorders) was associated with a thinner subfoveal choroid (beta, −0.070; 95% CI, −0.141 to −0.001; P = 0.046). When each of eight CSHQ subscale scores was analysed by the multivariable model, only the Daytime Sleepiness subscale score was negatively associated with the SFCT (beta, −0.115; 95% CI, −0.183 to −0.046; P = 0.001). The children with clinically significant daytime sleepiness (n = 364, 27.2%) had significantly thinner subfoveal choroid than other children (295.47 vs. 308.52 μm, P = 0.007). Conclusions Only daytime sleepiness was significantly associated with SFCT in preschool children in this study. The potential relationship between sleep disorders during childhood and children’s ocular development needs further research.

Objectives The tinnitus functional index (TFI) is becoming a new international gold standard for tinnitus assessment. This study aimed to evaluate the efficacy of hearing aids for chronic tinnitus, using the Japanese version of the TFI, while focusing on its subscales. Materials and methods This is a retrospective study. A total of 21 patients with chronic tinnitus were included. All participants were treated with hearing aids for at least 12 months. They answered the TFI and tinnitus handicap inventory (THI) at the first visit and 12 months later. We analyzed each TFI subscale score and the overall scores of TFI and THI. Results The overall TFI score decreased significantly after treatment (p=0.005) with moderate effect size (d=0.70). The scores of the intrusive, sense of control, sleep, and emotional subscales decreased significantly after the treatment. Large effect sizes were found in the intrusive and sense of control subscales (d=1.33 and d=1.25, respectively). Conclusion Hearing aids are highly effective for improving the intrusive and sense of control subscales in patients with tinnitus. Identifying better treatments for the small effect size subscales and combining these with the use of hearing aids could achieve a higher therapeutic effect with better outcomes.

Objective: Adolescents with chronic disease are as likely to exhibit risk-taking behavior as their peers. The aim was to investigate the risk behaviors of adolescents with type 1 diabetes (T1D) and the effect of orthorexic eating behaviors (OEB) on glycemic control (GC). Methods: This cross-sectional study was conducted with 107 adolescents with T1D, aged between 13-18 years and attending high school. The Risk Behavior Scale (RBS) and Orthorexic Behavior Scale (ORTO-11) were administered. A high RBS score indicates risky behavior; a low ORTO-11 score suggests a tendency to OEB. Participants hemoglobin A1c (HbA1c) status was used to assess GC: optimal GC (HbA1c ≤7%); or poor GC (HbA1c >7%). Results: Among females, those with poor GC had significantly lower (p=0.031) ORTO-11 scores than those with optimal GC, which was not the case in males. A significant correlation (r=0.358, p

Background In the present study, we investigated the satisfaction of patients following sutured surgical treatment of an ingrown toenail with nail preservation and without matricectomy. Materials and methods This study was retrospective. In total, 37 consecutive patients underwent 54 ingrown toenail surgeries. The clinical outcomes, satisfaction of surgery, recurrence rates and the duration of symptoms were compared. Results Recurrence with the technique was very low (one toenail). The mean overall satisfaction score on the surgical satisfaction questionnaire was 86.4 ± 10.4 and extended with a modified esthetic subscale (88 ± 10). The mean pain subscale score was the lowest at 77.1 ± 16.8, while the subscale returns to baseline scored 80.9 ± 16.4, the subscale global satisfaction scored 98.1 ± 7.2 and the subscale esthetics scored 92.1 ± 15. Conclusion Our suturing technique was associated with low recurrence and high satisfaction rates. We showed that higher levels of satisfaction with the treatment were achieved in men, and the duration of symptoms was no longer than one year., Highlights • This sutured surgery technique for ingrown toenails with the complete preservation of the nail and matrix led to high patient satisfaction with the therapeutic and esthetic results. • This approach preserved nail function to improve both therapeutic and cosmetic results.

Aim: This study was conducted to determine the obstacles experienced by nursing students in research and use of results. Material and Methods: This study was descriptive type. The universe of the study consisted of 348 nursing students studying in the nursing department of a university between March and May 2019, and the sample consisted of 241 nursing students. The data were collected with an introductory information questionnaire and the Attitude Scale Towards Scientific Research. Results: The mean age of students was 20.97 ± 1.51 and 78.0% were women. The percentage of students who didn’t take part in research was 90.9%. Only 21.6% of the students read a scientific publication, and 29.9% followed periodicals in nursing. The “Negative Attitude towards Research" subscale score was found to be 18.71 ± 4.98, and the "Positive Attitude towards Research" subscale scores were found to be 23.50 ± 5.81. It was determined that negative attitude towards research was significantly higher in students who didn’t know to access data sources (p

This study investigated the effects of a number sense intervention in 5-year-old Italian children (n = 96) from different socioeconomic status (SES) backgrounds. We investigated whether a short-term intervention could enable low SES children to reach the same level of their middle-upper SES peers in number sense; in addition, we compared the efficacy of the intervention for low SES children at two levels of intensity. Four groups of children were compared as follows: 2 low SES groups that received 8 or 20 intervention sessions, 1 middle-upper SES group that received eight intervention sessions, and 1 middle-upper SES control group. The results show that at the baseline, the middle-upper SES children obtained higher scores than the low SES children in three of the four scales of the Battery of Numerical Intelligence (BIN). Regarding the effectiveness of the intervention, all intervention groups showed a higher change in the counting subscale score than the control group. The low SES group that received the high-intensity intervention showed a greater change in the BIN total score than all other groups.

Interprofessional education (IPE) is based on collaborative practices that increase the occasions for communication among those in various health professions. However, there is a paucity of literature about the effectiveness of IPE programs in health professions education. The aim of this systematic review and meta-analysis was to objectively assess the literature on the effectiveness of IPE in improving health professions students' attitudes after training. The major scholarly databases were searched for relevant IPE studies involving predoctoral health professions students. Two independent researchers selected the studies, extracted the data, and assessed the quality of the studies. Meta-analyses of the outcomes were performed using random effects models. Sixteen articles were ultimately selected for detailed review and meta-analysis. The meta-analysis showed that IPE training had a significant influence on students' understanding of collaboration and resulted in better attitudes about interprofessional teamwork. Subscale analysis showed that one subscale score (roles and responsibilities) did not statistically significantly improve after IPE training (p=0.06), whereas the other four subscale items showed statistically significant improvements (p0.01). The test for overall effects showed that IPE training had a significantly positive influence on students' attitudes about IPE (Z=6.85, p0.01). Subgroup results showed that medical students had more positive attitudes about IPE than did dental students. Regardless of profession, women students responded with significantly more positive feedback than did men students (p=0.02). These results suggest that intervention through IPE training has had positive effects in health professions education. Gender was an important factor impacting the outcomes of IPE. However, further clinical practice interventions may be helpful to enhance the IPE competence of health professions students.

Objective: To evaluate the self-concept level of female students with acne vulgaris in junior high school and the relevant influencing factors. Methods: A total of 598 students in Grade 7 at two junior high schools in Nantong City, Jiangsu Province, China were sampled by cluster sampling method, and divided into two groups: the acne group and the healthy control. Both groups were surveyed using a self-designed demographic questionnaire, and the self-concept level was determined using the six-dimensional Piers-Harris Children’s Self-Concept Scale (PHCSS). The differences were compared between two groups using Chi-square test, non-parametric test, and multiple regression analysis. Results: We released a total of 598 questionnaires, and 576 valid questionnaires were received, including 267 in the acne group and 309 in the healthy group. The subscale score of the popularity dimension of the PHCSS in the acne group (8.89±1.780) was significantly lower than that in the healthy group (9.45±1.78, P

This study aimed to analyze the effects of mental training through imagery on the competitive anxiety of adolescent tennis players fasting during Ramadan. This is an experimental study conducted with 38 male tennis players, randomly allocated to two groups: an experimental group (EG, n = 18), aged 16.9 ± 0.6 years, and a control group (CG, n = 20), aged 16.7 ± 0.8 years. The study was designed as a randomized, controlled experimental trial (registration code PACTR 202006847771700). CG watched historical videos of the Olympics, while EG performed mental training. The competitive anxiety state assessment was recorded four times. The first measurement was carried out 1 week before Ramadan, the second measurement during the first week of the month, the third measurement at the end of the second week, and, finally, the fourth measurement during the fourth week of Ramadan. Our results revealed a significant interaction (time × groups) for all competitive anxiety subscales. Higher intensity and direction scores for the cognitive and somatic anxiety subscales during Ramadan compared with before Ramadan for both groups could be reported at P < 0.001. Higher intensity and direction scores for the cognitive and somatic anxiety subscales during Ramadan compared with pre-Ramadan for both groups could be found at P < 0.01. This increase in scores was greater for the CG than for the EG in the middle and at the end of Ramadan at P < 0.001. Finally, for the self-confidence subscale score, results revealed that intensity and direction scores were lower during Ramadan compared with pre-Ramadan for the two groups at P < 0.01. The score for the intensity of self-confidence was higher for the EG compared with the CG at the end of Ramadan at P < 0.001. It was concluded that mental imagery training was effective in reducing anxiety (cognitive and somatic) and increasing self-confidence in the intensity dimension of adolescent tennis players who fast during Ramadan.

OBJECTIVES:. Family members commonly have inaccurate expectations of patient’s prognosis in ICU. Adding to classic oral information, a visual support, depicting day by day the evolution of the condition of the patient, improves the concordance in prognosis estimate between physicians and family members. The objective of this study was to evaluate the impact of this tool on symptoms of anxiety/depression of family members. DESIGN:. Bicenter prospective before-and-after study. SETTING:. A nonacademic and a university hospital. SUBJECTS:. Relatives of consecutive patients admitted in the two ICUs. INTERVENTIONS:. In the period “before,” family members received classic oral information, and in the period “after,” they could consult the visual support in the patient’s room. The primary endpoint was the Hospital Anxiety and Depression Scale score of relatives at day 5. Secondary outcomes were the prevalence of symptoms of anxiety (Hospital Anxiety and Depression Scale anxiety subscale score > 7) and depression (Hospital Anxiety and Depression Scale depression subscale score > 7) at day 5 and Hospital Anxiety and Depression Scale score at day 90. MEASUREMENTS AND MAIN RESULTS:. A total of 140 patients and their referent family members were included (77 in period before and 63 after). Characteristics of patients of the two groups were similar regarding age, reason for admission, Simplified Acute Physiology Score II at admission, and Sequential Organ Failure Assessment score at day 5. At day 5, median Hospital Anxiety and Depression Scale score was 17 (9–25) before and 15 (10–22) after the implementation of the visual support (p = 0.43). The prevalence of symptoms of anxiety and depression was similar in the two groups (66.2% and 49.4% before and 68.3% and 36.5% after [not significant], respectively). At day 90, median Hospital Anxiety and Depression Scale score was 11 before (7–16) and 9 (5–16) after the implementation of the tool (p = 0.38). CONCLUSIONS:. In this study, the use of a visual support tool dedicated to prognosis did not modify the level of stress of family members.

Background/Aim Multiple perpetrator sexual assaults (MPSA) often involve more severe forms of sexual violation and result in a host of impairments for the victim. To further investigate the characteristics of MPSA, researchers have taken an interest in personality traits, varying group dynamics, and the role a leader may play. This study examines the possible linkage between dominant personality characteristics and the propensity to engage in multiple perpetrator sexual assault. Method Using anonymous online surveys, university student participants were assessed on The Personality Scale for Dominance and the Multiple Perpetrator Rape Proclivity Scale (M-PRIS). We hypothesized that dominant personality traits would predict M-PRIS proclivity score. Results Of 176 respondents, 84 heterosexual males completed both measures. Dominance scores did not significantly predict total M-PRIS score, F(1,82) = 1.1, p = .296, the Enjoyment subscale score, F(1,82) = .66, p = .420, the Likelihood subscale score, F(1,86) = 1.13, p = .292, or the Arousal subscale score, F(1,82) = 0.66, p = .419. Conclusion In this study, dominance was not associated with a proclivity for multiple perpetrator sexual violence. Other important factors, such as psychopathy or deviant sexual interests, may mediate the relationship between dominant personality traits and the tendency to initiate a multiple perpetrator sexual assault. Future studies should examine alternative relationships in hopes of gaining a clearer picture of individuals who exhibit a proclivity for sexual violence with the aim to inform prevention and practice.

Rhinosinusitis without nasal polyps (RSsNP) is prevalent in COPD. Previous studies on its association with health-related quality of life (HRQoL) have limitations, and RSsNP is currently not recognized as a comorbidity. This study investigates HRQoL in COPD including a focus on RSsNP. Generic HRQoL was assessed with the Short Form-36 (SF-36v2) questionnaire and compared between 90 COPD and 93 control subjects and in subgroups with and without RSsNP. The association between RSsNP and COPD versus not and generic HRQoL was assessed by multivariable linear regression with adjustments for age, education, and body mass index (BMI). Disease-specific HRQoL was assessed by Sinonasal outcome test-22 (SNOT-22), St. Georges Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT) and compared between COPD with and without RSsNP, and their association to RSsNP was assessed by multivariable linear regression with adjustments for age, BMI, and FEV1% predicted. RSsNP was associated with poorer disease-specific HRQoL, with higher SNOT-22 total score (14.67 points; 95% CI, 7.06–22.28; P < .001) and psychological subscale score (3.24 points; 95% CI, 0.37–6.11; P = .03), SGRQ symptom score (13.08 points; 95% CI, 2.73–23.4; P = .014), and CAT score (4.41 points; 95% CI, 1.15–7.66; P = .009). Generic HRQoL was poorer in COPD patients than in the control subjects. In addition to COPD, concomitant RSsNP was associated with poorer physical functioning, general health, vitality, and physical component summary. RSsNP in COPD is associated with poorer disease-specific HRQoL that is clinically relevant and, as it is amenable for treatment, should be recognized as a comorbidity of COPD.

Background The movement subscale score of the Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ) is reportedly lower than other subscale scores after total hip arthroplasty (THA). This study aimed to assess factors related to the movement subscale score of the JHEQ six months after THA. Methods Participants were 90 female patients with hip osteoarthritis who underwent THA. We examined clinical background factors and surgical information, and measured hip joint range of motion, lower extremity muscle strength, maximum walking speed, physical activity, Japanese Orthopaedic Association score, and JHEQ score. We also measured the number of steps and “fast walking time” as physical activity, and calculated the moderate intensity activity ratio. A stepwise logistic regression analysis was used to identify factors related to high and low movement subscale scores. Results Six months after surgery, the total score and all subscale scores of the JHEQ were significantly higher compared to preoperative scores (p p

Background: Assessment of quality of life can significantly impact the diagnosis and treatment course of breast cancer, resulting in a better prognosis among patients. However, very limited data are available regarding quality of life among breast cancer patients in Saudi Arabia. Objective: To determine the quality of life of women with breast cancer referred to the Surgery Department of King Salman Armed Forces Hospital for treatment and follow-up. Materials and methods: This cross-sectional study used a questionnaire to assess the quality of life of 96 adult Saudi female patients diagnosed with breast cancer from January 2016 to September 2017. Results: One-third of the surveyed patients (31.3%) were >48 years of age, and 29.2% were in the 18- to 27-year age group. Regarding marital status, 35.4% of the women were married and 8.3% were single. The highest score was observed for the physical well-being subscale (7.65±071), followed by the spiritual well-being subscale (7.19±0.66), psychological well-being scale (7.09±0.30) and social concerns subscale (7.02±0.41). Age, marital status and cancer stage differed remarkably (P=0.00) for the physical well-being subscale scores. Meanwhile, employed women differed significantly (P=0.01) in terms of psychological well-being compared to those who were not employed. The social well-being subscale score of single and married women was significantly higher than that of widowed and divorced women. Women who underwent radiation and immunotherapy had significantly higher scores for the spiritual well-being subscale. Conclusions: Scores were determined for the physical, spiritual, psychological and social well-being scales. Age, marital status and cancer stage significantly influenced the physical well-being scale; the occupation status of the patients significantly impacted the psychological well-being scale. Social well-being can be predicted by marital status, and chemotherapy and radiation significantly impacted the spiritual well-being scale.

Objective: This study aimed to clarify the relationships between the acceptance of disability and daily life difficulties in patients after total laryngectomy. Methods: An anonymous questionnaire was mailed to 135 patients who were participating in a self-help group after laryngectomy. The questionnaire included items on personal attributes, daily life difficulties, and acceptance of disability according to the Nottingham Adjustment Scale – Japanese Laryngectomy version (NAS-J-L). Multiple regression analysis was conducted using the NAS-J-L acceptance of disability subscale score as the dependent variable and daily life difficulties as the independent variables. Results: Among the 57 respondents, 43 who provided valid answers were included in the analysis (41 men and 2 women; mean age = 67.5 ± 10.6 years). Acceptance of disability was significantly associated with difficulties in defecation (β = −0.409, P < 0.01) and breathing (β = −0.356, P < 0.05). Conclusions: Our findings suggested that difficulties in defecation and breathing due to airway alterations influence acceptance of disability after laryngectomy. Therefore, nurses should carefully assess daily life difficulties and patient's ability to perform self-care activities such as defecating and breathing to promote acceptance of disability and facilitate adaptation to daily life after total laryngectomy.

Objective: Ambulance workers experiences some of the highest risks of job-related violence. This descriptive study was conducted to analyze the exposure to violence and burnout levels of ambulance workers in Turkey. Method: The research was conducted via web survey with the ambulance staff. The sampling size was 143 ambulance workers who participate in this study. A 30-item questionnaire and the Maslach Burnout Inventory (MBI) were used to collect data. Results: In study, 58.7% of respondents were female; 57.3% were paramedics. 86.5% of respondents were exposed to verbal abuse, and 35% of them were exposed to physical violence. Swearing and yelling were the most common forms of verbal abuse whereas pushing and throwing objects were the most common forms of physical violence. 47.3% of the physical violence cases were reported. In the sampling, MBI scores indicated that the mean Depersonalization subscale score was X = 7.97 ± 3.82; Emotional Exhaustion subscale score was X = 12.07 ± 6.57; and Personal Accomplishment subscale score was X = 9.16 ± 5.14. Significant differences were determined in MBI scores (p

BACKGROUND: Beta thalassemia major is considered one of the serious health problems and the commonest hemoglobinopathy in Egypt that creates a burden not only on health system but also on the affected families and children who become vulnerable to emotional, social, psychological and behavioural problems. AIM: This study was designed to assess the psychosocial burden and the adaptive functioning in children with beta-thalassemia major. SUBJECTS AND METHODS: A group of 50 children with thalassemia major and 50 normal children matched for age and sex were included in a case-control study. Vineland Adaptive Functioning Scale was used to assess the adaptive functions; while the Pediatric Symptom Checklist (PSCL) was used to assess psychosocial morbidity. RESULTS: A group of 50 children aged 5-17 years old with thalassemia major, their mean age was 11.05 ± 3.8, showed a statistically significant lower total adaptive behaviour score and communication subscale score. All the mean values of adaptive behaviour for cases and controls were within the average values. Results from the PSCL revealed no significant difference between mean scores of children with thalassemia and controls. A score of attention domain was markedly higher in children with thalassemia. Internalising behaviour was the most dominant as it was detected in 10% of the patient group. CONCLUSION: Thalassemic patients had a relatively mild affection for adaptive and psychosocial functioning that can be explained by social and medical support they receive, which may increase their competence and psychological wellbeing.

Objective The present study aimed to validate a severity cut-off of negative symptoms for persistent negative symptoms (PNS) identification using the Clinical Assessment Interview for Negative Symptoms (CAINS). Method A total of 206 patients with schizophrenia were recruited and divided into the PNS group (n = 57) and the Non-PNS group (n = 149) using PNS criteria based on the SANS and the SAPS. To determine the appropriate cut-offs on the CAINS in identifying PNS, Receiver Operating Characteristic (ROC) curve analysis was conducted in the PNS and Non-PNS groups. Results Our results showed that the cutoffs for identifying PNS on the CAINS total score, the Motivation and Pleasure (MAP) subscale score and the Expression (EXP) subscale score were 25, 17, and 5 respectively. Area Under the Curve (AUC) analysis indicated excellent discrimination of the PNS group from the Non-PNS group using the cut-off for the CAINS total score. However, discrimination was somewhat better for the MAP subscale score than the EXP subscale score. The Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of the MAP subscale were 81.54% and 97.16%. Conclusion We found that the cut-off scores derived from the CAINS to identify PNS are comparable to existing scales. The CAINS offers an alternative means in identifying PNS patients in clinical trials that overcomes methodological and conceptual limitations of older scales.

Objective: The aim of this study was to investigate prevalence of depressive symptoms among Turkish women experiencing premenstrual symptoms and correlated factors.Method: This descriptive and cross-sectional study. The data were collected with Beck Depression Inventory (BDI) and Premenstruel Syndrome Scale (PMSS), and questionnaire form. A total of 121 married and literate women who agreed to participate were included in the study.Results: The proportions depressive symptoms among women with severe premenstrual symptoms and without severe premenstrual symptoms were 51% and 13.5% respectively. Statistically significant positive correlations were found between the BDI score; the total PMSS score (r = 0.403) and its subscales scores including depressive feelings (r = 0.439); anxiety (r = 0.412); fatigue (r = 0.280); irritability (r = 0.253); depressive thoughts (r = 0.456); pain (r = 0.204); and the changes in appetite (r = 0.418). A negative correlation was found in the swelling subscale score of PMSS (r = -0.079), but there was no correlation with the changes in the sleeping habits subscale score (r = 0.024). There was correlation between BDI scores and occupation, education, perception of outcome, domicile, and a history of psychiatric disorders of the women. There was correlation between PMSS scores a history of psychiatric disorders and complaint of dysmenorrhea in the women.Conclusions: In conclusion, women who experienced premenstrual syndrome had higher depressive symptoms than women without premenstrual syndrome. Women with premenstrual syndrom should be assessed for depression by health professionals.Keywords: Premenstrual syndrome, Depressive symptom, Women, Correlated factors

Body image concerns and body ideals are linked with eating disorders and psychological health. Body image and ideals among men differ by sexual orientation, which may influence the utility of common measures of such constructs. The present study used differential item functioning (DIF) analyses to examine whether item endorsement differs as a function of sexual orientation in three commonly used measures of body image concerns and ideals. Participants were sexual minority (n=209) and heterosexual (n=494) men in the United States. Scores on the Drive for Muscularity Scale (DMS), Sociocultural Attitudes Towards Appearance Questionnaire-4 (SATAQ-4), and Objectified Body Consciousness Scale (OBCS) were examined. DIF was tested in a three-step regression wherein item scores were predicted by: (1) subscale score, (2) subscale and sexual orientation, and (3) subscale, sexual orientation and their product term. Model fit and variance explain comparisons identified DIF. Δ pseudo R(2) value ≥ .035 from step 1 to 3 signified clinical significant DIF. There was no evidence of clinically significant DIF for the DMS, SATAQ-4, or OBSC. Findings suggest that DMS, SATAQ-4, and OBSC perform similarly for sexual minority and heterosexual men.

Objective to explore the effect of network teaching platform in Five-year Higher Vocational Basic nursing teaching. After the implementation of the teaching, the final theoretical examination and skill operation examination results of the two groups were compared. Results: after the implementation of the teaching, the test group students’ skill operation examination scores were higher than the control group, the difference was statistically significant; there was no significant difference between the two groups of students’ final theoretical examination scores; the total score and each subscale score of the test group students’ autonomous learning ability were higher than the control group, the difference was statistically significant. Conclusion: the application of network teaching platform improves the skills operation level and autonomous learning ability of five-year higher vocational nursing students.

Purpose The aim of this longitudinal study was to analyze trends in fatigue among colorectal cancer patients during chemotherapy and examine the predictors of multidimensional fatigue. Methods A mixed sample of colorectal cancer patients who were receiving chemotherapy (N = 200) was recruited in China. The patients completed the Cancer Fatigue Scale (CFS) at baseline (before chemotherapy) and after 3 and 6 months of chemotherapy. Repeated measures ANOVAs were conducted to evaluate the effect of time on the CFS score. The data on violations of the statistical assumptions (independence, normality, and sphericity) from the repeated measures ANOVAs were examined. Stepwise regression analyses were conducted to evaluate the associations of the potential predictor variables at baseline on the total fatigue score and subscale scores at follow-up. Results As chemotherapy progressed, significant increases in the three subscale scores and total scores were observed. Physical fatigue and total fatigue scores increased continuously during chemotherapy (P < 0.001). However, affective fatigue and cognitive fatigue scores increased significantly in the first 3 months (P < 0.001) and basically remained stable thereafter (P > 0.05). Multiple stepwise regression was used to analyze the predictors. The results showed that the baseline fatigue subscale score was the strongest predictor of each dimension of fatigue. In addition, age affected physical fatigue, and monthly income and education affected cognitive fatigue. Conclusion Fatigue increased during chemotherapy. Early assessment and intervention may be better for controlling fatigue, especially in patients with higher baseline fatigue level, older age, and lower economic and educational levels.

BACKGROUND Increased levels of endogenous opioids have been observed in patients with schizophrenia; however, the influence of these endogenous opioids on the biology of schizophrenia remains unclear. The aim of this study was to evaluate the impact of beta-endorphin (BE) on the course of schizophrenia and risk of relapse. MATERIAL AND METHODS The study included 25 patients hospitalized with schizophrenia and 47 controls. Their symptoms were evaluated using Positive and Negative Syndrome Scale (PANSS) and composite index at five points: at the onset of hospitalization; after 4, 6 and 10 weeks of treatment; and after 12 months. s-endorphin plasma concentrations were assessed in patients at study enrollment and after 6 weeks of treatment. Data regarding rehospitalization during follow-up were also collected. RESULTS Patients had higher BE concentration than controls at study enrollment (P=0.002) and after 6 weeks (P=0.000). BE levels increased during treatment (mean 0.538ng/mL vs. mean 0.624 ng/mL; P=0.007). No correlation was found between BE concentration and PANSS subscale score at any stage of the study. A higher BE level at study enrollment was related to a predominance of negative symptoms after 1 year, measured with composite index (R=-0.404; P=0.045). Patients who were later hospitalized again were significantly more likely to demonstrate an increase in BE levels over 6 weeks (P=0.001). CONCLUSIONS Individuals with schizophrenia demonstrated higher BE concentrations than healthy controls; this tendency was particularly apparent in those affected by negative symptoms. The imbalance in the endogenous opioid system might adversely alter the course of disease and predispose patients to persistence of negative symptoms, despite antipsychotic treatment.

The treatment for coeliac disease (CD) has a considerable psychological impact on patients, which may vary depending on subjects and clinical characteristics. The aim of this study was to describe the quality of life (QoL) in CD patients during follow-up, evaluating which factors can influence it. Patients with CD who consecutively visited the outpatient clinic of CD Unit of the University Hospital of Padua from January to September 2019 were enrolled. Demographics and clinical information were collected, and all patients were asked to answer the CD-QoL and Biagi&rsquo, s validated questionnaires. Student&rsquo, s t-test and chi-square test were used to compare the continuous and categorical variables, respectively. One hundred patients were enrolled (86 females, mean age at test &plusmn, SD: 39.73 &plusmn, 13.51, mean age at diagnosis &plusmn, SD: 33.09 &plusmn, 12.92), with 61% of them having been diagnosed with CD within the previous 5 years. At the time of diagnosis, 43 CD patients reported classical CD presentation, 32 non-classical features, 16 only anaemia and 9 were asymptomatic. The mean CD-QoL value was overall high (80.54 &plusmn, 11.91). We found that the &ldquo, health concerns&rdquo, subscale score was significantly lower in subjects aged more than 35 years compared to younger subjects (p = 0.03). We also observed that the CD-QoL score in gluten-free diet (GFD)-adherent patients tended to be higher compared to subjects who were non-compliant, with a significantly higher percentage of patients with low score for the &ldquo, dysphoria&rdquo, subscale (p = 0.05). This study showed an overall good QoL in subjects on a GFD. However, subjects older and non-compliant to GFD appear to experience more health concerns and suffer from dysphoria, respectively.

Promoting patient-centered communication among physicians is one core strategy for improving physician&ndash, patient relationships and patient outcomes. Our study aims to understand the physicians&rsquo, attitudes towards patient-centered communication and its effects on physicians&rsquo, intention and behavior of involving patients in medical decisions in primary care in China. One cross-sectional study was conducted in primary facilities in Hubei province, China, from December 2019 to January 2020, where physicians&rsquo, attitudes towards patient-centered communication were measured by the Chinese-revised patient&ndash, practitioner orientation scale. Multilevel ordinal logistic regression was conducted for estimating the effects of physicians&rsquo, attitudes on their intention and behavior of patient involvement in medical decisions. Six hundred and seventeen physicians were investigated for the main study. Physicians had a medium score of patient-centered communication (3.78, SD = 0.56), with relatively high caring subscale score (4.59, SD = 0.64), and low sharing subscale score (3.09, SD = 0.75). After controlling physicians&rsquo, covariates, physicians&rsquo, attitudes towards patient-centered communication was significantly associated with a higher intention of involving patients in medical decisions (OR &gt, 1, p = 0.020). Physicians&rsquo, positive attitudes towards patient-centered communication affected their intention of involving patients in medical decisions, which implies the importance of taking the physicians&rsquo, attitudes into account for the accomplishment of patient involvement processes.

OBJECTIVE To explore the association of dietary habits and Mediterranean diet adherence with menopausal symptoms. METHODS The present study included 172 women recruited from the FLAMENCO project. Menopausal symptoms were assessed with the Kupperman Menopausal Index and the Cervantes Menopause and Health Subscale from the validated Cervantes Scale. A food frequency questionnaire was employed to evaluate dietary habits. Adherence to the Mediterranean diet was assessed with the Mediterranean diet score. RESULTS Intake of poultry and skimmed dairy products was associated with a worse Kupperman Menopausal Index score (β: 0.17, P = 0.03 and β: 0.18, P = 0.01, respectively). On the contrary, soy milk consumption was associated with a better Kupperman Menopausal Index score (β: -0.17, P = 0.02). Poultry and skimmed dairy were associated with worse scores in the total Cervantes Menopause and Health Subscale score (β: 0.22, P =

The purpose of this exploratory, cross-sectional study was to identify child-related factors associated with maternal parenting stress in toddlers born very preterm and followed in a neonatal follow-up (NFU) clinic. The study aimed to describe the associations of current medical complications and presence of developmental delays with total parenting stress. Participants were 53 mother-child dyads presenting in a NFU clinic. Mothers completed the Parenting Stress Index-Short Form (PSI-SF), and children were administered the Brigance Early Head Start Screen II. Medical variables were also collected from the child's medical record. Approximately 24% of mothers had at least one elevated subscale score on the PSI-SF. Regression analyses indicated that receipt of early intervention services was associated with increased parenting stress among mothers of toddlers born very preterm, though number of current medical complications was not. Parents of children born very preterm are at increased risk for parenting stress that extends beyond discharge from the neonatal intensive care unit . Clinicians working in NFU clinics are positioned to monitor for increased parenting stress, particularly among families of children with emerging signs of developmental delay.El propósito de este estudio exploratorio y transversal fue identificar factores relacionados con el niño, asociados con el estrés de crianza maternal en niños pequeñitos nacidos muy prematuramente en una clínica de seguimiento neonatal (NFU). El estudio se propuso describir las asociaciones entre las complicaciones médicas actuales y la presencia de retardos en el desarrollo y el estrés de crianza en su totalidad. Las participantes fueron 53 díadas madre-hijo que se presentaron a una clínica NFU. Las madres completaron el Formulario Corto del Índice de Estrés de Crianza (PSI-SF) y a los niños se les administró el Examen Brigance para Un Comienzo Temprano - Nivel II de Detección. También se recolectaron las variables médicas a partir de la trayectoria médica del niño. Aproximadamente el 24% de las madres tuvo por lo menos un puntaje de sub-escala elevado en el PSI-SF. Los análisis de regresión indicaron que recibir servicios de intervención temprana, no así el número de actuales complicaciones médicas, estaba asociado con el incremento en el estrés de crianza entre madres de niños pequeñitos nacidos muy prematuramente. Los padres de niños nacidos muy prematuramente enfrentan un incremento en el riesgo de estrés de crianza, todo lo cual se extiende más allá del momento en que se les da de alta de la unidad neonatal de cuidados intensivos (NICU). El personal clínico que trabaja en clínicas NFU está en posición de observar con atención el aumento del estrés de crianza, particularmente entre familias de niños en quienes aparecen señales de retardo en el desarrollo. Palabras claves: estrés de crianza, infantes prematuros, seguimiento neonatal.Developmental and Medical Factors Associated with Parenting Stress in Mothers of Toddlers Born Very Preterm in a Neonatal Follow-Up Clinic Le but de cette étude d'exploration transversale était d'identifier des facteurs liés à l'enfant associés au stress de parentage maternel chez de jeunes enfants nés très avant terme et suivis dans une clinique de suivi néonatal (ici abrégé NFU selon l'anglais). L’étude s'est donné pour but de décrire les associations entre les complications médicales du moment et la présence de délais de développement avec le stress de parentage totale. Les participantes ont consisté en 53 dyades mère-enfant dans une clinique NFU. Les mères ont rempli le Formulaire d'Index de Stress de Parentage - version courte (PSI-SF dans l'abréviation anglaise) et les enfants ont reçu le dépistage Brigance Early Head Start Screen II. Les variables médicales ont été rassemblées à partir du dossier médical de l'enfant. A peu près 24% des mères avaient au moins un score de sous-échelle élevé pour le PSI-SF. Des analyses de régression ont indiqué que le fait de recevoir des services d'intervention et non le nombre de complications médicales actuelles était lié à un stress de parentage plus élevé chez les mères de jeunes enfants nés bien avant terme. Les parents d'enfants nés bien avant terme sont à un risque plus élevé de stress parental qui se prolonge bien après la sortie de de l'unité néonatale de soins intensifs à l'hôpital. Les cliniciens travaillant dans les cliniques NFU sont bien positionnés pour surveiller le stress parental accru, particulièrement chez les familles d'enfants avec des signes émergeant de retard de développement. Mots clés: Stress de parentage, bébés prématurés, suivi néonatal.Entwicklungs- und Gesundheitsfaktoren im Zusammenhang mit dem elterlichen Stress bei Müttern von frühgeborenen Kleinkindern in einer Neugeborenen-Nachsorgeklinik Das Ziel dieser explorativen Querschnittsstudie bestand darin, kindbezogene Faktoren zu identifizieren, die mit dem Stress von Müttern frühgeborener Kleinkinder zusammenhängen, die in einer Neugeborenen-Nachsorgeklinik (neonatal follow-up; NFU) in Behandlung waren. Die Studie zielte darauf ab, mögliche Einflüsse aktueller medizinischer Komplikationen und Entwicklungsverzögerungen auf elterlichen Stress zu untersuchen. 53 Mutter-Kind-Dyaden, die an einer NFU-Klinik vorstellig geworden waren, nahmen an der Untersuchung teil. Die Mütter füllten die Kurzversion des Elternstressindex (Parenting Stress Index-Short Form; PSI-SF) aus und mit den Kindern wurde der Brigance Early Head Start Screen II durchgeführt. Des Weiteren wurden medizinische Variablen aus der Krankenakte des Kindes erhoben. Ca. 24% der Mütter hatten mindestens einen erhöhten Subskalenwert im PSI-SF. Regressionsanalysen ergaben, dass der Erhalt von Frühinterventionsleistungen, nicht aber die Anzahl der aktuellen medizinischen Komplikationen mit erhöhtem elterlichem Stress bei den Müttern assoziiert war. Eltern frühgeborener Kinder haben ein erhöhtes Risiko für elterlichen Stress, der über die Entlassung aus der Neugeborenen-Intensivstation (neonatal intensive care unit; NICU) hinausgeht. Kliniker_innen, die in NFU-Kliniken arbeiten, sollten auf erhöhten elterlichen Stress achten, insbesondere bei Familien von Kindern mit aufkommenden Anzeichen einer Entwicklungsverzögerung. Schlüsselwörter: elterlicher Stress, Frühgeborene, Neugeborenen-Nachsorge.新生児フォローアップ・クリニックにおけるかなり早期に出生した乳幼児を抱え た母親の子育てストレスに関係する発達的要因と医学的要因 この探査的・横断的研究の目的は、新生児フォローアップ・クリニック(NFU)に おけるかなり早期に出生した乳幼児を抱えた母親の子育てストレスに関係する子 ども関連の要因を同定することであった。本研究は、現在の医学的な症状や発達 遅滞の存在と、子育てストレスの全体との関連について述べることをねらいとし た。参加者は、NFUクリニックにいた53組の母子である。母親は、PSI 育児スト レスインデックス ショートフォーム(PSI-SF)を全て行い、子どもはブリガンス・ アーリー・ヘッド・スタート・スクリーンⅡを行った。医学的な変数も子どもの 医療記録から集計した。母親の約24％がPSI-SFにおけるある尺度のスコアが少な くとも1つ上がっていた。回帰分析は、早期介入サービスを受けたことが、かな り早期に出生した子どもの母親において子育てのストレスの増加に関係していて、 現在の医学的な症状の数とは関係していなかったことを示した。かなり早期に出 生した子どもの親は、新生児集中治療室(NICU)から退院した後も続く子育てスト レスに関して、リスクが高い。NFU クリニックで働いている臨床家は、特に発達 の後れの症状が出る子どもの家族において、子育てストレスの増加に関して観察 するために配置されている。 キーワード: 子育てのストレス、早期産児、新生児フォローアップ.这项探索性的横断面研究是为了确认新生儿随访 (NFU) 门诊中早产儿母亲育儿压力的儿童关联因素, 旨在描述现有医疗并发症、发育迟缓症与总育儿压力之间的关系。研究对象是53对在NFU门诊中就诊的母婴二人组。母亲填写了“简式育儿压力问卷 (PSI-SF) ”, 儿童接受了“布里根斯早期启蒙筛选测验II”, 并从儿童的病历中收集了医学变量。研究显示约24%的母亲在“PSI-SF”中至少有一个较高的因子评分。回归分析表明, 早产儿母亲育儿压力的增加与其接受早期干预服务有关, 而不是由现有医疗并发症数量引起的。早产儿父母正面临着育儿压力增加的风险, 而这种压力超过了从新生儿重症监护室 (NICU) 出院时所承受的范围。NFU门诊的临床医生应去监测这种增加的压力, 特别是监测那些有发育迟缓迹象孩子的家庭。 关键词: 育儿压力, 早产儿, 新生儿随访.عوامل النمو والعوامل الطبية المرتبطة بإجهاد الرعاية الوالدية لدي أمهات الأطفال الصغار المبتسرين في عيادة متابعه حديثي الولادة كان الغرض من هذه الدراسة الاستكشافية المقطعية تحديد العوامل المتعلقة بالأطفال المرتبطة بإجهاد الرعاية الوالدية للأمهات مع الأطفال الصغار المولودين قبل الأوان في عيادة متابعه حديثي الولادة (NFU). وتهدف الدراسة إلى وصف ارتباطات التعقيدات الطبية الحالية وتأخيرات النمو بالتعرض لإجهاد الرعاية الوالدية. اشترك في الدرسة 53 من ثنائيات الأمهات والأطفال داخل عيادة متابعة حديثي الولادة .أكملت الأمهات النموذج مؤشر إجهاد الرعاية الوالدية المختصر (PSI-SF) وتلقى الأطفال اختبار بريجانس (هيد ستارت سكرين 2). وتم أيضا جمع المتغيرات الصحية من السجل الطبي للطفل. وكان لدي 24 في المائة تقريبا من الأمهات ما لا يقل عن درجه فرعيه واحده مرتفعه علي مقياس (PSI-SF). وأشارت تحليلات الانحدار إلى ان تلقي خدمات التدخل المبكر وليس التعقيدات الطبية الحالية يرتبط بزيادة إجهاد الرعاية الوالدية بين أمهات الأطفال الصغار المبتسرين. ويتعرض آباء وأمهات الأطفال المبتسرين لخطر متزايد من إجهاد الرعاية الوالدية الذي يمتد إلى ما بعد الخروج من وحده العناية المركزة لحديثي الولادة (NICU). ويمكن للأطباء العاملين في عيادات NFU أن يكونوا في موقع جيد لمتابعة زيادة إجهاد الرعاية الوالدية ، وخاصه بين أسر الأطفال الذين تظهر عليهم علامات التاخر في النمو. الكلمات الرئيسية: إجهاد الرعاية الوالدية ، الرضع المبتسرين ، متابعه حديثي الولادة.

The Griffiths Mental Development Scale-Chinese (GDS-C) is used in China to assess the development of children from birth to 8 years of age. Language disorders are a common symptom of autism spectrum disorder (ASD) and global developmental delay (GDD)/intellectual disability (ID). There is a need to identify distinct clinical characteristics in children suspected of having these 2 disorders, mainly presenting as language disorders. Here, we aimed to use the GDS-C to evaluate children presenting with language problems to identify characteristics that distinguish ASD and GDD/ID. Children with language problems were recruited between August 2018 and December 2019. A total of 150 children aged 25 to 95.2 months were enrolled (50 in the ASD group, 50 in the GDD/ID group, and 50 in the typical group). Each group was subdivided by age as follows: 24-36 months, >36-60 months, and >60-96 months. Developmental characteristics assessed using the GDS-C were analyzed and compared. Both, children with ASD and GDD/ID presented with a lower developmental level than typical children in all six subscales of the GDS-C. No significant differences were observed in the six subscale scores between the ASD and GDD/ID groups, except for the practical reasoning subscale score in the >36 to 60 months subgroups, which was significantly lower in the GDD/ID group than in the ASD group. The developmental imbalance of subscales within the ASD and GDD/ID groups identified troughs in the personal-social, language, and practical reasoning areas in children with ASD and in the language and practical reasoning areas in children with GDD/ID relative to typical children. The GDS-C is a useful, comprehensive tool for the assessment of the developmental state of children with ASD and GDD/ID. Characteristics of practical reasoning subscale help diagnose autism in >36 to 60 months old children.

Aim: This study was planned as cross-sectional and correlational to compare the empathy levels of the students studying in Social Work and Computer Engineering departments of Duzce University. Material and Methods: By applying proportional stratified sampling method, a research sample was created by randomly selected 100 students from each department and agreed to participate in the study. Personal information form and Empathy Level Determination Scale were used to collect the data. Results: It was found that the empathy level of the students studying in the Social Work department was significantly higher than the empathy level of the students studying in the Computer Engineering department. According to the department, socio-demographic characteristics such as parents' education levels, gender, class, family type, place of residence (except for cognitive empathy level), status of dealing with art/sports did not affect students' empathy level. Only the difference between the cognitive empathy subscale scores measured from them according to place of residence was found to be different in both departments. The cognitive empathy subscale score of the students in Social Work department living in the town/village was significantly higher than the score of the students studying in the Computer Engineering living in the town/village (p

Purpose Bilateral neovascular age‐related macular degeneration (nAMD) causes difficulties in daily life, especially with regard to near‐vision tasks, despite well preserved Early Treatment of Diabetic Retinopathy Study (ETDRS) best corrected visual acuity (BCVA) at distance. Therefore, alternative visual function measures were evaluated in terms of their correlation with vision‐related quality of life scores (QoL). Methods A prospective cross‐sectional pilot study including patients with a diagnosis of bilateral nAMD having lesions within the central 1 mm ETDRS grid subfield. Standardised testing included a vision‐related QoL assessment (NEI‐VFQ25), best corrected visual acuity (BCVA), low luminance visual acuity (LLVA), Radner maximum reading speed and Pelli‐Robson contrast sensitivity (CS). Results N = 54. The mean better eye (range) BCVA was 79 (55–96) letters, median (range) LLVA 79.5 (58–97) letters and median (range) CS 1.35 (0–1.65) log units. Mean binocular maximum reading speed was 117.33 ± 28.42 wpm. The best correlations with the near subscale score were found for CS followed by binocular maximum reading speed (r = 0.59, p = 0.0001; r = 0.36, p = 0.008, respectively). A weaker correlation was observed for the BCVA in the better eye (r = 0.33, p = 0.02). The correlation between the NEI‐VFQ25 distance subscale and BCVA was weaker (r = 0.37, p = 0.005) than the correlations with CS (r = 0.67, p = 0.0001) and LLVA (r = 0.40, p = 0.003). Conclusions For patients with a bilateral centre‐involving nAMD, the best correlation with near QoL was the better eye CS followed by maximum binocular reading speed. These measures could be valuable in quantifying vision‐related QoL outcomes in AMD clinical trials.

Structured Abstract Study Objective To examine the association between reproductive autonomy and adolescent receptivity towards long acting reversible contraceptive (LARC) methods. Design A survey assessing sexual history and contraceptive practices/knowledge/attitudes was administered. Reproductive autonomy was measured with an adapted validated scale. Setting Adolescent medicine clinic in an urban academic medical center in the Midwestern United States. Participants Girls ages 14-21 years presenting for well or contraceptive visits. Main Outcome Measures Primary outcome was a favorable rating towards the question “How much do you like the idea of LARC for yourself?” Primary independent variable was the reproductive autonomy decision-making subscale score (higher score indicating increased autonomy). Results Eighty-nine participants with a mean age of 16 years completed surveys. Almost all (92%) identified as African American. At study enrollment 56.2% were using Depo-Provera, 15.7% oral contraceptives, 3.4% implants, and 24.7% no method. Only 13.5% of participants liked the idea of LARC for themselves. The mean score on the decision-making subscale was 9 (range 4-12). In bivariable analysis, age was associated with decision-making subscale score, but was not retained as a confounder in multivariable analysis. The odds of liking LARC decreased by 30% with each unit increase in autonomy decision-making subscale score (OR 0.70, 95% CI 0.52 to 0.94, p=0.02). Conclusion Our findings suggest that adolescents with higher reproductive autonomy, as measured by score on the decision-making subscale, were less likely to favor LARC. Further research should explore participants’ perceptions of autonomy and the relational dynamics between adolescents and their parents/partners in contraceptive choice.

Objective The educational experience in operating rooms (OR) plays a central role in the transformation of a trainee into a surgeon. As Canadian residency programs transition to competency-based medical education, and since most surgical competencies are attained in the OR, we investigated the perceptions of Canadian surgical residents about their OR learning environment. Design Cross-sectional, national survey. Setting An online questionnaire, including the validated 40-item operating room educational environment measure (OREEM) inventory, was sent to residency programs of all surgical specialties in Canada. The OREEM assesses the trainees’ perceptions of the “trainer and training,” “learning opportunities,” “atmosphere in the operating room,” “supervision, workload, and support,” Each individual item was rated using a 5-point Likert scale ranging from “strongly disagree” (scores 1) to “strongly agree” (scores 5). The mean score of each individual item was measured, and the mean scores of each subscale and an overall score of the questions were also measured. Participants Surgical residents in Canada. Results Four hundred thirty residents were included for final analysis. The overall mean OREEM score was 3.72 ± 0.4. “Atmosphere in the OR” was the subscale with the highest mean score (3.87 ± 0.5), while “supervision, workload, and support” had the lowest subscale mean score (3.49 ± 0.5). The overall OREEM mean score for junior and senior residents was 3.67 ± 0.4 and 3.80 ± 0.4, respectively (p = 0.001). No significant differences were seen in the mean OREEM score between males and females or different surgical programs. Nevertheless, general surgery had the lowest “supervision, workload, and support” subscale score (3.27 ± 0.5; p Conclusions The overall educational environment in OR may be considered satisfactory as perceived by Canadian surgical residents; however, several areas for potential improvement are identified and suggestions for optimizing the learning environment are described.

Objectives Dental implant treatment (DIT) improves peoples’ oral health-related quality of life (OHQoL). Assessment of longitudinal changes in OHRQoL may be undermined by response shift (RS). RS is the process by which quality of life changes, independent of health status as a result recalibration, reprioritization or reconceptualization. Thus, this study aimed to describe RS in the OHRQoL and perceived oral health of individuals receiving DIT and to compare the then-test, a self-anchored scale and the classification and regression trees (CRT) approaches for assessing RS. Methods OHRQoL was assessed in 100 patients receiving DIT using the OHIP-Edent (n = 100) and a self-anchored scale (n = 45) before placement of the final restoration and 3 to 6 months after treatment was completed. The OHIP-Edent was also used as a retrospective assessment at follow-up. CRT examined changes in the OHIP-Edent total score as a dependent variable with global changes in oral health and each OHIP-Edent subscale score as independent variables. Results OHRQoL and perceived oral health improved after treatment. The OHIP-Edent score decreased from 36.4 at baseline to 12.7 after treatment. On average, participants recalibrated their internal standard downwards (− 4.0 OHIP-Edent points). CRT detected downwards recalibration in 5% of participants and upwards in 15%. Reprioritization was observed in the social disability and psychological discomfort aspects of OHRQoL. Conclusions RS affects longitudinal assessments of OHRQoL in DIT, reducing the apparent magnitude of change. The then-test and CRT are valid and complementary methods to assess RS.

IntroductionEvidence from a recent randomised controlled trial1 suggests that in severely stressed subjects with low magnesemia, supplementation with magnesium (Mg) in combination with vitamin B6 (B6) provides greater benefits than Mg alone. B6 was reported to facilitate Mg absorption and its cellular uptake and to exert synergistic effect with Mg. The current secondary analysis explored the relationship between Mg-B6 combination and erythrocyte Mg concentration, used as a biomarker of body Mg status.Material and MethodsAn 8-week, Phase IV, controlled, single-blinded, parallel-group trial (EudraCT Number 2015-003749-24) stratified by sex was conducted in adults (n = 264) with a Depression Anxiety Stress Scales - stress subscale score (DASS-42SS) > 18 and serum Mg of 0.5–0.85mmol/L, randomised 1:1 to daily oral Mg-B6 (Magne B6®, Mg 300 mg; B6 30mg) or oral Mg alone (Magnespasmyl®, Mg 300mg). Outcomes were stress score, serum Mg (mmol/L), erythrocytes Mg (mmol/L), and serum B6 (nmol/L) from baseline to Week4 and Week8. Data are given as mean(SD) values.Results & DiscussionBaseline characteristics. Baseline magnesemia was 0.80(0.04) for both groups. Erythrocyte Mg concentration for the lower quintile of the studied population (n = 53) was 0.73–1.62, below the normal range of 1.65–2.65 in general population. The mean stress score in this subgroup was higher [29.5(6.3)], but not significantly different from that in other quintiles [lowest value: 26.1(7.6)]. Baseline B6 serum level for the lower B6 quintile (5–23), below the normal range for general population, was suggestive of possible B6 deficiency.Treatment effects. Both treatments increased slightly but not significantly erythrocyte Mg level from baseline to Week8 [1.84(0.03) to 1.86(0.03), and 1.86(0.03) to 188(0.03), respectively for Mg + B6 and Mg groups]. Significant changes were observed in subjects with low erythrocyte Mg level at baseline (< 1.6), namely an increase of + 0.13(0.04–0.22) for Mg + B6 and + 0.17(0.08–0.25) for Mg groups, but with no difference between treatments. Moreover, Mg + B6 supplementation led to a significant change (p < 0.0001) in serum B6 level between baseline and Wk8 [55.9(4.8) to 370.9(11.3)], as compared to Mg alone [51.9(4.8) to 51.5(11.3)].In conclusion, both treatments significantly increased erythrocyte Mg in subjects with low Mg status. B6 supplementation did not lead to further increase in erythrocyte Mg level. We have previously shown that severely stressed population benefits from B6 supplementation in combination with Mg, however, the mechanism of the interaction between Mg and B6 remains to be elucidated.1Sponsored by Sanofi

OBJECTIVES To determine changes in the vision-related quality of life in patients undergoing deep anterior lamellar keratoplasty (DALK) by using the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25). METHODS Thirty-five patients who were scheduled for DALK between March 1, 2013, and March 1, 2014 were asked to complete the NEI VFQ-25. NEI VFQ-25 was administered again at 6 months and at 1 year postoperatively. Data on patients' age, sex, preoperative diagnosis, preoperative and postoperative best-corrected visual acuity, and postoperative astigmatism were recorded. RESULTS Successful DALK with the Anwar big bubble technique was achieved in 23 of 35 (65.7%) patients. The indications for surgery were keratoconus in 15 patients (62.2%), stromal corneal dystrophies in 4 (17%), and corneal scar in 4 (17%). The mean preoperative NEI VFQ-25 composite score (55.2±19.7) improved significantly (76.9±11.6) at 6 months after DALK and continued to improve (84.3±6.6) at 1 year postoperatively (Friedman test, P=0.001). All NEI VFQ-25 subscale item scores increased significantly after surgery. The patients' age was significantly correlated with the NEI VFQ-25 subscale score of mental health at 6 month and at 1 year postoperatively (r=0.92, P=0.008 and r=0.94, P=0.005, respectively). There was a negative relationship between postoperative astigmatism at 1 year and NEI VFQ-25 ocular pain, social functioning, peripheral vision, and mental health subscale scores (r=-0.76, P=-0.07; r=-0.53, P=0.2; r=-0.53, P=0.27; r=-0.80, P=0.05). CONCLUSION Vision-related quality of life improved significantly after DALK and continued to improve after suture removal.

This study examines the association between religiosity and physician lifestyle from a Family Health Strategy perspective. This is a cross-sectional study with 30 physicians, who completed the religiosity and lifestyle questionnaires. Among the participants, 70% (n = 21) had no “focus” on spirituality and health. The average total lifestyle score was 74.1 (SD = 8.1), but the “Physical Activity” subscale score was below average (3.4, SD = 2.37). We found eight significant correlations between religiosity and lifestyle subscales (p

Human beings can express their emotions through various ways, such as facial expressions, bodily expressions, prosody, or language. Autism Spectrum Disorder (ASD) is a life-long neuro developmental disorder, characterized by varying levels of deficit in social and communication skills. A "serious game" called "JeStimule" has been developed to improve on the facial emotion recognition skills of children with autism. As many as 17 autistic children with distinctive characteristics were recruited for this cross-sectional study. The level of language comprehension and academic learning is slightly heterogeneous. The participants are predominantly boys, with an average age of 11.23. Our finding shows that children have gradual ease in recognizing the following emotions: Happiness, surprise, sadness, anger, pain and fear. However, they find it challenging to recognize the remaining three emotions, namely neutral, funny face, and disgust. JeStimule is an effective educational game for children with autism that could improve their skills in recognizing others’ emotion. However, further research needs to be carried out to test the game in the context of Moroccan children. Autism recognition of emotions is a cognitive remediation area of great interest to this population.

The 20-item Toronto Alexithymia Scale (TAS-20) is a self-report questionnaire designed to measure the three components of alexithymia; difficulty identifying feelings in the self (DIF), difficulty describing feelings (DDF), and externally orientated thinking (EOT). We examined the scale’s psychometric properties in Australian nonclinical (N = 428) and psychiatric (N = 156) samples. In terms of factorial validity, confirmatory factor analyses found the traditional 3-factor correlated model (DIF, DDF, EOT) to be the best and most parsimonious solution, but it did not reach adequate levels of goodness-of-fit in either sample. Several EOT items loaded poorly on their intended factor, and a reverse-scored item method factor was present; the factor structure of the scale was invariant across both samples. A higher-order factor model (with a single higher-order factor) was slightly inferior to the correlated models, but still tenable. The total scale score and DIF and DDF subscales displayed sound internal consistency, but the EOT subscale did not. We conclude that the TAS-20 has, for the most part, adequate psychometric properties, though interpretation should focus only on the total scale score and DIF and DDF subscales; we recommend the EOT subscale score not be used. Implications for clinical use and future revision of the scale are discussed.

(Purpose) Targeted therapy has been standard therapeutic approach for advanced renal cell carcinoma (RCC). General fatigue is frequently observed in patients who receive targeted therapies for advanced RCC. General fatigue makes it difficult to continue a standard schedule of treatment in many cases. In this preliminary report, we explored the effect of Koujin powder (red ginseng powder) with Ninjin-youeito for general fatigue induced by targeted therapies for advanced RCC. (Material and method) The patients who complained of general fatigue during the treatment of Tyrosine Kinase Inhibitors (TKIs) as targeted therapies for advanced RCC were included in this retrospective analysis. Thirty patients with advanced RCC were enrolled from January 2016 to December 2016 at Chiba University Hospital. Twelve patients were given 3 g of Koujin powder with 9 g of Ninjin-youeito orally for two to four weeks (ginseng combination group). Eighteen patients who were not orally administered were compared as a control group (ginseng non-combination group). General fatigue was assessed with the Cancer Fatigue Scale (CFS), which divides quality of fatigue into three subgroups by using a "physical subscale", an "affective subscale", and a "cognitive subscale". We compared CFS scores at baseline and 2-8 weeks after administration. (Results) There was no statistical difference in the clinical variables between the two groups. The total CFS score was significantly decreased after treatment in the ginseng combination group (average score, 21.8 points at baseline vs 18.5 points after treatment; p=0.041). On subgroup analyses, the physical subscale score was significantly reduced after treatment in the ginseng combination group (average score, 9.7 points at baseline vs 7 points after treatment; p=0.0042). In the ginseng non-combination group, the total CFS score was significantly increased during the course (average score, 16.2 points at baseline vs 20.6 points during the course; p=0.047). On subgroup analyses, the physical subscale score was significantly increased during the course (average score, 4.4 points at baseline vs 7.3 points during the course; p=0.0042). (Conclusions) Koujin powder with Ninjin-youeito can be a therapeutic approach for general fatigue induced by targeted therapies. The precise management for general fatigue can keep patients on therapy, consequently provides a survival benefit.

Background Previous research has examined the components of depression and fatigue in multiple sclerosis (MS), but the findings have been inconsistent. The aim of this study was to explore the associations between overall and subscale scores of the Center for Epidemiologic Studies-Depression Scale (CES-D) and the Modified Fatigue Impact Scale (MFIS) as well as the longitudinal changes in scores in a large cohort of MS patients. Methods MS subjects who completed a battery of patient reported outcome (PRO) measures including the CES-D and MFIS ( N = 435) were included in our analysis. At the first available MFIS measurement, Pearson's correlation coefficient was used to estimate the association between the CES-D and MFIS in terms of both total scores and subscale scores. In addition, the longitudinal change in each total score and subscale score was estimated using a linear mixed model, and the association between the measures in terms of longitudinal change was estimated using Pearson's correlation coefficient and linear mixed models. Results At baseline, 15% of subjects were classified as high on both depression and fatigue scales, 16% were classified as high on the fatigue scale only, and 9% were classified as high on the depression scale only. There was a high correlation between CES-D and MFIS total scores ( r = 0.62). High correlations were also observed between the somatic and retarded activity subscales of the CES-D and each of the MFIS subscales ( r ≥ 0.60). In terms of longitudinal change, the change over the first year between the CES-D and MFIS total scores showed a moderate correlation ( r = 0.49). Subjects with high fatigue scores but low depression scores at baseline were more likely than subjects with low baseline fatigue and depression scores to develop high depression scores at follow-up. Conclusions Our study demonstrated that depression and fatigue in MS share several features and have a similar longitudinal course. But using cut-off scores to define depression and fatigue, our study also found that non-depressed subjects with high fatigue may be at a greater risk for developing depression.

In their article on specific learning disorders (SLDs), Toffalini, Giofré, and Cornoldi conducted a profile analysis of index scores from individuals diagnosed with an SLD. Their data interpretation—and subsequent clinical recommendations—have many of the same problems that have plagued the research in subscale score interpretation for decades. In this article, I describe some problems with Toffalini et al.’s analysis and conclusions as well as provide some recommendations for future research and clinical use of subscale scores.

This study aimed to evaluate the factor structure of Calgary depression rating scale (CDSS) and Hamilton Depression Rating Scale (HDRS) among patients with schizophrenia in acute and remission phase of illness by using exploratory factor analysis. For this, 267 patients with schizophrenia were assessed on CDSS and HDRS. Exploratory factor analysis of CDSS yielded 2 factor models for the whole sample, patients in clinical remission and patients not in clinical remission phase of schizophrenia. Factor analysis of HDRS yielded 3 factor models; however, there was significant difference in the factor structure between those in clinical remission and those not in clinical remission phase of schizophrenia. CDSS total score did not correlate with PANSS positive and negative subscale scores. In contrast, HDRS total score correlated positively with PANSS positive subscale score, PANSS negative subscale score and PANSS general psychopathology subscale score. To conclude, present study suggests while CDSS items separate out into 2 factors, which are stable across different stages of illness, whereas HDRS factor structure appears to be less stable across different stages of illness. Correlation analysis suggests that rating on HDRS may be affected by positive and negative symptoms of schizophrenia, whereas CDSS do not correlate with positive and negative symptoms of schizophrenia.