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Multiple issues are associated with company cars in the academic debate, such as excessive car use and welfare loss. Company cars, provided by organizations to their employees, are often seen as a subsidy for private car ownership throughout Europe, especially in Belgium. Belgium is the first country in Europe to develop a legal framework in which organizations can replace the company car system with alternative solutions such as a corporate mobility budget. The objective of this study was to gain insight into the intentions of employees to replace their company car with this mobility budget. We have carried out an online survey among 527 company car drivers to predict the financial compensation that is required to replace the company car with more sustainable transport modes. On average, respondents required €683 per month to give up their company car. A stepwise linear regression analysis identified familiarity with alternative transport modes, environmental concern, accessibility, and income as the primary predictors of this financial preference. These variables have been proven to be significant predictors of mode choice as well. The findings can help to identify opportunities for generating a modal shift in organizations.

Objectives: The aim of this systematic review and meta-analysis is to assess the prevalence of loneliness in many countries worldwide which have different ways of assessing it., Design: Systematic review and meta-analysis., Setting: We searched seven electronic databases for English peer-reviewed studies published between 1992 and 2021., Participants: We selected English-language peer-reviewed articles, with data from non-clinical populations of community-dwelling older adults (>60 years), and with "loneliness" or "lonely" in the title., Measurements: A multilevel random-effects meta-analysis was used to estimate the prevalence of loneliness across studies and to pool prevalence rates for different measurement instruments, data collection methods, and countries., Results: Our initial search identified 2,021 studies of which 45 ( k = 101 prevalence rates) were included in the final meta-analysis. The estimated pooled prevalence rate was 31.6% ( n = 168,473). Measurement instrument was a statistically significant moderator of the overall prevalence of loneliness. Loneliness prevalence was lowest for single-item questions and highest for the 20-item University of California-Los Angeles Loneliness Scale. Also, differences between modes of data collection were significant: the loneliness prevalence was significantly the highest for face-to-face data collection and the lowest for telephone and CATI data collection. Our moderator analysis to look at the country effect indicated that four of the six dimensions of Hofstede also caused a significant increase (Power Distance Index, Uncertainty Avoidance Index, Indulgence) or decrease (Individualism) in loneliness prevalence., Conclusions: This study suggests that there is high variability in loneliness prevalence rates among community-dwelling older adults, influenced by measurement instrument used, mode of data collection, and country.

Executive functions (EFs) refer to a set of cognitive processes, specifically shifting, inhibition, updating of working memory, and are involved in the cognitive control of behavior. Conflicting results have been reported regarding impairments of EFs in Primary Progressive Aphasia (PPA). We performed a multi-level meta-analysis to confirm whether deficits of EFs exist in this population, focusing on a common EFs composite, and the components shifting, inhibition and updating separately. We included 141 studies that report on 294 EFs tasks. The overall mean weighted effect size was large (d = -1,28), indicating poorer EFs in PPA as compared to age-matched cognitively healthy controls. Differences between effect sizes of the EFs components were not significant, indicating all components are affected similarly. Overall, moderator analysis revealed that PPA variant and disease duration were significant moderators of performance, while task modality and years of education were not. The non-fluent/agrammatic PPA and the logopenic PPA variants were similarly affected, but the semantic variant was affected to a lesser extent. We discuss implications for clinical and research settings, and future research. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to identify clinical and laboratory phenotype distribution patterns and their usefulness as prognostic markers in COVID-19 patients admitted to the intensive care unit (ICU) at Tygerberg Hospital, Cape Town., Methods and Results: A latent class analysis (LCA) model was applied in a prospective, observational cohort study. Data from 343 COVID-19 patients were analysed. Two distinct phenotypes (1 and 2) were identified, comprising 68.46% and 31.54% of patients, respectively. The phenotype 2 patients were characterized by increased coagulopathy markers (D-dimer, median value 1.73 ng/L vs 0.94 ng/L; p < 0.001), end-organ dysfunction (creatinine, median value 79 µmol/L vs 69.5 µmol/L; p < 0.003), under-perfusion markers (lactate, median value 1.60 mmol/L vs 1.20 mmol/L; p < 0.001), abnormal cardiac function markers (median N-terminal pro-brain natriuretic peptide (NT-proBNP) 314 pg/ml vs 63.5 pg/ml; p < 0.001 and median high-sensitivity cardiac troponin (Hs-TropT) 39 ng/L vs 12 ng/L; p < 0.001), and acute inflammatory syndrome (median neutrophil-to-lymphocyte ratio 15.08 vs 8.68; p < 0.001 and median monocyte value 0.68 × 10 9 /L vs 0.45 × 10 9 /L; p < 0.001)., Conclusion: The identification of COVID-19 phenotypes and sub-phenotypes in ICU patients could help as a prognostic marker in the day-to-day management of COVID-19 patients admitted to the ICU., Competing Interests: All authors declare no conflicts of interest., (© 2022 The Authors.)

Background: Advanced cancer is associated with a significant symptom burden, and timely identification of palliative care (PC) needs, and provision of appropriate PC can improve treatment outcomes, reduce healthcare cost, and enhance patient and family satisfaction with care. Several tools have been used to identify PC needs in different clinical settings and patient groups., Objective: The primary objective was to determine the prevalence and associated characteristics of PC needs among cancer patients admitted to the surgical emergency center (SEC) of a large academic hospital in South Africa (SA). The association between PC needs and early death were explored as a secondary outcome., Design: This was a cross-sectional observational study that included all patients with known malignancy admitted through the SEC for acute surgical emergencies. The validated Supportive and Palliative Care Indicators Tool (SPICT™) was applied to patients' files on admission to the SEC. In addition, attending physicians were asked to estimate the 1 year survival probability of these patients by answering The Surprise Question (SQ)., Setting: A tertiary level, public, academic hospital in Cape Town, SA., Results: One hundred and twelve admissions were included with a median age of 58 years. Fifty-two admissions (46.4%) were for metastatic patients and 60.7% were known with palliative treatment intent. The prevalence of SPICT- and SQ-defined PC needs was 46.4% and 54.7% respectively. Pain was the most prevalent presenting symptom and bowel obstruction the most prevalent presenting diagnosis. SPICT-positivity was a significant predictor of death before discharge and death within 6 months of first admission. Proportional agreement in predicting for PC needs of greater than 70% was shown between the two tools., Conclusion: Patients with PC needs comprise a significant proportion of SEC cancer admissions. This study shows the clear need for investment in staff and infrastructure to provide integrated palliative and end-of-life care as part of surgical services. The SPICT TM and SQ were shown to predict for early death in this cohort. Further validation of PC needs assessment tools is needed to guide the cost-effective implementation of PC services in low resource settings., (Copyright © 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: Recent research has recognized executive dysfunction as another component affected in Primary Progressive Aphasia (PPA). This systematic review aimed to examine what information distinctive neurophysiological markers can provide in the evaluation of executive function (EF) deficits in PPA, and to what effect executive function deficits can be assessed through the characteristics of functional markers. Methods: We conducted a systematic literature search following the PRISMA guidelines across studies that employed neuropsychological assessments and neurophysiological imaging techniques (EEG, MEG; PET, SPECT, fMRI, fNIRS) to investigate executive dysfunction correlates in PPA. Results: Findings from nine articles including a total number of 111 individuals with PPA met our inclusion criteria and were synthesized. Although research on the neural correlates of EF deficits is scarce, MEG studies revealed widespread oscillatory slowing, with increased delta and decreased alpha power, where alterations in alpha, theta, and beta activities were significant predictors of executive function deficits. PET findings demonstrated significant correlations between executive dysfunction and hypometabolism in frontal brain regions. fMRI results indicated elevated homotopic connectivity in PPA patients, with a broader and more anterior distribution of abnormal hippocampal connections of which were associated with reduced executive performance. Conclusion: Our study provides indirect support for the assumption regarding the significance of the frontal regions and inferior frontal junction in executive control and demonstrates that neurophysiological tools can be a useful aid to further investigate clinical-neurophysiological correlations in PPA. [ABSTRACT FROM AUTHOR]

Background: Loneliness has been identified as a significant independent predictor of depression among older adults. Social support has been reported to play a protective role against both loneliness and depression in older adults. However, few studies to date have investigated the three constructs concurrently and the mediating role of Perceived Social Support (PSS) on the relationship between loneliness and depression in this age group. The current study aimed to assess the relationship between loneliness and depression among community-dwelling Nepalese older adults based on the mediating role of PSS. Methods: This descriptive cross-sectional research study included 367 community-dwelling older adults from a randomly selected ward in Kathmandu, Nepal. The University of California, Los Angeles Loneliness Scale, Geriatric Depression Scale, and Multidimensional Scale of Perceived Social Support were used. Correlation analysis, regression analysis, and the PROCESS 4.1 macro developed by Hayes with a bootstrapping procedure were used to test the mediating effect of the PSS on the relationship between loneliness and depression. Results: Loneliness was negatively associated with the PSS (β = -0.405; 95% CI: −0.473, -0.337; P < 0.001), and the PSS was positively associated with depression (β = 0.057; 95% CI: 0.014, 0.099; P = 0.009). The direct effect of loneliness on depression was positive and significant (β = 0.151; 95% CI: 0.117, 0.184; P < 0.001), whereas the indirect effect of loneliness on depression through the PSS was negative (path c; β = -0.023, 95% CI: -0.041, -0.005). The results indicated that the PSS partially mediated the relationship between loneliness and depression. Conclusion: These findings suggest that interventions focusing on reducing loneliness and fostering social support may be able to lessen depressive symptoms in older adults. By addressing these factors, healthcare providers and carers can promote the mental health of older adults. [ABSTRACT FROM AUTHOR]

Despite the growing acknowledgment of the importance of loneliness among older individuals, questionnaire length constraints may hinder the inclusion of common multi-item loneliness scales in surveys. Direct, single-item loneliness measures are a practical alternative, but scholars have expressed concerns that such measures may lead to underreporting. Our aim was to test whether such reservations are justified. We conducted a preregistered list experiment among 2,553 people aged 50 + who participated in the Dutch Longitudinal Internet studies for the Social Sciences (LISS) panel. The list experiment method has been developed to unobtrusively gather sensitive information. We compared the list experiment estimate of the prevalence of frequent loneliness with the corresponding direct question estimate to assess downward bias in the latter. Next to pooled models, we estimated models stratified by gender to assess whether loneliness underreporting differed between women and men. Relying on the direct question, we estimated that 5.9% of respondents frequently felt lonely. Our list experiment indicated that the prevalence of frequent loneliness was 13.1%. Although substantial in magnitude, the difference between both estimates was only marginally significant (Δb: 0.072, 95% CI: − 0.003;0.148, p =.06). No evidence of gender differences was found. Although we cannot be conclusive that loneliness estimates are biased downward when a direct question is used, our results call for caution with direct, single-item measures of loneliness if researchers want to avoid underreporting. Replications are needed to gain more precise insights into the extent to which direct, single-item loneliness measures are prone to downward reporting bias. [ABSTRACT FROM AUTHOR]

The logopenic variant of primary progressive aphasia (lvPPA) shows different features from the non-fluent (nfvPPA) and semantic (svPPA) variants of PPA. Although language impairments remain the core symptoms, studies have highlighted the presence of executive disorders at the onset of the disease. Nevertheless, the results are contradictory, particularly in lvPPA. The aim of this study was to explore the executive profile of lvPPA. We compared executive functioning in lvPPA with the other two variants of PPA, Alzheimer's disease (AD) and a cognitively healthy group. In total, 70 patients with PPA, 32 patients with AD, and 41 healthy controls were included. They underwent a comprehensive executive battery assessing short-term and working memory, inhibition, flexibility, planning, and initiation. The analyses showed significant differences between the lvPPA group and the control group, except on visuospatial spans and the Stroop test, and between the lvPPA group and the other PPA groups and the AD group for several tasks. Thus, this research highlighted the existence of an executive dysfunction from the onset of the disease in lvPPA but also in the other two variants of PPA. [ABSTRACT FROM AUTHOR]