Checklist Research Articles

Practice of French urologists concerning the checklist of the operating room

In 2018, the French High Authority of Health (HAS) included a "time-out" phase in the latest version of the checklist for the operating room in order to improve the safety of operated patients. The aim of this study is to evaluate the practice of French urologists concerning the check list (CL) of the operating room. A survey of 30 items was developed by the committee of accreditation of the French Association of Urology (AFU) and other contributors. It was centered on the characteristics of the urologists, the details of application of the CL, and the evaluation of the current version. After validation, the questionnaire was emailed as an online form in July 2021 for all the members of the AFU and AFUF. Overall, 369 form the 1700 contacted urologists responded to the survey. The majority were more than 40 years old (70.11%) and less than 20 year of experience (54.49%). The engagement in individual or team accreditation was observed in 222 (60.7%) and 145 (39.84%) urologists, respectively. Almost half of them were present at the beginning of the CL (47.18%), and prescribed postoperative medication with the anesthesiologist (55.56%). The CL has modified the practice in 47.54%, however, with greater administrative burden, and 80% preferred that the AFU adapts the CL to the urology field. The practice of CL between urologists is variable. On multivariate analysis, the engagement in team accreditation was the only variable to influence the practice of time out.

Safety in electrosurgery: results of the All-Russian survey

To assess the level of knowledge in electrosurgical safety among specialists in the Russian Federation. An Internet survey was devoted to the issues of electrosurgical safety. The questionnaire consisted of 15 questions in 5 items. Data were collected for 2 months. Data analysis included final assessment of respondents, correlation of results with their own assessment of knowledge and parameters of surgical experience, the fact of training and belonging to the department. Question design, survey and presentation of results were performed in accordance with the CHERRIES (Check list of Reporting Results of Internet E-Surveys) criteria for Internet surveys. Survey enrolled 231 specialists. Excellent rating was given to 13 (5.6%) respondents, good - 66 (28.3%), satisfactory - 105 (45.1%) respondents. Forty-nine (21.03%) respondents did not overcome the passing score (7) and showed unsatisfactory knowledge of electrosurgical safety. Mean score among all participants was 8.6±2.6 (median 8 points, interquartile range [7-11]) or 53.3% of maximum value (15). In multivariate logistic model, significant factors were the completed course in electrosurgical safety (OR 2.26, 95% CI 1.30-3.97; p=0.004), experience of work (OR 1.03, 95% CI 1.01-1.05; p=0.011) and work in the department (OR 1.74, 95% CI 1.03-2.95; p=0.038). Respondents who did not take the course (positive significant correlation r=0.1629, p=0.02674) and non-departmental employees (r=0.1655, p=0.031) assess the level of knowledge more adequately with respect to real results. Respondents with completed course (r=0.1078, p=0.4659) and departmental staff (r=0.1411, p=0.2699) are prone to overestimate self-assessment (positive insignificant correlation of their own assessment and received points). We found significant knowledge gaps in electrosurgical safety among various practitioners. The main causes are no mandatory specialized courses on electrosurgical safety and insufficient motivation of specialists for self-education due to false ideas about their own level of knowledge.

Sistemik İzotretinoin Tedavisinin Depresyon ve Diğer Psikolojik Belirtiler Üzerine Etkisi: Bir Vaka Kontrol Çalışması

Objective: Isotretinoin is highly preferred in the treatment of severe and resistant acne, but there are still disagreements about whether it has psychogenic side effects. In this study; we aim to investigate the changes in psychological symptoms before and after the treatment in a group of patients treated with isotretinoin. Material and Methods: A total of 110 patients who had moderate or severe acne, and decided to start isotretinoin treatment, were included. Acne Quality of Life Scale, Beck Depression Inventory (BDI), Beck Suicidal Ideation Scale, and Symptom Check List (SCL-90-R) Psychological Symptom Screening tests were performed and compared before starting treatment and at the 6th month of treatment. Results: In our study, in both the pre-treatment and post-treatment groups, the rate of patients at risk for depression was significantly higher in the group that had severe acne (p<0.05). The scores of psychiatric tests with moderate acne were found to be significantly lower than those with severe acne in all parameters (p<0.05). We have found that somatization, depression, phobic thoughts, and general symptom index scores were significantly higher in women before and after the treatment (p<0.05). Acne treatment was associated with improved quality of life and BDI scores in both male and female patients (p=0.001). SCL-90-R somatization, obsession, depression, sensitivity, anger, and general symptom index scores decreased significantly after the treatment. Conclusion: Our study objectively demonstrated that isotretinoin treatment does not cause depression and psychological symptoms, and even improves depression and psychological symptoms caused by acne and improves the quality of life.

Ergonomic evaluation of the chicken hanger workplace in a bird processing company

Introduction: in the poultry processing industry, activities are developed that require the performance of multiple repetitive tasks, generally while standing upright; which increases the risk of developing musculoskeletal disorders in the upper extremities and lower back. These risk factors include: repetitive movements, forced postures, awkward and static postures, vibration and high and low temperatures. Affecting body segments such as neck, shoulders and back. Aim: To ergonomically evaluate the work station: "chicken hanger" of a poultry processing company, in the state of Aragua-Venezuela, during the year 2022. Methods: Quantitative, descriptive, non-experimental, field and cross-sectional research. The population and census sample is constituted by eight (8) workers. In the collection of information, the interview was applied to obtain sociodemographic and labor data, in the description of the work position the documented observation technique was used and for the determination of musculoskeletal discomfort the body schema of pain and the Check List OCRA method were used. Result: the entire population is male, right-handed, average age 33 ±2.67, normal weight, average seniority 4 years ±2.36, with pain at the end of the workday in the shoulder, lower back, upper back and knees. Their Ocra Index was high on the right side and medium on the left side. Conclusion: in the job "chicken hanger" there is a high risk of suffering musculoskeletal disorders in the upper limbs, with greater relevance in the right upper limb

Persisting high rates of omissions during anesthesia induction are decreased by utilization of a pre- & post-induction checklist

IntroductionAlthough Checklists (CL) for routine anesthesia cases have demonstrated their values in various studies, they have found little traction so far. While several reports have shown the benefit of CL preventing omissions prior to anesthesia induction, no investigation yet has scrutinized omissions during the post-induction phase immediately after intubation. This study evaluated the rate of omissions prior to and following the induction of non-emergent general anesthesia, as well as the impact of checklists on omission prevention. MethodsWe performed a monocentric, prospective, observational study during induction of general anesthesia cases. We evaluated the omission rate made for the pre- as well as the immediate post-induction phase and determined the impact of pre-and post-induction CL on the rate of omission corrections. The CL used were introduced two years prior to the study. The observed providers were limited to those familiar with the institutional CL. Usage of CL was not mandated. Results237 general anesthesia inductions were included in the observation. At least one omission in 32% of all cases in the pre-induction setup was found and in 40% within the immediate post-induction phases. CL significantly reduced omission rates (relative risk = 0.64, 95% CI = 0.45−0.92, p = 0.01). ConclusionOmission rates during the pre- and post-induction phases of routine general anesthesia procedures remain high. Pre- and post-induction CL have the potential to increase patient safety and should be considered for routine anesthesia with appropriate training provided.

TEACHING SPEAKING USING VOICE NOTE TO SECOND SEMESTER STUDENTS-2021A OF STKIP PGRI SIDOARJO

The aims of the study were to describe the implementation of teaching speaking by using Voice Notes; and to describe the student’s perceptions in teaching speaking using Voice Notes for second semester students at STKIP PGRI Sidoarjo. The method used descriptive qualitative. The subjects of this study were the lecturer and the 25 students second semester. The instruments were used Observation Check List, Handphone and Questionnaires. The findings of the implementation of teaching speaking by using Voice Notes for second semester students at STKIP PGRI Sidoarjo were first, Lecturer, distributed text and Voice Note to students thru Voice Note in WhatsApp, then explained to students about text of “A Tour Guide in the Everglades National Park”. Lecturer asked to translate all the text on the home work book, then asked the students to shadow and to follow the native speaker’s voice from Voice Note many times, until comprehended. Lecturer evaluated students’ speaking ability, the results were 32% students who got excellent scores, 52% students who got good scores, one student got average score 8% and students who got poor score 12%. While, the students’ perception results were 78,8% liked the implementation of teaching using Voice Note on the other hand 21,2% didn’t like the implementation of teaching using voice note.

Heterogeneous impacts of the spot check‐list program in US crop insurance: A disaggregated analysis at the crop level

AbstractThis article examines the heterogeneous impacts of the “Spot Check List” (SCL) on producer claims filing behavior across five major crops. Our proposed empirical approach takes into account all the salient data features, namely, state dependence, nonnegativeness of the dependent variable, two‐way fixed effects, observed heterogeneity, as well as potentially endogenous control variables. Our results show that the SCL program is effective in reducing the amount of claims filed by producers of corn, soybeans, and cotton, but there is no evidence that it has a statistically significant impact on producers of wheat and tobacco.

Covidophobia: Psychiatric and addict ION impacts in patients in the psychiatry department of Toamasina Madagascar University Hospital

Introduction: The Covid-19 pandemic changes radically the modalities of care for almost worldwide hospitals, such as in the Psychiatry Department of the University Hospital of Analankininina Toamasina Madagascar. Phone exchanges reduced the transferal dimension of care approach, which is so important for patients treated in Psychiatric Department. The objective of this study is to describe the psychiatric and addictological impacts of the pandemic in patients in the Psychiatry Department Hospital of Toamasina Madagascar. Methods: This is a single-center descriptive prospective study conducted in the Psychiatric Département of Analankinina Toamasina University Hospital, which is the only hospital reference for mental disorders in the eastern region of Madagascar. The population studied were made up of outpatients and those hospitalized from September 01st to October 31st, 2021, more specifically, after the first pandemic of Covid-19 infection and after the first Lock-down period. Were included patients having or not a Covid-19 infection and who presented psychological disorders, a depressive mood, anxiety disorders, obsessive-compulsive disorders or a delusional state, with or without psychiatric and addiction past. Were excluded patients whose authorizatipn was not obtained. Questionnaires translated into the local dialect were used. Results: Thirty patient cases were included with Male-Female equitability. The average age was 42 years old. The study showed the predominance of psychiatric disorders in low-income patients (56.66%), who had mainly moderate forms of Covid-19 infection (66.67%). The majority of them (93.33%) presented significant psychological disorders according to the Mental Health Inventory-5 (MHI-5) Scale. Depression mood was found in 26.67% of cases according to the Hospital Anxiety and Depression Scale. A significant proportion of patients (90%) presented pathologic anxiety according to the same scale. Post-Traumatic Stress Disorder was observed in 46.66% of patients, according to the PTD Check List DSM5 (PCL-5) Scale. An increase of alcohol and cigarettes addiction and heroin withdrawal precisely due to financial problems have been noticed. Conclusion: Despite health restrictions due to spread of Covid-19 infections, contact and touch should always be at the heart of medical practice because according to traditional Malagasy belief, touch is synonymous of healing.

Adolescents with Neuropsychiatric Disorders during the COVID-19 Pandemic: Focus on Emotional Well-Being and Parental Stress.

(1) Introduction: The aim of our research was to explore emotional/behavioral changes in adolescents with neuropsychiatric conditions during the COVID-19 pandemic, and parental stress levels through a standardized assessment, comparing the data collected before and during the first months of lockdown. Moreover, an additional goal was to detect a possible relationship between emotional/behavioural symptoms of adolescents and the stress levels of their parents. (2) Methods: We enrolled 178 Italian adolescents aged between 12-18 that were referred to the Child Neuropsychiatry Unit of the University Hospital of Salerno with different neuropsychiatric diagnoses. Two standardized questionnaires were provided to all parents for the assessment of parental stress (PSI-Parenting Stress Index-Short Form) and the emotional/behavioral problems of their children (Child Behaviour Check List). The data collected from questionnaires administered during the six months preceding the pandemic, as is our usual clinical practice, were compared to those recorded during the pandemic. (3) Results: The statistical comparison of PSI and CBCL scores before/during the pandemic showed a statistically significant increase in all subscales in the total sample. The correlation analysis highlighted a significant positive relationship between Parental Stress and Internalizing/Externalizing symptoms of adolescent patients. Age and gender did not significantly affect CBCL and PSI scores, while the type of diagnosis could affect behavioral symptoms and parental stress. (4) Conclusions: our study suggests that the lockdown and the containment measures adopted during the COVID-19 pandemic could have aggravated the emotional/behavioral symptoms of adolescents with neuropsychiatric disorders and the stress of their parents. Further studies should be conducted in order to monitor the evolution of these aspects over time.

The relationship between negative life events and non-suicidal self-injury (NSSI) among Chinese junior high school students: the mediating role of emotions

BackgroundAdolescent non-suicidal self-injury (NSSI) is common and adolescence is the most common period of first self-injury, and the occurrence of NSSI is influenced by negative life events and emotional symptoms. The mediating role of emotional symptoms in the interaction between negative life events and NSSI has not been carefully investigated yet.MethodsFor middle school students in three schools in a Chinese province, the Adolescents Self-Harm Scale was used to investigate NSSI, the Adolescent Self-Rating Life Events Check List was used to investigate adolescent negative life events, and the Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to assess their emotional symptoms. After the description of general data and the test for differences between groups, the relationship between negative life events, emotional symptoms and NSSI was analyzed using Pearson correlation analysis. Structural equation modeling was used to analyze the mediating role of emotions in negative life events and NSSI.ResultsA total of 2376 junior high school students completed this survey, which revealed an annual NSSI prevalence of 37.1% (n = 881) and a higher prevalence of NSSI among girls and rural adolescents. Among adolescents who developed NSSI, 67.4% (N = 594) used multiple means of self-injury. The most common means of self-injury was hair pulling (51.0%), and the most common NSSI purpose and external factors/events were venting bad emotions or feelings (57.5%) and poor academic performance (44.9%), respectively. Negative life events, emotional symptoms and NSSI were positively associated (P < 0.05). Structural equation modeling with negative life events, emotional symptoms and NSSI as variables showed that the model-fit index matched the data well, with RMSEA = 0.073, AGFI = 0.945, GFI = 0.980, CFI = 0.985, NFI = 0.982, TLI = 0.968, IFI = 0.985, and negative life events, emotional symptoms (anxiety, depression) and NSSI all had direct effects with standardized path coefficients of 0.16, 0.19, and 0.23, respectively, with negative life events playing an indirect role in NSSI through emotional symptoms and emotional symptoms playing an incomplete mediating role in negative life events and NSSI.ConclusionThe prevalence of NSSI was higher among Chinese junior high school students. Both negative life events and emotional symptoms were direct risk factors for NSSI. In addition, negative life events were also indirect risk factors for NSSI, and emotional symptoms played an incomplete mediating role in the relationship between the effects of negative life events and NSSI. This indicates that the combination of reducing the frequency of negative life events while maintaining individual emotional stability during adolescent development can effectively reduce the prevalence of NSSI in adolescents.

Check list Hypogonadism. Part 2: Diagnostic procedure and therapy

Check list Hypogonadism. Part 2: Diagnostic procedure and therapy

Child internalizing and externalizing behaviors: Interplay between maternal depressive symptoms and child inhibitory control.

Maternal depression is a risk factor for child internalizing and externalizing behaviors. Aiming to investigate the moderating role of child inhibitory control on this relationship, we invited a sub-sample of dyads from the Norwegian Mother, Father, and Child Cohort study (MoBa) for a lab-based assessment (N=92, M age=68months, Range=59-80, 50% girls). Maternal depression was assessed using the Beck Depression Inventory (BDI-II), while child behaviors were measured using the Child Behavior Check List, and inhibitory control using a child friendly version of the Flanker-task. As expected, higher levels of concurrent maternal depressive symptoms predicted higher levels of child internalizing and externalizing behaviors. Importantly, and in line with our predictions, child inhibitory control moderated the association. Lower levels of inhibitory control predicted a stronger association between concurrent maternal depressive symptoms and child behavioral outcomes. The results support prior research suggesting that concurrent maternal depression poses a risk for child development, and highlight that children with lower levels of inhibitory control are more vulnerable to negative environmental influences. These findings contribute to our understanding of the complexity of parental mental health issues on child development and suggest avenues for personalized treatment programs for families and children at risk.

Longitudinal impact of the COVID19 pandemic on mental health in a general population sample in France: Evidence from the COMET Study

BackgroundTo study the longitudinal impact of co-occurring mental health problems, and to identify vulnerable groups in need of mental health support during the COVID-19 pandemic. MethodsAnalyses were based on data from 681 French participants in the international COVID-19 Mental Health Study, collected at four times (05/2020–04/2021). Symptoms of depression, anxiety and post-traumatic stress disorder (PTSD) were assessed using the Patient Health Questionnaire 9, the Generalized Anxiety Disorder-7 and the PTSD Check List for DSM-5. We performed k-means for longitudinal data to build trajectories of adults' depression, anxiety and PTSD symptoms and identify subgroups psychologically vulnerable. We then assessed whether mental health trajectories were predicted by lockdown regulations. ResultsA high and a low cluster of mental health scores were identified. In both groups, mental health scores varied significantly across time. Levels of all mental health scores were lowest when COVID-19-related restrictions were lifted and highest when restrictions were in place, except for PTSD. No scores returned to the previous level or the initial level of mental health (p < 0.05).Participants with high levels of symptoms were characterized by younger age (OR: 0.98, 95 % CI: 0.97–0.99), prior history of mental disorders (OR: 3.46, 95 % CI: 2.07–5.82), experience of domestic violence (OR: 10.54, 95 % CI: 1.54–20.68) and medical issues (OR: 2.16, 95 % CI: 1.14–4.03). LimitationsPre-pandemic data were not available and the sample was recruited mainly by snowball sampling. ConclusionThis study revealed subtle differences in the evolution of symptom trajectories during the first year of the Covid-19 pandemic, and highlighted several characteristics associated with the two clusters.

Intervention in professional dance students to increase mental health- and nutrition literacy: A controlled trial with follow up.

IntroductionThere is a need to change the culture within the art of dance, as it has been associated with injuries and mental health consequences. This study evaluates an intervention designed to increase mental health literacy, enhance nutritional knowledge, reduce symptoms and effects of low energy availability, and strengthen understanding of sports nutrition and recovery strategies, in dance students of mixed genders.Material and methodsA total of 125 dance students received three workshops, with 39 arts and crafts students serving as references. The results were evaluated by the Eating Disorder Examination questionnaire, the Low Energy Availability in Females questionnaire, the Hopkins Symptom Check List, and questions on mental health literacy, sports nutrition, and recovery knowledge.ResultsDance students achieved sustained improvements in mental health and nutrition knowledge and temporary improvements in driven exercise (i.e., performing exercise because of a compulsive drive). No other benefits were identified from the intervention.ConclusionOur findings indicate the need for an ongoing education program to reduce the occurrence and development of negative mental health outcomes and low energy availability in professional dance students. Such approaches may not only improve the mental health of dance students but also potentially prevent the high frequency of injuries.

Effectiveness of time-limited eye movement desensitization reprocessing therapy for parents of children with a rare life-limiting illness: a randomized clinical trial

BackgroundParents of children with a rare progressive life-limiting illness are at risk for parental posttraumatic stress disorder (PTSD). Studies on the treatment of parental PTSD with eye movement and desensitization reprocessing (EMDR) therapy in pediatric practice are lacking. Therefore this study aims to evaluate the feasibility and effectiveness of time-limited EMDR therapy in reducing PTSD symptoms, comorbid psychological symptoms, distress, and parental stress.MethodsMono-center randomized clinical trial conducted between February 2020 and April 2021. Fourteen parents (N = 7 mothers, N = 7 fathers) of mucopolysaccharidosis type III patients reporting PTSD symptoms on a (sub)clinical level were assigned to EMDR or a wait-list control condition followed by EMDR. Four sessions of EMDR (each 90 min) divided over two half-days were offered. Measurements were conducted at baseline, post-treatment/post-waitlist, and 3-months post-treatment. The primary outcome was PTSD symptom severity (PTSD Check List for DSM-5). Secondary outcomes included comorbid psychological symptoms (Brief Symptom Inventory), distress (Distress Thermometer for Parents) and parenting stress (Parenting Stress Questionnaire). Between-group comparisons pre-to-post treatment (N = 7 EMDR vs. N = 7 wait-list) and within-group comparisons (EMDR, N = 14) from pre-to-post treatment and from pre-treatment to 3-months follow-up were carried out per intent-to-treat linear mixed model analyses.ResultsCompared to wait-list, EMDR resulted in a significant reduction on total PTSD symptom severity (d = 1.78) and on comorbid psychological symptoms, distress and parenting stress (d = .63–1.83). Within-group comparisons showed a significant effect on all outcomes at post-treatment (d = 1.04–2.21) and at 3-months follow-up (d = .96–2.30) compared to baseline. EMDR was well-tolerated, associated with a low drop-out rate, a high therapy adherence and no adverse events.ConclusionTime-limited EMDR reduces PTSD symptoms, psychological comorbidity, distress and parenting stress in parents of children with a rare progressive life-limiting illness. This treatment was feasible for these overburdened parents. Recurrent monitoring of PTSD symptoms, and, if needed, offering this time-limited type of trauma treatment should be introduced in everyday pediatric practice.Trial registration Netherlands Trial Register, NL8496. Registered 01-04-2020, https://trialsearch.who.int/Trial2.aspx?TrialID=NL8496.

Prevalence and Characteristics of Frailty at 6 months FollOwing Total Hip and Knee Arthroplasty in Patients With End-Stage OA.

IntroductionLower-limb osteoarthritis (OA) in the elderly can be a risk factor for frailty, which is the preliminary of disability, but it may be reversible with appropriate interventions. We aimed to use the Kihon Check List (KCL) to assess multiple domains of frailty and to identify the characteristics of frailty in patients with hip or knee OA following total joint arthroplasty.Materials and MethodsThis study included 136 ≥ 65-year-old patients (mean age: 73.0 years) who underwent total arthroplasty with end-stage hip and knee OA. We assessed frailty status, instrumental activities of daily living (IADL), and health-related quality of life (HRQoL) according to the KCL, functional ambulatory index (FAI) and EuroQol-5 Dimension (EQ5D), respectively, as well as the extent of pain preoperatively and at postoperative 6 months.ResultsUsing KCL, seventy-eight (57.4%) patients were frail preoperatively, but the prevalence significantly decreased to 52 patients (38.2%) at postoperative 6 months. Total arthroplasty intervention provided significant improvements in the total KCL scores, including the physical domain (P < .01), pain (P < .01), FAI scores (P < .01), and EQ5D (P < .01), but not the social domain. Multivariate logistic regression analysis identified age at surgery (OR: .93, 95% CI: .86-.99) and preoperative FAI score (OR: 1.10, 95% CI: 1.03-1.19) as independent predictors of postoperative frailty.ConclusionsTotal arthroplasty procedures on patients with hip and knee OA reduced their KCL score, but social aspects were less improved than physical aspects in the shortterm. Older age and preoperative lower IADL score can be useful for accurately estimating less improvement of frailty in the early postoperative phase. Our results suggest that long term follow-up of OA is needed to provide comprehensive interventions, including in social aspects, especially for patients with lower activity.

A randomized controlled trial of Goal Management Training for executive functioning in schizophrenia spectrum disorders or psychosis risk syndromes

BackgroundExecutive functioning is essential to daily life and severely impaired in schizophrenia and psychosis risk syndromes. Goal Management Training (GMT) is a theoretically founded, empirically supported, metacognitive strategy training program designed to improve executive functioning.MethodsA randomized controlled parallel group trial compared GMT with treatment as usual among 81 participants (GMT, n = 39 versus Wait List Controls, n = 42) recruited from an early intervention for psychosis setting. Computer generated random allocation was performed by someone independent from the study team and raters post-intervention were unaware of allocation. The primary objective was to assess the impact of GMT administered in small groups for 5 weeks on executive functioning. The secondary objective was to explore the potential of the intervention in influencing daily life functioning and clinical symptoms.ResultsGMT improved self-reported executive functioning, measured with the Behavior Rating Inventory of Executive Function – Adult version (BRIEF-A), significantly more than treatment as usual. A linear mixed model for repeated measures, including all partial data according to the principle of intention to treat, showed a significant group x time interaction effect assessed immediately after intervention (post-test) and 6 months after intervention (follow-up), F = 8.40, p .005, r .37. Improvement occurred in both groups in objective executive functioning as measured by neuropsychological tests, functional capacity, daily life functioning and symptoms of psychosis rated by clinicians. Self-reported clinical symptoms measured with the Symptoms Check List (SCL-10) improved significantly more after GMT than after treatment as usual, F = 5.78, p .019, r .29. Two participants withdrew due to strenuous testing and one due to adverse effects.ConclusionsGMT had clinically reliable and lasting effects on subjective executive function. The intervention is a valuable addition to available treatment with considerable gains at low cost.Trial registrationRegistered at clinicaltrials.gov NCT03048695 09/02/2017.

Effects of negative life events on depression in middle school students: The chain-mediating roles of rumination and perceived social support.

BackgroundNegative life events in middle school students have a significant impact on depression. However, the mechanism of this association is not fully understood. This study used rumination and perceived social support as mediating variables to explore the influence of negative life events on depression.Materials and methodsDue to the COVID-19 pandemic and social distancing, a convenient sampling method was adopted to collect information about middle school students in Shandong Province by means of online questionnaire. Adolescent Self-Rating Life Events Check List, Ruminative Responses Scale, Perceived Social Support Scale and Children’s Depression Inventory were used. Descriptive statistics and correlation analysis were conducted for four variables of middle school students, including life events, depression, rumination thinking and perceived social support, and the chain mediated effect was tested by using process plug-in. All statistically analysis was conducted by SPSS 23.0.Results493 middle school students (16.7000 ± 0.9500 years) including 343 female students (69.6000%) from Shandong Province recruited. Results showed that the total effect between life events and depression was significant (effect = 0.2535, 95%CI: 0.2146, 0.2924). The total indirect effect was significant (effect = 0.1700, 95%CI: 0.1349, 0.2072). The indirect effect was significant (effect = 0.0988, 95%CI: 0.0741, 0.1252) with rumination as the mediating variable. The indirect effect of pathway with perceived social support as the mediating variable was significant (effect = 0.0476, 95%CI: 0.0295, 0.0674). The indirect effect of pathway with rumination and perceived social support as mediating variables was also significant (effect = 0.0236, 95%CI: 0.0147, 0.0339).ConclusionThis study indicated that ruminant thinking and perceived social support had a significant chain mediating effect on adolescents’ life events and depression. Life events can not only directly affect depressive emotions, but also indirectly affect depressive emotions by affecting ruminant thinking and perceived social support. The results of this study not only provide new directions for the relationship between life events and depression, but also provide possible approaches for future prevention and intervention of depression in middle school students.

Automated planning stage tracking and analysis through an integrated whiteboard system

Purpose:One of the common challenges in delivering complex healthcare procedures such as radiation oncology is the organization and sharing of information in ways that facilitate workflow and prevent treatment delays. Within the major vendors of Oncology Information Systems (OIS) is a lack of tools and displays to assist in task timing and workflow processes. To address this issue, we developed an electronic whiteboard integrated with a local OIS to track, record, and evaluate time frames associated with clinical radiation oncology treatment planning processes. Methods:We developed software using an R environment hosted on a local web-server at Seattle Cancer Care Alliance (SCCA) in 2017. The planning process was divided into stages, and time-stamped moves between planning stages were recorded automatically via Mosaiq (Elekta, Sweden) Quality Check Lists (QCLs). Whiteboard logs were merged with Mosaiq-extracted diagnostic factors and evaluated for significance. Interventional changes to task time expectations were evaluated for 6 months in 2021 and compared with 6 month periods in 2018 and 2019. Results:Whiteboard/Mosaiq data from the SCCA show that treatment intent, number of prescriptions, and nodal involvement were main factors influencing overall time to plan completion. Contouring and Planning times were improved by 2.6 days (p<10−14) and 2.5 days (p<10−11), respectively. Overall time to plan completion was reduced by 33% (5.1 days; p<10−11). Conclusions:This report establishes the utility of real-time task tracking tools in a radiotherapy planning process. The whiteboard results provide data-driven evidence to add justification for practice change implementations.

Improvement of pain experience and changes in heart rate variability through music-imaginative pain treatment.

Music-imaginative Pain Treatment (MIPT) is a form of music therapy addressing pain experience and affective attitudes toward pain. It includes two self-composed music pieces: one dedicated to the pain experience (pain music, PM) and the other to healing imagination (healing music, HM). Our non-experimental study addresses patients with chronic somatoform pain disorders participating in MIPT. The goal is to gain insight into the direct effect mechanisms of MIPT by combining outcome measures on both the objective physiological and subjective perception levels. The research questions are directed toward changes in pain experience and heart rate variability and their correlations. Thirty-seven hospitalized patients with chronic or somatoform pain disorders receiving MIPT participated in this study. Demographic data and psychometric measures (Symptom Check List SCL90, Childhood Trauma Questionnaire CTQ) were collected to characterize the sample. Subjective pain experience was measured by McGill Pain Questionnaire (SF-MPQ), and Heart Rate Variability by 24 h-ECG. Data analysis shows a reduction of reported pain from MT1 = 19.1 (SD = 7.3) to MT2 = 10.6 (SD = 8.0) in all dimensions of the SF-MPQ. HRV analyses shows a reduced absolute power during PM and HM, while a relative shift in the autonomic system toward higher vagal activity appears during HM. Significant correlations between HRV and MPQ could not be calculated. Findings are interpreted as a physiological correlate to the psychological processes of the patients. Future studies with more participants, a control-group design, and the integration of medium- and long-term effects are recommended.