Clinical Questionnaire Research Articles

Pharmacy Students’ Self-Reported Cultural Competence in a Pharmacy Curriculum by Academic Year

ObjectiveThis study aims to explore results of a Cultural Competency Assessment of Pharmacy Students (CCAPS) survey to identify areas where cultural competence content in one college of pharmacy curriculum can be improved. MethodsThe 39-item CCAPS survey was developed and administered to Doctor of Pharmacy (PharmD) students from July 2022 (after the end of the didactic curriculum and at the beginning of experiential rotations for fourth-year students) through October 2022 (at the beginning of the Fall semester for first-year, second-year, and third-year students). Self-perception of cultural competency items were selected from the Cultural Competence Assessment Instrument and the Clinical Cultural Competency Questionnaire items. Responses were collected anonymously and analyzed in the aggregate by academic year using SPSS. ResultsFive hundred forty-one students participated, with ethnicities including White/European American (26.6%), East/South/Southeast Asian (17%, 18.5%, 5.4%), Arab/Middle Eastern (17.9%), African-American/Black (6.7%), and Hispanic (6.1%). Two-thirds of respondents identified as “very or extremely” culturally competent, and 78% reported comfort interacting with culturally diverse patients. Students scored lower on questions that assessed their comfort interacting with patients who have limited English proficiency or who refuse medications due to cultural reasons. Students in fourth year reported more difficulty practicing skills related to cultural competency in their daily life compared to students in other years. ConclusionUsing the CCAPS survey annually could help evaluate the cultural competency of pharmacy students across different academic years and identify gaps in the curriculum related to cultural competency.

The long-term functional outcome of the mangled upper extremity intricate management. A single center experience

PurposeSevere injury of multiple anatomical structures of the upper extremity can be caused by an extremely violent mechanism during labor and motor vehicle accidents, gunshots and explosions. The mangled upper extremity consists of trauma of at least 3 of 4 tissue types: connective tissue (skin, subcutaneous tissue, tendons, muscles), vessels, nerves, and bones. The purpose of this study is to evaluate the medium and long-term results of the limb salvage management of those injuries in our department. MethodsSixty-seven patients with multi-injured upper limb were operated in our department between 2014 and 2022 and evaluated with clinical examination and questionnaires (PROMs) on an outpatient basis at a mean follow up of 7.4 years. Patients’ demographics, the injured anatomic structures and the surgical interventions needed, were recorded. ResultsThe overall outcome, configured by functional scores was quite acceptable concerning injuries’ severity. Nineteen patients (29 %) underwent more than one operation, 2-point discrimination test was impaired in 30 % of the patients who had an injured nerve and total loss of regional sensation was diagnosed in 2 patients. Primary amputation was necessary in 8 % of the patients. ConclusionsEven though the mangled upper extremity refers to a severe injury with often poor postoperative results and high rates of amputations, a thorough evaluation and management by expert hand surgeons is essential for maximizing the possible outcomes.

Association of depression in multiple sclerosis with fatigue, sleep disturbances, disability, and health-related quality of life: Outcomes of a cross-sectional study

IntroductionDepression affect individuals with multiple sclerosis (MS) more frequently compared with the general population. It can worsen the symptoms of MS, influence disability progression, and significantly reduce the quality of life (QoL). MethodWe investigated the prevalence of depressive symptoms in a cohort of 200 patients with MS (76% women) and their association with sleep patterns, fatigue, QoL, demographics, and other clinical characteristics in real-world settings. The study was conducted through clinical evaluations and questionnaires related to depression: Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS); fatigue: Modified Fatigue Impact Scale; sleep quality: Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale; and QoL: Multiple Sclerosis Quality of Life-54 (MSQOL-54). ResultsAccording to the BDI and HDRS, the prevalence of depressive symptoms was 40.5 and 28.27%, respectively. Patients with depressive symptoms exhibited higher disability scores, longer ambulation times, worse cognitive function in the Symbol Digit Modalities Test, and poorer sleep quality. They also had significantly higher fatigue and daytime somnolence scores, as well as lower scores on the MSQOL-54: physical (40.55 vs. 62.3; P<.001) and mental (44.49 vs. 71.89; P<.001) health composites. We demonstrated the correlation between depression and fatigue, as well as their negative impact on QoL in patients with MS. ConclusionThis study underscores the prevalence and impact of depression in MS, emphasizing the importance of routine screening and active management of psychiatric comorbidities in individuals with MS. These findings contribute valuable insights into the complex interplay between mental health, disease variables, and QoL in MS.

The paradoxical impact of periodic limb movements on isolated REM sleep behavior disorder patients.

Recently, the α-synuclein origin and connectome model described two types of Parkinson's disease: "brain-first" and "body-first" subtypes. We aimed to investigate the role of periodic limb movements during sleep (PLMS) in identifying these subtypes starting from a prodromal stage of α-synucleinopathies. 191 patients with isolated REM sleep behavior disorder (iRBD) underwent video-polysomnography (vPSG), questionnaires, clinical interview, and neuropsychological battery. Patients who presented PLMS index (PLMSi) > 15 were compared with patients presenting PLMSi ≤ 15 on clinical questionnaires, vPSG, and neuropsychological domains with age as a covariate. Correlations were performed between PLMSi and vPSG and neuropsychological domains in both groups of iRBD. 48.2% of patients presented PLMSi > 15. iRBD subgroup with PLMSi > 15 performed better than the iRBD subgroup with PLMSi ≤ 15 in the executive function domain. In patients with PLMSi > 15 negative correlations were observed between PLMSi and some neuropsychological domains (memory, language, and executive function). Moreover, this subgroup was older and their PLMSi was positively correlated with wake-after-sleep onset and inversely correlated with total sleep time and sleep efficiency, suggesting a detrimental effect of PLM on sleep also in this cohort. Patients with PLMSi > 15 are characterized by a more preserved cognitive status, despite a more disrupted sleep. PLMSi could be explored in longitudinal studies concerning the "brain-first" and "body-first" model.

Patients With Nonobstructive Coronary Artery Disease and Chest Pain: Impact of Obesity and Depressive Symptoms.

Chest pain (CP) in patients with nonobstructive coronary artery disease is a therapeutic challenge affecting morbidity and mortality. We aimed to identify clinical factors associated with CP in this population, hypothesizing that obesity and depressive symptoms are associated with CP. In 814 patients with angiographically confirmed nonobstructive coronary artery disease, we measured sociodemographic variables, clinical risk factors, medications, and Patient Health Questionnaire 9 scores for depressive symptoms. We assessed CP frequency and prevalence by using all items from the Seattle Angina Questionnaire angina frequency domain to generate an angina frequency composite score. In the overall sample (58.8±11.7 years old, 52.6% female), 42.8% had obesity, and 71.5% had CP, with an angina frequency composite score (SD) score of 76.4 (22.1). Compared with individuals without obesity, individuals with obesity had a higher prevalence (77.6% versus 67%, P<0.001) and more frequent CP (angina frequency composite score, 74.9 [SD, 22.2] versus 78.3 [SD, 21.9], P=0.02). Obesity was independently associated with CP occurrence (odds ratio [OR], 1.7 [95% CI, 1-2.9], P=0.04). Obesity's connection with CP was only in men: men with obesity had more frequent CP (angina frequency composite score, 75.8 [SD, 20.1] versus 82.1 [SD, 19.9], P=0.002) and more prevalent CP (79.5% versus 58.2%, P<0.001) than their counterparts insofar as men with obesity had similar CP to women. Patient Health Questionnaire 9 score (OR, 1.07 [95% CI, 1.01-1.13], P=0.03) was independently associated with CP and partly mediated the association between obesity and CP. Obesity and depressive symptoms were independently associated with CP in individuals with nonobstructive coronary artery disease, particularly in men, and depressive symptoms partly mediated this association.

Специфика психических состояний осужденных женщин, содержащихся в местах лишения свободы с малолетними детьми

Introduction. The aim of the empirical study was to research the mental states of convicted women with young children. The study sample consisted of 153 convicted women with young children serving their sentences in a correctional institution. The study was conducted on the basis of the State Department of the Federal Penitentiary Service of Russia for the Kemerovo Region, the Federal Penitentiary Service of Russia for the Moscow Region, the Federal Penitentiary Service of Russia for the Vladimir Region, the Federal Penitentiary Service of Russia for the Republic of Mordovia. The scientific problem is to study the mental states of convicted women with young children. Research methods and techniques. The following set of methods was used to study mental states: ‘16-factor personality questionnaire - 16 PF’, form C (R. Kettell), “Depression scale” (A. Beck), clinical questionnaire for identification and assessment of neurotic states (K. K. Yakhin, D. M. Mendelevich), methodology for determining the dominant mental state “Dominant state” (L. V. Kulikov), questionnaire for studying the level of aggression (A. Bass and A. Darkey). The results of the conducted research were the identification of mental states of convicted women in prison with young children. It was established that negative mental states (tension, emotional instability, frustration, anxiety, irritation, depression, anxiety) prevail among these women.They are expressed fatigue, hysteria, vegetative disorders, which are manifested in unpleasant or painful somatic sensations. A high level of aggression and hostility has been diagnosed. The revealed negative mental states need timely psychological correction.

Reduced multiscale complexity of daily behavioral dynamics in autism spectrum disorder.

Autism spectrum disorder (ASD) is difficult to diagnose objectively due to its heterogeneous and complex manifestations. This study aimed to objectively characterize the behavioral phenotypes of ASD children by exploring the multiscale behavioral dynamics. We applied behavioral organization (BO) and multiscale sample entropy (MSE) analyses to physical activity data collected from ASD and typically developing children, using wearable monitors in their daily life. We also examined their correlation with auditory startle response measures and clinical questionnaires, including the Social Responsiveness Scale (SRS) and the Strengths and Difficulties Questionnaire (SDQ). A significant decrease in MSE at timescales longer than 6 min was observed in ASD children, suggesting decreased irregularity or unpredictability, potentially linked to repetitive behaviors or stereotyped patterns commonly observed in ASD. Additionally, an increase in MSE positively correlated with prepulse inhibition levels, indicating its relationship with sensorimotor gating. Moreover, the observed significant negative correlation with the total difficulty score of SDQ substantiates MSE's potential as an objective metric for assessing general mental health problems associated with ASD. Multiscale analysis enhances the understanding of ASD's behavioral dynamics, providing valuable metrics for real-world assessments.

Biopsychosocial factors affected by muscle dysmorphia: to what extent do clinical assessment questionnaires cover them?

Background: muscle dysmorphia (MD) affects several health-related aspects. Assessing how MD questionnaires cover biopsychosocial domains helps clinicians to better describe health status and set treatment goals. Aim: to identify clinical questionnaires for MD and link their content with the International Classification of Functioning, Disability and Health (ICF). Methods: a literature review identified MD questionnaires. The instruments’ items were linked to the ICF. Results: four questionnaires were identified: ACQ, MASS, MDDI and MDI. Forty-four significant concepts were identified from the seventy-two questionnaire items and linked to twenty-six ICF categories, with predominance of body functions (42,4%, n = 11 categories), activities and participation (34,6%, n = 9), environmental factors (19,2%, n = 5), and body structures (3,8%, n = 1). Conclusion: All instruments focused on body functions, and they poorly covered body structures and environmental factors. MASS and ACQ presented the most diverse coverage of categories, enabling broader assessment of health aspects.

The Relationship Between Clinical Education Status and Academic Motivation of Clinical-Stage Medical Students at Gonabad University of Medical Sciences

Introduction: Motivation in education and learning are significant challenges in clinical education. This study aimed to determine the relationship between clinical education status and academic motivation among clinical-stage medical students Gonabad University of Medical Sciences. Method: This cross-sectional study was conducted with 198 medical interns and residents at Gonabad University of Medical Sciences during the academic year 2021-2022 using a census method. Data collection tools included the Clinical Education Status Questionnaire and the Harter Academic Motivation Questionnaire. Descriptive statistics (mean and standard deviation) were used to describe the participants' status, and data were analyzed using independent t-tests, Pearson, and Spearman correlation tests. Results: The mean score for clinical education status among interns was 51.93 ± 16.56, while for residents, it was 12.93 ± 08.12. The mean score for academic motivation among interns was 102.07 ± 11.30, and for residents, it was 100.07 ± 11.54. Overall, the clinical education status averaged 93.31, indicating a relatively moderate level and Academic motivation averaged 101.05 ± 11.44, indicating a high level, with a significant correlation observed between clinical education status and academic motivation (r = 0.454). Conclusion: Given the weakness in the clinical education status, as well as the direct relationship between clinical education status and academic motivation, it is recommended that university officials, particularly in the educational and clinical departments, focus on special attention and planning to improve the clinical education status at the university.

Health literacy of rheumatology patients in three clinics in Australia and its association with sociodemographic and clinical characteristics.

To describe and compare health literacy (HL) using contrasting instruments of Rapid Estimate of Adult Literacy in Medicine (REALM) and the Health Literacy Questionnaire (HLQ) in patients attending three Australian rheumatology clinics and their associations with sociodemographic and clinical characteristics. We conducted a cross-sectional study of rheumatology patients at Liverpool (Sydney) and Canberra public hospital clinics and a private Liverpool clinic using the REALM test and HLQ sociodemographic and clinical questionnaires. One-way analysis of variance and multivariate ordinal and binary logistic regressions were used to examine the association between HL and sociodemographic and clinical factors. A total of 278 people participated (111 Liverpool public, 112 private, 55 Canberra public clinic). Compared with Canberra, Liverpool patients were older, non-native English speakers, had less than a tertiary education and were more likely to have comorbidities. A total of 40% of Liverpool public, 29% of private and 13% of Canberra patients had suboptimal REALM HL scores (P < 0.05). Lower REALM scores were associated with male gender, <10 years of education, being born outside Australia/New Zealand and English as a secondary language, but was not associated with clinical characteristics. All nine HLQ domain scores did not differ across sites despite intergroup comparisons as stratified by REALM bands. Completing 10 years of schooling was associated with better scores in three HLQ scales: 'Navigating the healthcare system' (P = 0.009), 'Ability to find information' (P < 0.001) and 'Reading and understanding information' (P < 0.001). Patient HL as measured by the REALM differed across sites, explained by differences in gender distribution, country of birth, English as the primary language and years of education. HL as measured by the HLQ did not differ across sites and was more informative for understanding differing patient HL needs.

Persistent Psychological Distress and Its Associated Determinants Among Iranian COVID Survivors: A Cross-Sectional Study

Background: The COVID-19 pandemic has resulted in widespread physical and psychological challenges, including persistent psychological distress (PD). Research suggests that while some COVID survivors maintain satisfactory psychological functioning, others may experience long-term, severe PD. Addressing these challenges, along with associated sociodemographic determinants, requires a comprehensive, community-based approach. Objectives: This study aims to determine the prevalence of PD, including depression, anxiety, and stress, among Iranian COVID survivors by analyzing various regional, temporal, and sociodemographic determinants. Methods: The study, conducted between July 2021 and February 2022, aimed to determine persistent PD among Iranian COVID survivors. Ethical approval and other necessary permits were obtained. The final sample size consisted of 300 participants selected from an initial pool of 11,337 medical records. Participants received questionnaires electronically, including the “Socio-Demographic Clinical Questionnaire (SDCQ)” and the “Depression, Anxiety, and Stress Scale 21 (DASS21).” The study used SPSS 26 for statistical analysis, calculating means, standard deviations, and frequencies. Relationships between determinants were examined using ANOVA and chi-square tests. Bayesian regression analysis was employed to explore correlations and predictive power between COVID-19, PD, and the various determinants. Results: The prevalence of depression, anxiety, and stress, considered collectively as PD among participants, was 49%, 53%, and 61%, respectively, with mean severity scores of 10.68 ± 2.16 for depression, 9.18 ± 1.84 for anxiety, and 15.93 ± 2.79 for stress. More severe manifestations of PD were observed in participants from Hospital III (P &gt; 0.05, r ≈ 0.17) and during the temporal period of 12 - 24 weeks post-infection (P &lt; 0.05, r ≈ -0.12). Additionally, significant correlations between PD and determinants such as sex, Intensive Care Unit (ICU) admissions, and intubation were noted (P &lt; 0.05). Bayesian analysis further highlighted cross-correlations between PD and other determinants among Iranian COVID survivors (P &lt; 0.05, BF &lt; 0.1). Conclusions: In conclusion, the study found that Iranian COVID survivors experienced mild levels of depression, anxiety, and stress, with prevalence rates ranging from 49% to 61%. The highest severity of PD was observed in participants from Hospital III and during the period of 12 - 24 weeks post-infection. Additionally, a network of cross-correlations was identified between PD and various other determinants among Iranian COVID survivors.

All-Polyethylene Tibial Component in Unicompartmental Knee Arthroplasty Offers Excellent Survivorship and Clinical Outcomes at Short-Term Follow-Up: A Multicenter Retrospective Clinical Study.

Background and Objectives: The ten-year survivorship of unicompartmental knee arthroplasty (UKA) is up to 96%, varying from implants and hospitals; however, most of registry studies do not distinguish between metal-back (MB) tibial implants and all-polyethylene (AP) tibial implants. The aim of the present retrospective clinical study was to analyze the clinical outcomes and survivorship of medial and lateral UKA with a newly designed all-polyethylene tibial plateau at short-term follow-up. Materials and Methods: A retrospective analysis of prospectively collected consecutive patients who underwent medial or lateral UKA with AP tibial plateau was conducted, with a minimum follow-up of 1 year. Primary outcomes were clinical score (VAS, OKS, and KOOS) variations from baseline up to the latest follow-up. Secondary outcomes were Likert scale variations from baseline to the follow-up, evaluation of the influence of demographic factors (age and BMI) at the time of surgery on the clinical outcomes, and evaluation of revision rate up to the last follow-up. Results: The final study population included 99 knees. The mean VAS score for the medial group significantly decreased from 7.61 ± 1.65 (pre-intervention) to 2.74 ± 2.26 (post-intervention). Similar improvements were registered for the OKS as well, for both the medial group (from 22.5 ± 12.6 to 36.6 ± 10.6, with a delta of 14.11 (10.05 to 18.17)) and the lateral group (from 22.6 ± 12.6 to 36.9 ± 11.8, with a delta of 14.24 (8.65 to 19.83)). Moreover, all the KOOS subscales reported an amelioration, both in medial UKA and lateral UKA. Furthermore, a logistic regression of delta VAS was performed in relation to the other clinical questionnaires and the demographic factors. For both medial and lateral UKAs, no statistically significant correlation was found between the VAS scale regression and the demographic factors. The survival rate free from any revision of the cohort at the latest follow-up was 96.32%. Conclusions: All-polyethylene tibial component in unicompartmental knee arthroplasty demonstrates significant improvements in clinical scores and a low failure rate at short-term follow-up.

Vision loss and diabetic retinopathy prevalence and risk among a cohort of Indigenous and non-Indigenous Australians with type 2 diabetes receiving renal haemodialysis treatment: The retinopathy in people currently on renal dialysis (RiPCORD) study

AimsDiabetic nephropathy, vision loss and diabetic retinopathy (DR) are frequent comorbidities among individuals with type 2 diabetes (T2D). The Retinopathy in People Currently On Renal Dialysis (RiPCORD) study sought to examine the epidemiology and risk of vision impairment (VI) and DR among a cohort of Indigenous and non-Indigenous Australians with T2D currently receiving haemodialysis for end-stage renal failure (ESRF). MethodsA total of 106 Indigenous and 109 non-Indigenous Australians were recruited in RiPCORD across five haemodialysis centres in urban and remote settings. Clinical assessments, questionnaires and medical record data determined the rates of ocular complications and risk factor profiles. ResultsPrevalence rates include unilateral VI, 23.5 %; bilateral VI, 11.7 %; unilateral blindness, 14.2 %; and bilateral blindness, 3.7 %, with no significant differences between sub-cohorts (p=0.30). DR prevalence rates were 78.0 % among non-Indigenous Australians and 93.1 % among Indigenous Australians (p=<0.001). Non-Indigenous ethnicity (OR: 0.28) and pre-dialysis diastolic blood pressure (OR: 0.84 per 10-mmHg) were protective, while peripheral vascular disease (OR: 2.79) increased DR risk. ConclusionsOcular complications among individuals with T2D and ESRF are disproportionately high, especially for Indigenous Australians, and beyond what can be accounted for by risk factor variation. Findings suggest a need to improve screening and preventative efforts within this high-risk population group.

The Effectiveness of Centella asiatica Extract and Aerobic Exercise on Plasma Levels of Amyloid Beta-42 and Phosphorylated Tau in Older Women with Dementia

Urgency: Effect of Centella asiatica (CA) and aerobic exercise on Amyloid beta-42 (Aβ42) and phosphorylated tau (p-tau) as biomarkers of dementia is not yet known. Objectives: This study aimed to analyze the effect of CA, aerobic exercise, and their combination on Aβ42 and p-tau in older women with dementia. Design: It was a 24-week randomized, double-blind controlled trial. Partisipants: Subjects were divided into four groups: the Centella asiatica group (CA, 1x500 mg/day, n = 16), the aerobic exercise group (AE, 3x60 minutes/week, n = 16), the CA-AE combination group (1x500 mg/day and exercise, n = 15), and the placebo group (n = 15). Instruments: The dementia screening test used the Mini Mental State Examination (Intraclass correlation coefficients : ranging from 0.60 to 0.93, sensitivity of 88.3%) and Clinical Dementia Rating questionnaires (sensitivity 93.6% and specificity 100%). The Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests were used to analyze the data. Results: Plasma amyloid beta-42 showed an increase in all groups: CA (p

Correlations between Social Isolation and Functional Decline in Older Adults after Lower Limb Fractures Using Multimodal Sensors: A Pilot Study

Older adults (OAs) recovering from lower limb fractures experience social isolation (SI) and functional decline (FD) after they are discharged from inpatient rehabilitation due to reduced physical mobility. Our research used MAISON (Multimodal AI-based Sensor platform for Older iNdividuals), a multimodal sensor system comprising various smart devices collecting acceleration, heart rate, step count, frequency of indoor motion, GPS, and sleep metrics. This study aimed to investigate the correlations between SI and FD with multimodal sensor data from OAs following lower limb fractures. Multimodal sensor data from eight OAs (8 weeks per person) living at home were collected. Five clinical metrics were obtained via biweekly video calls, including three clinical questionnaires (Social Isolation Scale (SIS), Oxford Hip Score, Oxford Knee score) and two physical mobility assessments (Timed Up and Go, 30 s chair stand). From the sensor data collected, 53 statistical and domain features were extracted. Spearman correlation coefficients were calculated between the extracted features and clinical data. The results indicated strong correlations between various items of SIS and sleep metrics in OAs and various items of Oxford Knee Score with GPS and acceleration data. Strong correlations between the questions of the Oxford scores and sensor data highlight the direct impact of physical health status on measurable daily physical activities.

Correlation between Respiratory Symptoms Questionnaire and Pulmonary Function Test in Chronic Obstructive Lung Disease Patients: A Tertiary Care Hospital Study

Abstract Objective: This study aimed to investigate the correlation between respiratory symptoms assessed by the Respiratory Symptoms Questionnaire (RSQ) and pulmonary function test (PFT) results in patients diagnosed with chronic obstructive pulmonary disease (COPD) at a tertiary care hospital. Methods: This analytical, cross-sectional study was conducted at Sree Balaji Medical College and Hospital, Chennai, involving 130 COPD patients presenting with symptoms of breathlessness, chronic cough, and wheeze. Data collection instruments used were: (1) RSQ: The RSQ was utilized to assess respiratory symptoms, including breathlessness, cough, and wheeze, (2) PFT: PFT assessments, including spirometry, were performed to measure lung function impairment objectively. Participants completed the RSQ under supervision, followed by PFT assessments conducted by trained respiratory technologists using standardized procedures. Results: Descriptive statistics were computed for demographic variables and questionnaire scores. Pearson correlation analysis was employed to assess the association between respiratory symptoms measured by RSQ and PFT parameters. The Chi-square analysis determined the overall association between symptom scores and PFT results across the COPD severity groups. Significant correlations were observed between severe COPD and St. George’s Respiratory Questionnaire, moderate COPD and Clinical COPD Questionnaire, and moderate-to-severe COPD and COPD Assessment Test (P &lt; 0.05). Nonsignificant correlations were found between mild COPD and symptom scores (P &gt; 0.05). The Chi-square analysis confirmed a strong association between respiratory symptoms and PFT results (P = 0.04). Conclusion: This study highlights the importance of comprehensive symptom assessment alongside the objective measures of lung function in COPD management. Integrating tools such as RSQ with PFTs enables clinicians to obtain a holistic understanding of patients’ disease status and tailor treatment strategies accordingly.

Statistical Analysis for Rating Scale in Clinical Trials.

In psychiatry clinical trials, an instrument or questionnaire with rating scale is often used to access safety and efficacy of a test treatment under investigation. Statistical analysis based on the collected rating scale is then performed a determine whether there is an improvement in endpoint change from baseline mean scale. This approach needs on absolute change, however, may not actually reflect the performance of the test treatment under study because the change, which may be considered of clinically importance, may fall within the same category in terms of disease severity such as mild, moderate, and severe. In this case, it is suggested, in addition to absolute change approach, a categorical shift analysis be considered to determine whether the endpoint change from baseline has resulted in an improvement in categorical shift, in terms of disease severity shift e.g., from severe to mild or moderate. In this article, we explore the relationship between absolute change approach and categorical shift analysis based on rating scales for assessment of test treatment under study.

Comparing the clinical utility of the alternative model for personality disorders to the Section II personality disorder model: A randomized controlled trial.

The alternative model for personality disorders (AMPD) has been extensively studied over the past decade, but to date there is no direct comparison of the clinical utility of the AMPD model relative to the Section II personality disorder (PD) model in an ecologically valid design. The current study examined the clinical utility of an AMPD-informed assessment procedure and Section II PD assessment procedure as assessed by both patients and clinicians in a randomized controlled trial. A sample of 119 patients were randomly assigned to either an AMPD or a Section II PD assessment procedure. At the end of the assessment, patients filled out questionnaires pertaining to clinical utility, satisfaction, motivation for treatment, and general experience of the assessment. Clinicians who subsequently started treatment with these patients also completed two clinical utility questionnaires. There were no significant differences between the AMPD and Section II PD assessment procedure on patients' reported clinical utility, motivation for treatment, satisfaction, and general experience of the assessment nor were there significant differences between the models on clinician reported clinical utility. Explorative analyses revealed that, for patients, a positive relationship with the assessor was predictive of experienced utility. This study shows no superiority of the AMPD in terms of clinical utility but suggests that the alliance with the assessor is a particularly salient factor in clinical utility. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Malocclusion and Deleterious Oral Habits in Vietnamese Children Between the Ages of 8 and 12 years: A Cross Sectional Study

Abstract Aim: This study aimed to determine the relationship between malocclusion and deleterious oral habits in the Vietnamese children aged 8–12 years. Materials and Methods: A cross-sectional descriptive analysis was undertaken on a total of 434 children (8–12 years old, 208 males and 226 females), separated into five age groups: 8 years old (16.8%), 9 years old (18.5%), 10 years old (20.7%), 11 years old (21.4%), and 12 years old (22.6%), with all four first permanent molars erupted, no previous orthodontic treatment, loss of the second primary molar or presence of the second primary molar root or decay, loss of surface material on the second primary molar, and underfilling of the second primary molar size in the mesiodistal direction. The deleterious oral habits and malocclusion were assessed through a clinical examination and questionnaires for parents. The descriptive statistical analysis revealed the following findings: mean and standard deviation. The chi-squared test and Fisher’s exact test were used to compare categorical variables. The data were considered significant at P &lt; 0.05. Result: Deleterious oral habits were found to have a significant relationship with malocclusion. Mouth breathing habits were associated with anterior open bites (P &lt; 0.05). The tongue thrusting habit was associated with anterior open bite (P &lt; 0.05), posterior crossbite (P &lt; 0.01), overbite greater than 4 mm (P &lt; 0.01), and angle class I malocclusion (P &lt; 0.05). Chewing habits on one side were associated with posterior crossbite (P &lt; 0.01) and posterior open bite (P &lt; 0.05). The habit of pen/pencil/nail biting was associated with midline deviation (P &lt; 0.05). As children got older, there was a greater need for orthodontic treatment for dental healthcare, according to the index of orthodontic treatment need. In the 8-year-old patient group, the need was 4.1%; in the 9-year-old patient group, it was 5%; in the 10-year-old patient group, it was 9%; in the 11-year-old patient group, it was 19.4%; and in the 12-year-old patient group, it was 22.4%. The distribution of orthodontic treatment needs for dental health was significantly different based on the number of deleterious oral habits children had (P &lt; 0.01). Conclusion: Abnormal oral habits were prevalent in about 30.6% of the study participants. Mouth breathing, tongue thrusting, pen/pencil/nail biting, and one-side chewing had a significant impact on malocclusion.

Assessing the Conceptualizations of Coping and Resilience in LGBTQ2S+ People with Cancer: Working towards Greater Awareness in Cancer Care.

People with cancer may suffer negative psychosocial outcomes due to the challenges of cancer. LGBTQ2S+ people routinely experience negative psychosocial outcomes in health care settings, but have showcased resilience in the face of discrimination; however, this has never been studied in a cancer context. Thus, this study aims to assess coping and resilience in LGBTQ2S+-identifying people diagnosed with cancer using a strengths-based approach. A qualitative exploratory design was used. Ten self-identified LGBTQ2S+ people who have completed their cancer treatment were recruited. Participants completed clinical, health, and demographic questionnaires and, subsequently, semi-structured qualitative interviews. Conceptualizations of coping and resilience in the semi-structured interviews were analyzed using interpretative phenomenological analysis (IPA). Participants were members of various gender identities and sexual orientations. In addition to identifying needed LGBTQ2S+-specific resources, four narratives emerged: support networks, regaining control in life, conflicting identities, and traditional coping methods. Most participants' cancer journeys were characterized by a 'Second Coming-Out' phenomenon, where LGBTQ2S+ people with cancer use coping strategies, similar to those used when coming out, to produce resilience throughout their cancer journey. This work provides exploratory insight into LGBTQ2S+ people with cancer, but more research is required with a larger sample.