Daily Diary Research Articles

The Bidirectional Relationship Between Sleep and Pain in Crohn’s Disease: A Daily Diary Study

Abstract Background Pain is common in Crohn’s disease (CD) even after endoscopic healing is achieved. Depression, sleep disturbances, fatigue, and worry about pain impact the pain experience. There is a bidirectional relationship between sleep and pain, though it has received minimal attention in CD. Herein, we sought to comprehensively assess this relationship in CD using daily diaries. Method Patients with active symptoms of insomnia and CD were recruited as part of an ongoing clinical trial. Participants completed 14-day diaries on sleep patterns and CD symptoms. Temporal associations between sleep and pain were assessed using cross-lagged path analysis and controlled for age, sex, and menstrual cycle. Results Overall, 26 participants completed 14-day diaries. All assessed aspects of sleep continuity disturbance were associated with worse next-day abdominal pain (Ps < 0.01). When assessed microlongitudinally, sleep onset latency predicted next-day pain (P = 0.07) and vice versa (P = 0.03). Similarly, nightly awakenings predicted next day pain (P = 0.02) and vice versa (P = 0.04). Sleep efficiency (P = 0.003), sleep quality (P < 0.001), and total sleep time (P = 0.04) predicted next-day pain whereas models with pain as the predictor were not significant. Conclusions Sleep continuity and abdominal pain are closely related, with sleep efficiency, total sleep time, and sleep quality potentially driving next-day abdominal pain. As interventions for pain in IBD are limited, it may be important to capitalize on the impact of sleep disturbances on pain to optimize overall wellbeing in people with CD.

Abstract 4136911: Daily Dyadic Symptom Appraisal Dynamics During Care Transitions in Persons with Heart Failure and Their Care Partners

Background: Symptom monitoring after heart failure (HF) hospitalization is a central aspect of patient education. However, appraising symptoms can be difficult for persons with HF (PWHFs), and studies suggest family care partners (CPs) play a key supportive role. The purpose of this study is to examine dyadic HF symptom appraisal dynamics in PWHF-CP dyads during hospital-to-home transitions. Methods: We conducted a daily diary study of dyadic symptom appraisal in which PWHFs and CPs were enrolled during a HF hospitalization. Over 5 weeks, both completed daily assessments of the PWHF’s symptoms (HF Somatic Perception Scale, PROMIS Fatigue 4a). Each dyad’s appraisal dynamics were quantified using a set of N of 1 dyadic autoregressive time series models examining total symptoms, hallmark symptoms (dyspnea, edema) and nonspecific symptoms (early/subtle cluster, fatigue). Models were examined for within-dyad dynamics (within-dyad associations on the same day or on a 1-day lag). Patterns in significant dynamics across dyads were narratively described. Results: This analysis includes n=14 cohabitating dyads, all partnered. On average, PWHFs and CPs were 69.6±5.4 and 67.4±8.0 years of age. The sample was relatively gender balanced (43% of PWHFs and 64% of CPs identified as female), and primarily identified as non-Hispanic (86% of PWHFs, 93% of CPs) and White (93% of PWHFs, 86% of CPs). Most PWHFs had non-ischemic cardiomyopathy (64%) and were NYHA Class III/IV (86%), with 57% HFrEF (mean EF 37%±17%). Symptom appraisals were highly variable within and across dyads (Fig 1). Most (n=11, 79%) had significant dyadic dynamics, but dynamics across dyads varied by symptom type and time structure (Fig 2). Conclusions: The types of symptoms that HF care dyads are able to appraise together and the time structure of appraisals are variable during care transitions. Precision approaches tailored to individual dyads are needed to optimize inclusion of CPs in symptom monitoring interventions.

Associations among negative weight‐related experiences, weight bias internalization, and body‐related self‐conscious emotions in adolescents: A daily diary study

AbstractIntroductionThe present study examined the between‐ and within‐person associations among negative weight‐related experiences, weight bias internalization, and body shame, embarrassment, and pride in adolescents.MethodsParticipants were 93 Canadian students (Mage = 15.54, 59.10% girls, 40.86% white) who completed a 5‐day daily diary study in 2021. Multilevel models were estimated to examine the between‐ and within‐person associations, as well as the cross‐level interactions.ResultsFifty‐nine negative weight‐related experiences were reported from 22 participants (23.66%) over the 5‐day study period. Adolescents with higher average negative weight‐related experiences (OR = 19.60, 95% CI = 1.90–202.67) and weight bias internalization (OR = 3.66, CI = 2.07–6.46) had greater odds of reporting shame. Similarly, higher average negative weight‐related experiences (OR = 16.29, CI = 3.65–72.75) and weight bias internalization (OR = 2.08, CI = 1.53–2.82) was associated with greater odds of embarrassment. No within‐person effects were noted, such that reporting more negative weight‐related experiences or weight bias internalization than one's own average was not related to body emotions.ConclusionsThis distinction underscores that the persistent, rather than episodic, aspects of negative weight‐related experiences and weight bias internalization are most impactful on adolescents’ body image. These findings have implications for recruitment and screening for individual‐level interventions for internalized weight bias and body image, and highlight the need for system‐level policies and changes that prohibit negative weight‐related experiences and messages to reduce likelihood of internalizing weight bias among adolescents.

Coffee consumption and alertness: a study among office workers in Jakarta

BackgroundCoffee is widely consumed by office workers, primarily for its caffeine content, which plays an important role in improving alertness. For white-collar workers, alertness is crucial to maintaining productivity, and one measurable parameter of alertness is reaction time. Changes in reaction time can be classified as either shorter or longer compared to the initial measurement taken before coffee consumption, with a longer reaction indicating a decrease in alertness. The objective of this study is to investigate the relationship between coffee consumption and improvements in alertness.Materials and methodsThis cross-sectional study compared coffee drinkers and non-coffee drinkers, assessing their alertness using the Lakassidaya tool and collecting data on coffee consumption and caffeine intake through a 7-day fluid diary. Alertness was measured in the morning (baseline) and 30 min after coffee consumption (end line). Study participants were office workers from a company in Jakarta, Indonesia.ResultsA total of 121 participants completed the study, with 47.1% (n = 57) of them being coffee drinkers. No significant differences were found in the characteristics of the respondents. The average daily coffee consumption among these workers was 247 (157–391) mL/day, with a caffeine intake of 72 (36–121) mg/day, which was below the minimum amount typically required to trigger a positive alertness reaction. There was no significant association between coffee consumption and alertness (OR = 1.538, 95% CI: 0.288–1.467, p = 0.403), nor was there a significant difference in the change in reaction time between coffee drinkers and non-coffee drinkers (17.3 [1.4–32.2] ms vs. 13.0 [−3.9–26.0] ms, p-value = 0.111). However, there was a trend toward improved alertness in coffee drinkers, as indicated by shorter reaction times at baseline (180 [160–195.2] ms) compared to post-consumption (155 [146.6–170.2] ms).ConclusionThere was no significant association between coffee consumption and alertness improvement between coffee drinkers and non-coffee drinkers among office workers in Jakarta, Indonesia.

Randomised controlled trial of HOYA One-day Multifocal Contact Lenses: – the HOMCL trial

Trial designDouble-masked crossover RCT (Research Registry: #8136) comparison of a new HOYA one-day disposable multifocal contact lens (HOMCL) with Alcon DAILIES TOTAL1® Multifocal (ADT1). MethodsSixty presbyopic participants from three countries attended for baseline measurements and fitting of both lens types and then for a fortnight completed daily diaries of symptoms with habitual optical correction, and VF-14 questionnaire. Participants collected either HOMCL or ADT1, when the vision was measured again, and they wore this product for a fortnight, completing daily diaries and VF-14. Participants then collected the other type and had vision and symptoms recorded in the same way. ResultsThere were no serious adverse events. Primary outcomes were no significant differences between the lens types in willingness to purchase nor stated preference; no significant differences in the daily symptom ratings of comfort; statistically significant findings with the daily symptom ratings and VF-14 of better near vision with HOMCL and better distance vision with ADT1. Secondary outcomes were better high contrast distance visual acuity with ADT1 (<1 line), better low contrast distance visual acuity with ADT1; faster Wilkins rate of reading test with HOMCL; no significant differences in near visual acuity, wearing time, or number of lenses during fitting process. Exploratory analyses were better handling scores with ADT1; and some, but not all of the dry eye data indicating better acceptance of HOMCL by patients with relatively dry eyes. For all measures, there were some participants who preferred/performed better with each lens type. ConclusionsThe differences between the performance of the two products were small. There was a trend in some clinical measurements and the daily diary data and VF-14 questionnaire, for HOMCL to outperform ADT1 for near vision and vice versa for distance vision.

Sleep Bad, Feel Bad: Unpacking the Role of Exercise and Socializing

This study investigates the daily associations between sleep disturbances and emotional well-being, focusing on exercise and social interaction as potential moderating factors. Using a longitudinal daily diary approach, we analyzed data from 455 participants (mean age = 41.98 years, 382 females) who reported daily diaries over 20 days. Multilevel modeling was employed to analyze both within- and between-person relations between sleep variables (duration, efficiency, difficulty falling asleep) and next day positive/negative affect. The analysis also explored the moderating roles of exercise and socializing, adjusting for age, sex, and COVID-related variables. Our findings indicate that at both within- and between-person levels, higher sleep efficiency predicted increased positive affect and reduced negative affect; conversely, difficulty falling asleep predicted diminished positive affect and heightened negative affect. Sleep duration had a nonlinear relationship with positive and negative affect, with both longer and shorter than usual sleep duration predicting less positive and more negative affect. Exercise and socializing showed different moderating roles in the relationship between sleep and negative affect. Exercise was found to mitigate the negative impact of poor sleep on negative affect, whereas extended socializing amplified the salutary impact of good sleep on reducing negative affect. Our findings underscore the importance of sleep health in daily emotional well-being, suggesting associations between sleep efficiency, difficulty falling asleep, and next-day affect at both within- and between-person levels. Furthermore, the distinct moderation patterns of exercise and socializing provide unique insights into the interplay of sleep, exercise, and social interaction, allowing more targeted interventions.

Day-to-day variations and effects of urinary and fecal incontinence among adults with spina bifida: an ecological momentary assessment diary pilot study

BackgroundNo studies have evaluated the day-to-day variations in urinary incontinence (UI) and fecal incontinence (FI) among adults with spina bifida (SB). We aimed to 1) describe variations in UI/FI over 30 days, 2) assess factors associated with the negativity effects of incontinence, and 3) correlate anxiety about incontinence and health-related quality of life (HRQOL) among adults with SB (exploratory). MethodsAdults with SB participated in a larger 30-day smartphone-based ecological momentary assessment (EMA) study of well-being and incontinence. We analyzed baseline demographics, temporal variables (baseline UI/FI, incontinence, and negativity on days prior), and incontinence episode-specific variables (number of daily episodes, incontinence interval, quantity). Urinary and fecal incontinence-related anxiety (UIA/FIA) was measured on a 5-point Likert scale (“How anxious were you because of urine/stool leaks today?”), HRQOL with QUALAS-A (scores range 0-100, 0=lowest HRQOL). Mixed-effects, random intercept ordinal and linear regression was used. ResultsEighty-nine adults participated at a median age of 33 years old (71% female, 53% shunted, 49% community ambulators). Participants contributed 2578 total diary days: 61% were associated with any incontinence (41% UI only, 6% FI only, 13% both). Eighty-two (92%) adults reported UI on a median of 16 days, but experiences varied: 6% had a single episode, while 33% had UI on 28-30 days (Summary Figure). Seventy adults (79%) reported FI on a median of 5 days, less frequently than UI (p<0.001), but experiences varied: 11% had a single FI episode, while 31% had FI on 10 or more days. Fewer participants reported any UIA than FIA (50% vs. 72%, respectively, p<0.001). On multivariate regression, (1) higher UIA was reported by individuals with higher baseline UIA, higher UIA on days prior, multiple daily episodes and higher UI quantity (p<=0.02), while (2) higher FIA was reported by those with lower baseline HRQOL, fewer FI episodes on days prior, higher FIA on days prior, and higher UI quantity (p<=0.02). FIA was correlated with lower end-of-study HRQOL (p=0.03). DiscussionInstances of incontinence are not uniform experiences. Their effects vary with factors beyond the actual episode. This suggests novel potential points of intervention to improving long-term HRQOL among people with incontinence. ConclusionDay-to-day experiences of UI and FI vary among adults with SB across multiple dimensions. Anxiety about incontinence when it occurs varies not only based on individual- and episode-specific characteristics, but also on incontinence in the preceding days. Operationalizing these insights into potential clinical interventions warrants further investigation.

Effects of E-Cigarettes on Combustible Cigarette Smoking Among Adults with Opioid Use Disorder on Buprenorphine: Single Arm ERASER Pilot Trial.

People with opioid use disorder (OUD) on buprenorphine smoke at high rates and have low cessation rates, even with evidence-based medications. Electronic cigarettes (EC) are a promising harm reduction strategy for combusted cigarette (CC) smokers unable to quit. Unfortunately, people with OUD are underrepresented in EC research. A pilot study assessed the feasibility, acceptability, and preliminary effectiveness of EC as a harm reduction tool among CC smokers with OUD on buprenorphine (N=30). Participants were provided with an EC and freebase nicotine liquid (6mg/mL) with a choice of flavor, and a brief training session. Research visits were scheduled in-person at baseline, week 4, and week 8 (follow-up). Daily diary assessments were completed during the 4-week EC period. Most visits (>74%) and 61.4% of daily diary assessments were completed. During the 4-week study period, 90% of participants used the EC at least one day, 66.7% used the EC for at least 16 days, and 43.3% used the EC every day. Significant reductions were observed between baseline and both weeks 4 and 8 in cigarettes smoked per day (CPDbaseline=16.2(8.3), CPDweek4=9.6(9.3), CPDweek8=8.4(8.3)) carbon monoxide (CO) levels (CObaseline=21.5(15.0), COweek4=16.9(9.6), COweek8=15.7(10.0)), and nicotine dependence measured using the Fagerström Test for Nicotine Dependence (FTNDbaseline=5.4(2.5), FTNDweek4=4.2(2.6), FTNDweek8=4.4(2.6))), with all p-values<.05. Implementing an EC protocol in outpatient maintenance treatment programs is feasible and acceptable. Preliminary results suggest that ECs may facilitate reductions in CPD, CO levels, and nicotine dependence. Future research should explore the effect of prolonged EC use on harm reduction and cessation milestones. EC are a potentially promising harm reduction strategy for adult CC smokers with OUD on buprenorphine who are unable to quit using evidence-based medications. However, previous studies have largely overlooked people with OUD on buprenorphine with recent drug use. This study addresses this gap through a pilot trial investigating the feasibility, acceptability, and preliminary effects of EC on CC behavior. The brief and standardized nature of the protocol and its implementation in outpatient settings highlights its potential for widespread implementation in facilities providing care to people with OUD on buprenorphine.

Parent and Peer Racial-Ethnic Socialization Facilitates Psychological Well-Being Via Proactive Coping: A Daily Diary Study

ObjectiveThe aim of this study was to assess the promotive and protective effects of parental and peer racial-ethnic socialization (RES) on adolescents’ psychological well-being in the context of racial-ethnic discrimination. We hypothesized that RES would buffer the pernicious effects of discrimination on well-being by promoting more proactive coping (problem-solving, seeking social support) and less avoidant coping responses. MethodParticipants were a nationally representative sample of 371 ethnoracially minoritized adolescents who were recruited through a research survey panel (51.75% assigned female sex at birth; 46.90% Black, 24.80% Latine, 20.22% Asian/Asian American; Mage= 14.47 years, SDage= 1.46, age-range= 10-19 years). Participants completed daily surveys of exposure to racial-ethnic discrimination, RES, coping, and psychological well-being across 30 days. ResultsResults indicated parental cultural socialization promoted more positive next-day well-being via increased problem-solving coping (B=0.01, SE=0.01, p<.05). The same pattern of findings emerged when examining cultural socialization messages from peers (B=0.02, SE=0.01, p<.01) and preparation for bias messages from parents (B=0.02, SE=0.01, p<.01). RES significantly moderated the effects of racial-ethnic discrimination on avoidance coping. ConclusionFindings suggest that RES from parents and peers may promote more positive psychological well-being in adolescents by facilitating proactive coping processes on days when they experience racial-ethnic discrimination. Overall, the study points to the need for continued efforts to develop, test, and disseminate evidence-based approaches to strengthening RES competency, as doing so may be a critical avenue for cultivating resilience among ethnoracially minoritized youth.

Accumulated seizure burden predicts neurodevelopmental outcome at 36 months of age in patients with tuberous sclerosis complex.

Epilepsy and intellectual disability are common in tuberous sclerosis complex (TSC). Although early life seizures and intellectual disability are known to be correlated in TSC, the differential effects of age at seizure onset and accumulated seizure burden on development remain unclear. Daily seizure diaries, serial neurodevelopmental testing, and brain magnetic resonance imaging were analyzed for 129 TSC patients followed from 0 to 36 months. We used machine learning to identify subgroups of patients based on neurodevelopmental test scores at 36 months of age and assessed the stability of those subgroups at 12 months. We tested the ability of candidate biomarkers to predict 36-month neurodevelopmental subgroup using univariable and multivariable logistic regression. Candidate biomarkers included age at seizure onset, accumulated seizure burden, tuber volume, sex, and earlier neurodevelopmental test scores. Patients clustered into two neurodevelopmental subgroups at 36 months of age, higher and lower scoring. Subgroup was mostly (75%) the same at 12 months. Significant univariable effects on subgroup were seen only for accumulated seizure burden (largest effect), earlier test scores, and tuber volume. Neither age at seizure onset nor sex significantly distinguished 36-month subgroups, although for girls but not boys there was a significant effect of age at seizure onset. In the multivariable model, accumulated seizure burden and earlier test scores together predicted 36-month neurodevelopmental group with 82% accuracy and an area under the curve of .86. These results untangle the contributions of age at seizure onset and accumulated seizure burden to neurodevelopmental outcomes in young children with TSC. Accumulated seizure burden, rather than the age at seizure onset, most accurately predicts neurodevelopmental outcome at 36 months of age. These results emphasize the need to manage seizures aggressively during the first 3 years of life for patients with TSC, not only to promote seizure control but to optimize cognitive function.

Using Geographic Momentary Assessment to Explore Spatial Environment Influences on Wellbeing in People With HIV.

Place-based socio-economic and racial inequities contribute to health disparities among people with HIV (PWH). We used geographic ecological momentary assessment (GEMA) methodologies to explore the interplay between psychosocial outcomes in daily diaries and community spatial measures among PWH in New Orleans. PWH (N = 69) were recruited from a clinic-based cohort study. Micro-longitudinal data were collected via smartphone-based daily diaries and geospatial tracking over 14 days. First, correlations were run between diary derived outcomes (e.g., feeling safe in current location, stress), and spatial measures (e.g., violent crime, alcohol outlets, and vacant lots) within a half-mile buffer around each diary point to understand the real time associations between mood and space. Next, we fit multilevel models, controlling for between-person effects, to assess within-person associations between accumulative spatial daily violence exposure (50m, 100m and 200m buffers), and measures of daily mood and coping. Violent crime, alcohol outlets and vacant lots were inversely correlated with feeling safe and positively correlated with perceived ease of obtaining drugs. Vacant lots were positively associated with stress and inversely correlated with positive mood. Within individuals, higher daily accumulated violence exposure was associated with increased rumination at the 50m buffer level, decreased trust in oneself and others at the 100m buffer, and decreased ratio of positive/negative mood at all buffers. Our results emphasize the intricate interplay between mental wellness, coping mechanisms, and spatial measures in PWH. Future research and interventions for PWH should consider how spatial factors may influence PWH in terms of mental health and care engagement.

Development of the celiac disease symptom diary version 2.1© (CDSD 2.1©) patient-reported outcome measure.

For patients with celiac disease (CeD), the only current management option is adherence to a strict gluten-free diet (GFD); however, many patients on a GFD continue to experience symptoms with asignificant impact on quality of life. Potential new treatments for CeD are under development and a validated patient-reported outcome measure is required to evaluate their utility in clinical trials. The purpose of this article is to provide a history of the development of the Celiac Disease Symptom Diary (CDSD) 2.1© for use in clinical trials. Qualitative and quantitative studies were conducted from 2010 to 2021, including concept elicitation and cognitive debriefing interviews with adult and adolescent participants with CeD (N = 93) diagnosed via biopsy and/or serology and input from eight interviews with CeD clinical experts. During these studies, different iterations of the CDSD were presented to the US Food and Drug Administration and the European Medicines Agency, and modifications were made in line with their feedback. These studies ultimately led to the development of CDSD 2.1©, a daily diary which focuses on key symptoms of CeD (abdominal pain, bloating, diarrhea, nausea and tiredness). This patient-reported outcome measure was readily understood by adult and adolescent participants with CeD and content validity was demonstrated in both populations. CDSD 2.1© is a content-valid patient-reported outcome measure developed in accordance with best practices and regulatory guidance. A thorough exploration of the psychometric properties of CDSD 2.1© for both adult and adolescent participants with CeDis ongoing to support utilization in clinical trials.

A randomized controlled clinical trial of a Wim Hof Method intervention in women with high depressive symptoms

ObjectiveStress is a driver of depression, and people with depression often struggle to cope with stress and anxiety. This study directly compares the mental health effects of a Wim Hof Method intervention to an active control condition (slow breathing) in women with high stress and high depressive symptoms. MethodsWe randomized 84 healthy midlife women with high stress and high depressive symptoms to either: 1) the hormetic stress condition based on the Wim Hof Method (WHM) involving a breathing technique designed to induce intermittent hypoxia and cold showers (n = 41) or 2) an active comparison condition involving slow-paced breathing and warm showers (n = 43). We provided participants with daily audio instructions (15 min) for three weeks during the COVID-19 pandemic (2020–2021). Our primary outcomes were depressive symptoms, anxiety symptoms, and perceived stress collected at pre-intervention, post-intervention, and 3 months later. We also assessed daily stress rumination and affect with daily diary during the intervention, and participants completed a laboratory stressor, the Trier Social Stress Test, before and after the intervention, and provided samples for salivary cortisol reactivity. ResultsParticipants in the active control condition perceived the intervention to be more credible and expected greater mental wellbeing benefits compared to those in the Wim Hof Method condition. Differential attrition was observed with six participants (7 %) dropping out -- all from WHM condition. Among the participants who completed the intervention, both groups improved on mental health outcomes immediately after the intervention with a 24 % reduction in depressive symptoms, a 27 % reduction in anxiety symptoms, and 20 % reduction in perceived stress. Improvements were maintained at the 3-month follow-up with 46 % of the sample reporting mild or no depressive symptoms. Participants in the WHM condition had significant reductions in rumination after daily stressful events compared to those in the active control group. Both conditions had reduced daily negative affect across the intervention and lower peak cortisol reactivity to the lab stressor post-intervention. ConclusionsCounter to the preregistered predictions, and despite participants’ differing expectations, the interventions led to equivalent reductions in depressive symptoms, anxiety symptoms, and perceived stress, which were sustained at three months. They also produced comparable reductions in cortisol reactivity and daily negative affect. However, the WHM condition was associated with greater reduction in reported rumination after daily stressful events than the active control, a finding that needs replication with larger and more diverse samples.

A co-created citizen science project on the short term effects of outdoor residential woodsmoke on the respiratory health of adults in the Netherlands

Background and aimWoodsmoke from household fireplaces contributes significantly to outdoor air pollution in the Netherlands. The current understanding of the respiratory health effects of exposure to smoke from residential wood burning is limited. This study investigated the association between short-term changes in outdoor woodsmoke exposure and lung function, respiratory symptoms, and medication use in adults in the Netherlands.MethodsThis study was co-created with citizen scientists and other relevant stakeholders. A panel study was conducted with repeated observations in 46 adults between February and May 2021 in four Dutch towns. Participants recorded their symptoms and medication use in daily diaries, and conducted morning and evening home spirometry measurements. Woodsmoke exposure was characterized by measuring levoglucosan (most specific marker for woodsmoke exposure), black/brown carbon, fine and ultrafine particulate matter at central monitoring sites. Individual woodsmoke perception (smell) was recorded in daily diaries. Linear and logistic regression models were used to investigate the association between respiratory health and woodsmoke exposure. Models were adjusted for time-varying confounders and accounted for repeated observations within participants.ResultsConsistent positive associations were found between levoglucosan and shortness of breath (SOB) during rest and extra respiratory medication use. Odds ratios for current day exposure to levoglucosan were 1.12 (95% CI: 0.97, 1.30) for SOB during rest and 1.19 (95% CI: 1.07, 1.33) for extra medication use, expressed per interquartile range of levoglucosan concentrations (69.16 ng/m3). Positive non-significant associations were found between levoglucosan and nasal symptoms, cough and waking up with SOB. No consistent association was found between levoglucosan and lung function. Associations found between woodsmoke markers, SOB during rest and extra medication use remained after the inclusion of PM2.5 and UFP in two-pollutant models.ConclusionsAdults experienced more SOB during rest, nasal symptoms and used more medication to treat respiratory symptoms on days with higher levels of outdoor woodsmoke concentrations.

What Interval of Daily Pain Assessment is Required to Reliably Diagnose Chronic Pain in Sickle Cell Disease? The PiSCES Project

Abstract Background Chronic pain in sickle cell disease has been defined as pain on most days over 6 months. In the landmark Pain in Sickle Cell Epidemiology Study, 60% of patients submitted &amp;lt; 5 of the expected 6 months of pain diaries. Identifying chronic SCD pain using this long daily assessment interval is impractical. We therefore examined whether shorter, less burdensome intervals could accurately identify chronic sickle cell disease pain. Method As the gold-standard sample, we chose the 116 Pain in Sickle Cell Epidemiology Study patients who submitted &amp;gt; 5 months of diaries (153) and &amp;gt;49% of diaries during all months from 1-4. Using the same dataset, we tested daily diary assessment over shorter intervals: 2 weeks, 1 month, 2 months, 3 months, and 4 months. We defined chronic pain as intensity rated as &amp;gt; 0 on &amp;gt; 50% of diary days, regardless of interval. We then calculated the sensitivity and specificity of each diary interval. Results Among the gold-standard sample, 51.3% of patients had diary-defined chronic pain. Collection intervals of two months or more yielded similar chronic pain prevalences with identically high sensitivity (98.3%) and specificity (93%). Intervals of one month and two weeks yielded increasingly lower specificity (80.7%, 73.7% respectively), but preserved sensitivity (≥96.6%). Conclusion In the Pain in Sickle Cell Epidemiology Study, intervals of two months or more of daily diary collection yielded high sensitivity and specificity, compared to an interval of 5-6 months. One may reasonably diagnose chronic sickle cell disease pain using two months of daily diaries.

Efficacy and safety of topical glycopyrronium bromide in treating axillary hyperhidrosis: systematic review and meta-analysis

BackgroundHyperhidrosis (HH), characterized by excessive sweating, poses a significant challenge to patients’ quality of life. This meta-analysis evaluates the safety and efficacy of topical glycopyrronium bromide (GBP) in treating primary hyperhidrosis, a chronic condition affecting various body regions. Despite its prevalence, primary axillary hyperhidrosis is often undertreated due to a lack of awareness and social stigma.MethodsFollowing PRISMA guidelines, we conducted a systematic review and meta-analysis of randomized controlled trials comparing GBP to a placebo in primary hyperhidrosis patients. Eligibility criteria included outcomes related to perspiration suppression and symptom improvement.ResultsFour RCTs involving 1401 patients were included. GBP significantly increased Hyperhidrosis Disease Severity Scale (HDSS) responders (RR = 2.33, 95% CI [1.99 to 2.74], p < 0.00001) and Axillary Sweating Daily Diary (ASDD/ASDD-C) responders (MD = 3.07, 95% CI [2.32 to 4.06], p < 0.002) without significantly causing adverse events. Dermatology life quality index was also significantly improved in the GBP group (MD = -2.32, 95% CI [-3.09, -1.55], P < 0.00001).ConclusionGBP demonstrated effectiveness in reducing sweat production while improving HDSS and DLQI scores. Adverse events included dry mouth and anticholinergic effects. Dry eye and local skin reactions were not significant, which makes GBP promising in managing primary hyperhidrosis, offering improvements in symptoms and quality of life. While adverse events should be considered, further research with larger sample sizes and long-term follow-up is warranted for comprehensive clinical integration.

Dyadic cannabis use, alcohol use and relationship satisfaction: A daily diary study

ObjectiveIntimate relationships are important contexts for understanding individuals’ substance use patterns and trajectories. Using a dyadic daily diary design reporting over 14 consecutive days, the present study examined the association between cannabis use, alcohol use, and momentary relationship satisfaction among adult couples MethodEligible individuals on Prolific were invited to participate. We identified 33 couples where both partners participated. Participants completed a baseline survey and a 14-day daily diary study assessing their daily cannabis use, alcohol use, and relationship satisfaction. Multilevel modeling was used, within an Actor-Partner Interdependence Model (APIM), to evaluate the individual and interactive effects of one’s own use and their partner’s use on relationship satisfaction ResultsSignificant actor and partner effects of alcohol and cannabis use were found using both baseline and daily report data. For individuals who use cannabis more heavily among sampled couples, cannabis and alcohol co-use was associated with reduction in their own next-day relationship satisfaction while alcohol-only use was significantly associated with increased next-day satisfaction. There were no significant effects of one’s own or their partner’s effects for individuals who use cannabis more lightly. ConclusionsFindings replicate and extend prior research by demonstrating the dynamic nature of dyadic substance use and highlighting the unique impact of alcohol and cannabis co-use on daily relationship functioning.

Becoming European: Mid- and Short-Term Development of a European Identity Among Adolescents

ABSTRACT European identity formation is a component of political identity and linked to the support of European institutions and values. To understand how it develops, we examined three processes of identity formation (commitment, in-depth exploration, and reconsideration of commitment) on a short- and mid-term time scale, and their interrelations. A total of 371 German adolescents (M age = 14.24, SD age = 0.55, 60.37% females) participated in a longitudinal study and in a ten-day daily diary study. We conducted latent growth curve analysis (LGCM) and assessed rank-order stability and profile similarity for both time scales. Next, conditional LGCMs were run to examine associations of both time scales. We found a significant increase of all identity processes from the beginning to the middle of the school year and a significant decrease from the middle to the end of the school year. Across 10 days, growth curves varied according to the identity process. Stabilities were high for both time scales. Commitment at the beginning of the school year was negatively associated with fluctuations in commitment. Our results highlight the importance of examining different time scales and focusing on specific domains for understanding identity development in adolescence. They further indicate that short-term processes are associated with long-term development.

From trait affect to situated performance of change-oriented organizational citizenship behavior: the pathway through situational construal and emotion utilization

Prior studies indicate that fostering change-oriented organizational citizenship behavior (OCB-CH) among employees, wherein they actively contribute to the collective welfare of modern organizations, correlates positively with their positive affect. However, the precise mechanisms linking trait positive affect with OCB-CH remain unclear. This study used aggregated 5-day daily diary data from a sample of 236 full-time employees in Greece to examine positive affectivity differences in the characteristics of situational experiences and how these differences relate to employee OCB-CH via the use of emotions to facilitate performance. Employing multilevel structural equation modeling, the findings revealed a positive association between trait positive affectivity and the situation characteristics of duty, intellect, and positivity, from the DIAMONDS taxonomy. Furthermore, it was determined that perceptions of situational characteristics and emotional utilization sequentially mediated the relationship between positive affectivity and OCB-CH. This study enhances our understanding of how employee trait positive affectivity influences the manifestation of positive change in the form of OCB-CH within organizations.

Psychometric Properties and Measurement Equivalence of the Workplace Incivility Scale Across Cultures: Insights from Daily Diary Study.

Despite extensive research on workplace incivility, little attention has been given to its validation in culturally distinct contexts such as China and Pakistan. This study aims to bridge this gap by investigating the psychometric properties of the workplace incivility scale within these cultural frameworks. Additionally, it seeks to explore the cross-cultural measurement equivalence of the workplace incivility scale between these two diverse settings using a daily diary study design. The sample consisted of employees from service-providing organizations in China and Pakistan. Data was collected through snowball sampling, resulting in responses from 100 Chinese and 115 Pakistani employees over 10 consecutive workdays. Analysis of the daily responses, encompassing 748 from Chinese and 833 from Pakistani workers, indicated successful validation of the scale within both populations. This demonstrates the transferability of the concept of incivility to these cultural contexts. An integral aspect of this study is the consideration of potential cultural variations in workplace uncivil behavior. The validation and measurement equivalence of the scale for the core construct serves as essential infrastructure supporting such research endeavors.