Differences In Mean Scores Research Articles

The Relationship Between Patient-Reported Outcome Measures (PROMs) in Patients Undergoing Hip and Knee Joint Replacement Surgery and Social Deprivation on the Wirral.

This study aimed to investigate the associa-tion between patient-reported outcome measures (PROMs), both pre- and post-operatively, and socio-economic deprivation among patients undergoing hip and knee replacement surgeries in the diverse socioeconomic region of Wirral. A retrospective cohort study was conducted, involving 1666 adult patients who underwent hip or knee replacement procedures between 2012 and 2019. Socioeconomic deprivation was assessed using the Index of Multiple Deprivation (IMD). Pre- and post-operative outcomes were measured using the Oxford Hip and Knee scores. The mean scores for both pre-and post-operative assessments (Q1 and Q2) exhibited a strong positive correlation with PROM scores, regardless of gender, across both hip and knee replacements. However, the mean difference in scores between Q1 and Q2 showed no significant correlation with the IMD decile. Notably, patients residing in areas of higher socioeconomic deprivation demonstrated lower PROMs both before and after the surgery. The Oxford Hip and Knee scores are widely employed for evaluating health status in patients. In our study, these scores were influenced by IMD decile, supporting the holistic assessment approach employed by the treating unit, which does not rely solely on PROM scores as a trigger for arthroplasty discussions. Furthermore, our findings align with the practice of NHS Digital, which publishes PROM scores based on changes in PROM scores pre- and post-operation rather than absolute PROM scores. This approach appears to be less influenced by deprivation in the catchment area, as the improvement or change in scores was poorly correlated with socioeconomic factors.

Implementing a research methods curriculum for first year hematology oncology fellows.

9034 Background: The Hematology/Oncology Fellowship Program at the University of Alabama at Birmingham is an ACGME accredited, three-year academic training program. Fellows are expected to participate in at least one mentored research project during their second and third years of training. The program, however, did not provide formal training in research methods. Here, we provide the results of implementing a research methods curriculum for first year fellows to fulfill that educational need and to facilitate engagement in research projects throughout their fellowship training. Methods: We developed a structured curriculum composed of 10 didactic sessions covering the fundamental concepts of epidemiology and biostatistics. Based on the core competencies of research methods, learning objectives integrated concepts of 1) study design; 2) identifying bias and confounding; 3) exploratory data analysis, statistical inference, hypothesis testing; and results interpretation; and 4) critical appraisal of research evidence. The course was designed to promote self-directed learning and build on individual experiences and interests. One-on-one meetings between curriculum faculty and fellows facilitated identification of fellow research interests and pairing with mentors with aligned expertise. The didactic sessions were evaluated using a 21 question pre- and post- knowledge assessment. Fellows also self-rated on a 10-point scale their level of confidence performing research related activities. Following the course, fellows were expected to complete at least i) one research project, present it at a scientific meeting and submit for publication in peer-reviewed journal; and/or ii) one research proposal grant application. Results: To date, 13 first-year fellows across three cohorts have participated in the course, two of which have been completed, and the third will conclude in March 2024. Complete pre- and post- assessment scores were available for 8 fellows. Mean score difference was statistically significant comparing pre- to post- knowledge scores (3.79 points (SD= 4.43), paired t-test p-value=0.02). Self- ratings improved across all components on average from 3.7 pre- to 6.5 post-course (p<0.001). The largest change in self-ratings were in understanding study design concepts, basic principles of research and critical appraisal, followed by interpreting statistical outputs. All fellows are leading at least one mentored research project and 7 out of 8 fellows have presented abstracts at national meetings including the American Society of Clinical Oncology and the American Society of Hematology. Conclusions: Implementing a dedicated research methods curriculum to clinical fellows is feasible, and improved learner knowledge, skills, and engagement in research activities. Research methods principles can be effectively incorporated into the first year of clinical fellowship training.

Development of a Standardized Clinical Pathway in Korean Patients with Gastric Cancer Clinical Application Observational Study

Objectives: The objective of this study was to explore the integration of Traditional Korean Medicine (TKM) into existing clinical pathways for the treatment of gastric cancer. focusing on enhancing treatment outcomes and improving patient quality of life.Methods: Employing a prospective observational design, the study targeted adults aged 20-75 diagnosed with gastric cancer. It assessed the TKM pathway's impact on quality of life, tumor markers, complete blood count test values, and patient satisfaction, and monitored adverse reactions to evaluate effectiveness and safety.Results: The study demonstrated improved quality of life(QOL), as indicated by increased Karnofsky Performance Scale(KPS) scores Mean Difference(MD)=20.37, and better quality of life (MD=19.79) assessments. Blood test results showed notable enhancements in immune function markers such as Neutrophil (MD=-7.34%) and Lymphocyte (6.80%), and Erythrocyte Sedimentation Rate (ESR)(MD=-11.05mm/hr). Both patient and medical staff satisfaction (MD=0.33) improved, although changes in tumor markers were not statistically significant.Conclusions: The integration of TKM into the treatment of gastric cancer can significantly improve patient quality of life and satisfaction. To further substantiate these results, developing and implementing more critical pathways across varied clinical settings, along with larger-scaled studies, are essential.

The Impact of Specialist Care on Teenage and Young Adult Patient-Reported Outcomes in England: A BRIGHTLIGHT Study.

Purpose: In England, health care policy promotes specialized age-appropriate cancer services for teenagers and young adults (TYA), for those aged 13-24 years at diagnosis. Specialist Principal Treatment Centers (PTCs) provide enhanced age-specific care for TYA, although many still receive all or some of their care in adult or children's cancer services. Our aim was to determine the patient-reported outcomes associated with TYA-PTC based care. Methods: We conducted a multicenter cohort study, recruiting 1114 TYA aged 13-24 years at diagnosis. Data collection involved a bespoke survey at 6,12,18, 24, and 36 months after diagnosis. Confounder adjusted analyses of perceived social support, illness perception, anxiety and depression, and health status, compared patients receiving NO-TYA-PTC care with those receiving ALL-TYA-PTC and SOME-TYA-PTC care. Results: Eight hundred and thirty completed the first survey. There was no difference in perceived social support, anxiety, or depression between the three categories of care. Significantly higher illness perception was observed in the ALL-TYA-PTC and SOME-TYA-PTC group compared to the NO-TYA-PTC group, (adjusted difference in mean (ADM) score on Brief Illness Perception scale 2.28 (95% confidence intervals [CI] 0.48-4.09) and 2.93 [1.27-4.59], respectively, p = 0.002). Similarly, health status was significantly better in the NO-TYA-PTC (ALL-TYA-PTC: ADM -0.011 [95%CI -0.046 to 0.024] and SOME-TYA-PTC: -0.054 [-0.086 to -0.023]; p = 0.006). Conclusion: The reason for the difference in perceived health status is unclear. TYA who accessed a TYA-PTC (all or some care) had higher perceived illness. This may reflect greater education and promotion of self-care by health care professionals in TYA units.

Prehospital neurologic assessment using mobile phones: Comparison between neurologists and emergency physicians

BackgroundAmbulance-based telestroke may be a promising solution to improving stroke care. We assessed the technical feasibility and reliability of prehospital evaluations using commercial mobile phones with fifth-generation wireless communication technology. MethodsSix standardized patients portrayed scripted stroke scenarios during ambulance transport in an urban city and were remotely evaluated by independent raters using tablets (three neurologists and three emergency physicians) in a hospital, assisted by paramedics (trained in National Institute of Health Stroke Scale [NIHSS] assessment) in the ambulance; commercial cellular networks were utilized for videoconferencing transmission. The primary outcomes were mean difference (MD) and correlation of NIHSS scores between the face-to-face and remote assessments. We also examined the Bland-Altman plot for itemized NIHSS components, and Kaplan–Meier curves were used to compare the differences in the duration of the two evaluations between neurologists and emergency physicians. ResultsWe conducted 32 ambulance runs and successfully completed all NIHSS examinations. No significant difference was found between the face-to-face and remote evaluations (MD, 0.782; 95% confidence interval [CI], −0.520–0.395). The correlation of NIHSS scores between the two methods was 0.994 (95% CI, 0.945–1.026), and three items exhibited the highest frequency of runs, with score differences between the two methods. There were no significant differences between neurologists and emergency physicians in the mean evaluation duration and NIHSS scores for the two methods. ConclusionPrehospital evaluation using commercial mobile phones with fifth-generation wireless communication technology is feasible and reliable during ambulance transport in urban areas. Emergency physicians and neurologists performed similarly in stroke evaluations.

Comparison of ultrasound-guided rhomboid intercostal and subserratus plane block versus thoracic paravertebral block for analgesia in thoracoscopic surgery: a randomized, controlled, non-inferiority trial.

To investigate the non-inferiority of ultrasound-guided rhomboid intercostal and subserratus plane (RISS) block compared to thoracic paravertebral block (TPVB) in postoperative analgesia for thoracoscopic surgeries. This study consecutively enrolled 50 patients undergoing elective thoracoscopic surgery. Following general anesthesia, the RISS group received a unilateral block with 40 mL of 0.25% ropivacaine, while the TPVB group received with 30 mL of 0.33% ropivacaine. The primary outcome measure was the 24-hour postoperative resting VAS score. Secondary outcome measures included nerve block operation time for two groups, postoperative 1, 2, 4, 8, 48-hour resting VAS scores, and different time points coughing VAS scores, time to first postoperative ambulation, total intravenous analgesic consumption at different time points postoperatively, complications related to the block. There were no significant statistical differences between the two groups in terms of postoperative rest and cough VAS scores at each time (P>0.05), and the mean difference in rest VAS scores did not exceed the non-inferiority margin in 95% CI. There were no significant differences in total intraoperative and postoperative analgesic consumption at different time points (P>0.05), and no significant differences in time to first postoperative ambulation (P>0.05). Compared to the TPVB group, the RISS group had a shorter nerve block operation time (259.43±30.11 vs. 335.23±30.96 s, P<0.001) and fewer instances of intraoperative hypotension (two vs. seven cases, P=0.022), bleeding at the puncture site, pneumothorax, and arrhythmia. In thoracoscopic surgeries, the postoperative analgesic efficacy of ultrasound-guided RISS block is not inferior to TPVB. Compared to TPVB, RISS block is simpler, quicker, and associated with fewer puncture-related complications.

The Effect of Living in Orphanage and Educational Counseling on Puberty Health Among Female Adolescents Living in Welfare Centers: An Interventional Study

Background: Adolescents living in orphanages are at risk of health problems. The current study aimed to determine the effect of living in an orphanage and educational counseling on puberty health of female adolescents living in welfare centers. Methods: This study contained two stages. In the first stage, a cross-sectional study was conducted among 416 students living in welfare centers (10-14 years of age). In the second stage, 60 orphans (30 in the control group and 30 in the intervention group) participated in the interventional study. The intervention group received five two-hour sessions of educational counseling once a week. Pre-test and post-test were performed using a researcher-made questionnaire. The data were analyzed in SPSS 18 using the Mann-Whitney U, chi-square, Wilcoxon, and Kolmogorov–Smirnov tests. Results: The cross-sectional study results indicated that the knowledge of orphans was lower (P&lt;0.001), but their attitudes and practices were higher (P&lt;0.001) than others. The trial study results demonstrated that in the intervention group, there was a significant difference (P&lt;0.001) in the mean difference of the puberty health score before and after the intervention. Conclusion: Educational counseling is recommended to improve the level of puberty among female adolescents.

Role of Demographic Characteristics in predicting Psychological Burden and Marital Satisfaction among Diabetic Patients

The study was conducted to predict the relationship of psychological burden and marital satisfaction among patients of diabetic mellitus with role of demographic variables. Sample size was 150 diagnosed diabetic patients in which 75 married males and 75 were married females. Sample was approached through purposive sampling technique. All diabetic patients were selected from public hospitals and private clinics of Multan Division, Pakistan. The Nishter Hospital Multan, Combined Military Hospital Multan and City Hospital Multan and it was focused to their gender, age, education, type of disease, working status and socio-economic condition. Depression, Anxiety, Stress Scale (Lovibond, 1995) and Index of Marital Satisfaction (Hudson, 1981) were used as a research instrument to collect the data. Data were analyzed on SPSS. Findings of the study reveal that there is negative correlation between psychological burden and marital satisfaction. Moreover, depression, anxiety and stress are the significant negative predictors of marital satisfaction. Results suggest that level of psychological burden was reported higher among female patients than male. Mean score of marital satisfaction was greater among male as compared to female patients. Furthermore, there was significant mean score difference on PB between educated and uneducated patients. Patients with type 2 have greater level of psychological burden as compared to type 1 diabetes. Level of psychological burden was greater in those patients who have above than 3 children as compared to those who have 1-3 children. Difference is significant between working and non-working diabetic patients on psychological burden. Results suggest that there is no significant mean score difference of marital status with respect to education, type of diabetes, family size, and working status. There was no significant difference of PB and MS with respect to socio-economic status. Role of demographic characteristics of the participants is significant in predicting psychological burden among them.

Health-related quality of life among Moroccan women after vaginal birth and cesarean section: Cross-sectional study

BackgroundDuring the postpartum period, understanding women's well-being, specifically their Health-related Quality of Life (HRQoL), is vital for comprehensive healthcare. ObjectivesOur study aims to explore the HRQoL and its associated factors in Moroccan women after vaginal birth (VB) and cesarean section (CS). Study designIn this cross-sectional study we assessed the HRQoL and its associated factors among Moroccan women who gave birth at the provincial hospital center of Settat. We gathered data from 566 women, using the EQ-5D-5L instrument alongside questionnaires about socioeconomic and obstetrical aspects. The assessment was conducted utilizing the improved Relative to an Identified Distribution (RIDIT) approach, and we employed a multiple linear regression model to pinpoint the associated factors. ResultsA total of 566 women were included in our study. Our results revealed that the HRQoL in women who underwent CS was significantly lower than in VB women (EQ-5D index score = 0.30 ± 0.28 vs 0.61 ± 0.31; p < 0.0001). Similarly, the CS reduced the EQ-VAS score (mean difference = −10.73 ± 3.78; p < 0.0001). The CS was associated negatively with problems in mobility (ARI = 55 % [42–67], p < 0.0001), autonomy (ARI = 67 % [57–80], p < 0.0001), and usual activities (ARI = 56 % [42–69], p < 0.0001). Also, CS was associated with pain/discomfort (ARI = 47 % [34–60], p < 0.0001) and anxiety/depression (ARI = 3 % [-5.8-12.6], p = 0.31). The women who had birth complications had the worst HRQoL (EQ-5D index score = 0.32) compared to those who had no complications (EQ-5D index score = 0.56). Likewise, women who had postpartum complications had the worst HRQoL (EQ-5D index score = 0.39 vs EQ-5D index score = 0.54). ConclusionThe results highlighted that mode of birth, childbirth complications, and postpartum complications are strongly associated with women's HRQoL. The EQ-5D-5L dimensions were affected after delivery. Hence, there is a requirement to create specialized initiatives for overseeing postpartum HRQoL, aiming to enhance the quality of maternal healthcare.

The Morbidity of Greater Trochanteric Pain Syndrome Versus That of Patients Awaiting Total Hip Replacement.

Greater trochanteric pain syndrome (GTPS) is a commonly diagnosed medical issue, yet there are little data assessing the relative morbidity of GTPS. We sought to characterize the morbidity on presentation of GTPS and compare it to that of patients with end-stage hip osteoarthritis awaiting total hip arthroplasty. We hypothesized that patients with GTPS would have morbidity similar to or worse than that of patients with osteoarthritis. This retrospective case-control study examined patient-reported outcome measures of 156 patients with GTPS (193 hips) and 300 patients with hip osteoarthritis before total hip arthroplasty (326 hips). Patients with secondary hip conditions or previous hip surgeries were excluded from the study. Patient-reported outcome measures were analyzed using an equivalence test and two one-sided t tests. Equivalence in mean visual analog scale pain scores between GTPS and osteoarthritis was established with a tolerance margin of ±10. The difference in mean visual analog scale pain scores was 0.35 (95% CI, -0.86 to 0.16; P=.02). The Hip disability and Osteoarthritis Outcome Score Quality of Life was much worse for patients with GTPS, placed well outside of the ±10 tolerance margin, and the difference in mean scores was 1.72 (95% Cl, -2.17 to -1.26; P=.99). Equivalence in mean UCLA Activity scores between GTPS and osteoarthritis was established with a tolerance margin of ±5. The difference in mean UCLA Activity scores was 0.002 (95% CI, -0.45 to 0.43; P<.01). The morbidity and functional limitations of patients with GTPS were similar to those of patients undergoing total hip arthroplasty. GTPS remains a functional problem for patients, and clinicians and researchers should consider GTPS as seriously as hip osteoarthritis. [Orthopedics. 2024;47(4):205-210.].

Rethinking students’ mental health assessment through GHQ-12: evidence from the IRT approach

BackgroundThe General Health Questionnaire-12 (GHQ-12) is a widely used screening tool for mental health assessment however its traditional scoring methods and cutoffs may not adequately capture the mental health complexities of younger populations.MethodsThis study explores GHQ-12 responses from a sample of university students. Possible differences in means scores considering gender, age, academic field and degree course were assessed through t-test or one-way ANOVA as appropriate. To deeper understanding different levels of severity and individual item impact on general distress measurement, we applied Item-Response-Theory (IRT) techniques (two-parameters logistic model). We compared students’ population with a population of workers who underwent a similar psychological evaluation.ResultsA total of 3834 university students participated in the study. Results showed that a significant proportion (79%) of students reported psychological distress. Females and younger students obtained significantly higher average scores compared to others. IRT analysis found item-specific variations in mental distress levels, with more indicative items for short-term fluctuations and potential severe mental health concerns. Latent class analysis identified three distinct subgroups among students (including 20%, 37%, 43% of the participants respectively) with different levels of psychological distress severity. Comparison with a population of adults showed that students reported significantly higher scores with differences in the scale behavior.ConclusionOur results highlighted the unique mental health challenges faced by students, suggesting a reevaluation of GHQ-12 applicability and cutoff scores for younger populations, emphasizing the need for accurate instruments in mental health evaluation.

Effect of intramuscular diazepam infusion on herpes zoster-related pain in older patients: a randomized, double-blind, placebo-controlled trial

ObjectivesThis study evaluated the effectiveness, psychological effects, and sleep quality using intramuscular diazepam infusion compared with placebo in patients with herpes zoster (HZ)-related pain.MethodsThe patients were randomized to either the diazepam or control group. The diazepam group received an intramuscular injection of diazepam for 3 consecutive days, while the control group received an intramuscular injection of 0.9% normal saline. The primary outcome was pain relief on posttreatment day 4, as measured using the Visual Analog Scale (VAS). Moreover, anxiety and depression were evaluated using the Generalized Anxiety Disorder-7 (GAD7) and Patient Health Questionnaire-9 (PHQ9), respectively. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI).ResultsIn total, 78 patients were enrolled in the trial. The mean differences in VAS scores between the two groups were 0.62 (P = 0.049) on posttreatment day 3 and 0.66 (P = 0.037) on posttreatment day 4. The effective rates of pain management in the diazepam group ranged from 10.26 to 66.67%, which were higher than those in the control group on posttreatment days 3 and 4 (P < 0.05). The mean difference in PSQI scores between the diazepam and control groups was 1.36 (P = 0.034) on posttreatment day 7. No differences were found in the incidence of analgesia-adverse 1reactions between the diazepam and placebo groups.ConclusionsThe intramuscular injection of diazepam for 3 consecutive days provides effective pain management and improves the quality of life. Our study suggests that diazepam is more effective than the placebo in patients with HZ-related pain.Trial registrationThe study was prospectively registered at https://www.isrctn.com/trialist(Registration date: 24/01/2018; Trial ID: ISRCTN12682696).

Coping strategies of school-going adolescents during the COVID-19 pandemic in the climate vulnerable Manafwa watershed, Uganda

BackgroundThe COVID-19 pandemic disrupted daily life, economies, and health, prompting strict government measures, including nationwide lockdowns and school closures in Uganda, resulting in significant academic setbacks for adolescents. The coping strategies employed by school-going adolescents in Uganda amidst the COVID-19 pandemic remain inadequately understood. This study aimed to assess the coping strategies adopted by school-going adolescents (early, middle and late adolescents) in the Manafwa watershed, recognized as one of Uganda’s most vulnerable regions, during the COVID-19 pandemic.MethodsA cross sectional study design was conducted from I5th May, 2023 to 30th June, 2023 on 762 school going adolescents from government-aided secondary schools within the Manafwa watershed area. The adolescent version of the KidCope tool was used to evaluate adolescents’ coping strategies. Factor analysis identified correlations among adolescents’ coping strategies. Independent Samples t-Test and One-Way Variance of Analysis (ANOVA) was used for comparing the mean score differences of the coping strategies among the gender and adolescents’ stages respectively.ResultsMajority (n = 141, 36.2%) of the participants employed adaptive coping followed by negative-emotion coping (n = 127, 32.6%) and avoidant coping (n = 122, 31.3%). Females employed statistically higher resignation as a coping strategy compared to males, (mean of 1.2 vs. 1.0, respectively; P = 0.026). A higher proportion (n = 88, 69.3%) of middle age adolescents employed negative-emotion regulation (P-value = 0.040). However, those in early adolescence significantly utilized distraction as a coping strategy more than those in middle adolescence (mean difference = 0.36, p = 0.013).ConclusionDuring the pandemic, majority of school-going adolescents employed adaptive coping mechanisms, including positive emotional regulation and social support. However, compared to males, females employed resignation more frequently. Moreover, middle-aged adolescents had a greater propensity for negative emotion copying. Findings from this study contribute valuable information for the development of targeted interventions and support mechanisms for adolescents facing unprecedented challenges.

THE HOLISTIC LEARNING MODEL OF BUSINESS ETHICS TO DEVELOP SPIRITUAL WELL-BEING

The purpose of this study is to investigate the impact of the holistic learning model of Business Ethics on the students’SWB. Two business ethics classes are randomly chosen as sample from all business ethics classes of Management Study Program, Tarumanagara University, Jakarta. The study uses a quasi-experimental design “pre-test-post-test design with one group”, in which the learning model is the independent variable and the students’ SWB is the dependent variable. The testing of hypothesis uses the SWB’s score mean differences of a paired sample t-test. The results of this study show that the holistic learning model of Business Ethics gives a significant impact on the quality improvement of the students’ SWB, both overall and on all four dimensions of SWB: communal, personal, transcendental, and environmental. Three dimensions: communal, transcendental, and environmental influence at a significant level of 5%; and one dimension (personal) has an effect on a significance level of 10%.

Impact of Cochlear Implantation on Quality of Life in Chinese Americans.

To investigate the quality of life (QOL) of adult Mandarin-speaking Chinese Americans after cochlear implantation (CI) using the cross-culturally adapted Chinese Cochlear Implant Quality of Life-10 (CIQOL-10) Global. Cross-sectional. Tertiary care neurotology practice in New York City. Thirty adult Mandarin-speaking Chinese Americans (22.8-89.4 yr, mean 48.9 yr) with prelingual (12) or postlingual (18) deafness who underwent CI between 1995 and 2020. All patients were at least 1 year from CI activation. CI. Chinese CIQOL-10 Global score. There were no detectable differences in mean Chinese CIQOL-10 Global scores between the prelingual (mean 51.9, SD 11.0) and postlingual (mean 44.0, SD 16.4) cohorts (p = 0.1; 95% CI, -2.3 to 18.1; Hedges' g = 0.5). Comparison of the overall cohort (mean 47.1, SD 14.8) with previously published CIQOL-10 Global scores of English-speaking American CI users (mean 51.5, SD 10.4) demonstrated a significant difference (p = 0.02; 95% CI, 0.4-8.4; Hedges' g = 0.4). For the overall cohort, multivariable analysis demonstrated that combined household income (p = 0.007, β = 7.4; 95% CI, 0.7-14.0) was positively associated with Chinese CIQOL-10 Global scores. This study is the first to evaluate QOL after CI in Mandarin-speaking Chinese American adults. The CIQOL-10 Global scores of Mandarin-speaking Chinese Americans CI users are significantly worse than those of English-speaking American CI users. Combined household income may be positively associated with QOL in the Mandarin-speaking Chinese American CI population. More resources are needed to assess outcomes and support rehabilitation in this population.

Iron deficiency in new onset heart failure: association with clinical factors and quality of life.

The prevalence of iron deficiency (ID) in newly diagnosed heart failure (HF) and the progression of ID in patients after initiation of HF therapy are unknown. We aimed to describe the natural trajectory of ID in patients with new onset HF during the first year after HF diagnosis, assessing associations between ID, clinical factors, and quality of life (QoL). A prospective cohort of patients with new onset HF in hospitals or outpatient clinics at five major hospitals in Stockholm, Sweden, during 2015-2018 were analysed with clinical assessment, electrocardiogram, blood samples including iron levels, Minnesota living with heart failure questionnaire (MLHFQ), and echocardiogram at baseline and after 12months. Of 547 patients with new-onset HF, 482 (88%) had complete iron data at baseline. Median age was 70years (interquartile range 61-77) and 311 (65%) were men; 55% of patients had ejection fraction (EF)≤40%, 19% had EF 41-49%, and 26% had HF with preserved EF (HFpEF) [Correction added on 26 June 2024, after first online publication: The 'Mean age was 70 years' has been corrected to 'Median age was 70 years' in this version.]. At baseline, 163 patients (34%) had ID defined as ferritin <100μg/L or ferritin 100-299μg/L and transferrin saturation <20%. After 12months of follow-up, 119 (32%) had ID of the 368 patients who had complete iron data both at baseline and after 12months and did not receive intravenous (i.v.) iron during follow-up. During the first year after HF diagnosis, 19% had persistent ID, 13% developed ID, 11% resolved ID, and 57% never had ID, consequently 24% changed their classification. Anaemia at baseline was the strongest independent predictor of ID 1year after diagnosis [odds ratio (OR) 3.91, 95% confidence interval (CI) 1.88-8.13, P<0.001], followed by HF hospitalization (OR 2.21, 95% CI 1.24-3.95, P<0.01), female sex (OR 2.04, 95% CI 1.25-3.32, P<0.01), HFpEF (OR 1.96, 95% CI 1.13-3.39, P<0.05), and diabetes mellitus (OR 1.92, 95% CI 1.06-3.48, P<0.05). ID was associated with low QoL at baseline (MLHFQ score mean difference 7.4 points, 95% CI 3.1-11.7, P<0.001), but not at follow-up. About one third of patients with new onset HF had ID both at the time of HF diagnosis and after 1year, though a quarter of the patients changed their ID status. Patients with anaemia, HF hospitalization, female gender, HFpEF, or diabetes mellitus at baseline were more likely to have ID after 1year implying that these should be carefully screened for ID to find those in need of i.v. iron treatment.

Digital Engagement Strategy and Health Care Worker Mental Health

The health care workforce continues to experience high rates of depression and anxiety. Finding ways to effectively support the mental health and well-being of health care workers is challenging. To test the effectiveness of remote, pushed digital assessments and engagement to improve depression and anxiety among health care workers compared with usual care. This was a 9-month randomized clinical trial with a 6-month intervention period. Participants were health care workers with self-reported daily access to a smartphone and at least 4 clinical hours per week. Participants were randomized to usual care or the intervention between January 2022 and March 2023. Data analyses were conducted between May and July 2023. All participants completed baseline, 6-month, and 9-month mental health, well-being, and burnout assessments. The control group had open access to a web-based mental health platform. Participants in the intervention group received monthly text messaging about mental health, mental health assessments, and linkages to care. The primary outcomes were mean change in depression and anxiety scores at 6 months from baseline. Secondary outcomes include mean change in well-being, burnout, and self-reported workplace productivity. In this study, 1275 participants were randomized (642 [50.4%] to the intervention group and 633 [49.6%] to control group). Participants had a mean (SD) age of 38.6 (10.9) years, 1063 participants (83.4%) were female, 320 (25.1%) self-identified as Black, and 793 (62.2%) self-identified as White. Across the groups, the mean difference in depression score was significantly different at 6 months (-0.96 [95% CI, -1.52 to -0.40]) and at 9 months (-1.14 [95% CI, -1.69 to -0.58]). The mean difference in anxiety score from baseline to 6 months was statistically significantly larger for those in the intervention group vs usual care (-0.71 [95% CI, -1.25 to -0.17]) and held true at 9 months (-1.06 [95% CI, -1.59 to -0.52]). In a trial of health care workers, a proactive digital engagement strategy, including pushed text messaging, mobile mental health assessments, and connection to care, improved depression and anxiety over a 6-month period compared with simply making the same resources available for individuals to find and use. ClinicalTrials.gov Identifier: NCT05028075.

P.078 fMRI-based deep brain stimulation programming: a blinded, crossover clinical trial

Background: Success of deep brain stimulation (DBS) in Parkinson’s disease (PD) relies on time-consuming trial-and-error testing of stimulation settings. Here, we prospectively compared an fMRI-based stimulation optimization algorithm with &gt;1 year of standard-of-care (SoC) programming in a double-blind, crossover, non-inferiority trial. Methods: Twenty-seven PD-DBS patients were prospectively enrolled for fMRI using a 30-sec DBS-ON/OFF cycling paradigm. Optimal settings were identified using our published classification algorithm. Subjects then underwent &gt;1 year of SoC programming. Clinical improvement was assessed, after an overnight medication washout period, under SoC and fMRI-determined stimulation conditions. A predefined non-inferiority margin was -5 points on the Unified Parkinson’s Disease Rating Scale (UPDRSIII). Results: UPDRSIII improved from 45.3 (SD=14.6) at baseline to 24.9 (SD=10.9) and 24.1 (SD=10.9) during SoC and fMRI-determined stimulation, respectively. The mean difference in scores was 0.8 (SD=8.5; 95% CI -4.5 to 6.2). The non-inferiority margin was not contained within the 95% confidence interval, establishing non-inferiority (p=0.013). Conclusions: This is the first prospective evaluation of an algorithm able to suggest stimulation parameters solely from the fMRI response to stimulation. It suggests equivalent outcomes may be achieved in 3 hours of fMRI scanning immediately after surgery compared to SoC requiring 6 or more in-person clinic visits throughout &gt;1 year.

Validity and reliability of the Persian version of food preferences questionnaire (Persian-FPQ) in Iranian adolescents

The assessment of dietary intakes and habits using reliable and youth-specific measurement tools during adolescence is essential. The aim of the present study was to culturally adapt and investigate the psychometric properties of the Persian version of the food preferences questionnaire (Persian-FPQ) among Iranian adolescents. This methodological cross-sectional study was conducted among 452 Persian-speaking adolescents, living in Isfahan, Iran. Translation of the FPQ was performed using forward–backward method. Intra Class Correlation (ICC) and Cronbach’s α were used to assess test–retest reliability and internal consistency, respectively. Construct validity was investigated by using exploratory factor analysis (EFA). Divergent validity was determined using correlation analysis with Kessler Psychological Distress Scale (K-10). Known-group validity was assessed based on differences in mean food preference score between boys and girls and different categories of body mass index (BMI). The internal and external reliabilities for the Persian-FPQ were in the range of good to excellent in all domains (Cronbach’s α: 0.76–0.96 and ICCs: 0.982–0.998). Boys had higher scores of food preferences than girls, indicating good known-group validity. Construct validity evaluated by EFA led to extraction of seven factors (“Vegetables”, “Fruit”, “Dairy”, “Snacks”, “Meat/Fish”, “Starches” and “Miscellaneous foods”), explaining 37.8% of the variance. Divergent validity revealed significant negative correlations between five sub-scales of the Persian-FPQ and psychological distress. The Persian version of the FPQ is a reliable and valid instrument with applicability in a broad range of the population of Persian-speaking adolescents for assessing food preferences in community-based research projects.

Depression Conditions of the Elderly Living in Nursing Homes and the Factors Affecting Them

Aim: The aim of our article is to determine the depression status of elderly people living in nursing homes and the affecting factors. Material and Method: The study included 75 elderly individuals who lived in assisted living facilities. Data was collected through a Personal Information Form, the Geriatric Depression Scale, the Mini Mental Assessment Test, and retrospective blood results. The data were analyzed using SPSS 26.0 software and non-parametric tests were used due to the non-normal distribution of the data. The Mann-Whitney U test and the Kruskal-Wallis test were used to compare independent variables. Additionally, multiple regression analysis was employed. Results: The study found that 38.7% of elderly participants had abnormal mini-mental assessments, and 21.3% had significant depression. Statistical analysis revealed significant differences in the total mean scores of the Mini Mental State Test (MMST) based on gender (p=0.023), marital status (p=0.001), educational attainment (p=0.001), and level of schooling. Additionally, there was a statistically significant difference (p=0.002) between the Geriatric Depression Scale (GDS) total mean score and the presence of sleep issues. The total mean scores of MMST indicated a statistically significant difference between the status of urine incontinence (p=0.001) and exercise (p=0.006), as well as their combination. Conclusion: Approximately one third of the participants were depressed and had poor cognitive status. Depression was associated with being female, low educational status and sleep problems, whereas mental status was associated with gender, marital status, and educational status. It is recommended to conduct longitudinal studies with larger samples in future studies.