Emotional Domains Research Articles

An adaptive dynamical system model for development of schizophrenia: Epigenetics and false memories

This paper introduces a fifth-order adaptive dynamical system model represented as a self-modelling network model to understand the role of epigenetic factors in developing schizophrenia, particularly about the occurrence of false memories. Schizophrenia, affecting a significant portion of the global population, presents complex challenges due to its symptoms across cognitive, emotional, and social domains. Central to this paper is the exploration of epigenetic influences on the development of schizophrenia, with a focus on how these epigenetic factors contribute to the generation of false memories, a notable symptom of the disorder. The model assumes that early adverse experiences significantly affect hippocampal development, which is crucial for memory processes. By employing a fifth-order adaptive dynamical system model represented as a self-modelling network, this paper examines the intricate dynamics between genetic predispositions, environmental factors, and epigenetic modifications in schizophrenia. The model’s sophistication allows for a nuanced understanding of the gene-environment interactions, particularly highlighting the role of early-life trauma in shaping lifelong cognitive outcomes. This approach offers a comprehensive framework for analyzing the multifaceted nature of schizophrenia, contributing to a deeper understanding of its etiology and progression.

Risk and Protective Factors of Psychosocial Functioning inSurvivors of Childhood Cancer: Results of the DCCSS-LATER Study.

This study examines the association between psychosocial risk and protective factors and a wide range of psychosocial outcomes including emotional, social, cognitive, and physical domains in childhood cancer survivors (CCS). CCS from the Dutch Childhood Cancer Survivor Study (DCCSS)-LATER cohort (diagnosed 1963-2001) part 2 (age≥18years, diagnosed < 18years, ≥ 5years since diagnosis) completed questionnaires on psychosocial risk and protective factors (Benefit and Burden Scale, Illness Cognition Questionnaire, Rosenberg Self-Esteem Scale, and Impact of Cancer Scale), and psychosocial outcomes (Hospital Anxiety and Depression Scale, Self-Rating Scale for Post-Traumatic Stress Disorder, TNO-AZL Questionnaire for Adult Health-Related Quality of Life, and Short Form-36). Associations were assessed with regression analysis, adjusting for attained age, sex, number of health conditions, and time since diagnosis, while correcting for multiple testing (p< 0.004). A total of 1382 CCS participated, all diagnosed ≥ 15years ago. The mean age of participating CCS was 36years, and 51% were female. Perceived benefit and burden, acceptance, and helplessness, self-esteem and social support were associated with the psychosocial outcomes. In the models including all psychosocial factors, most associations with psychosocial outcomes were seen for self-esteem (10×), and perceived burden (9×). Self-esteem (all β≤ 0.47) and perceived burden (all β≤ 0.38) demonstrated strongest associations of medium/large size. Perceptions of childhood cancer, illness cognitions, self-esteem, and social support play a role in explaining psychosocial functioning in CCS, outweighing the influence of socio-demographic and medical variables. Addressing negative perceptions and reducing feelings of helplessness, while promoting acceptance, self-esteem, and social support, could provide intervention targets for CCS who encounter psychosocial challenges.

Longitudinal assessment of cancer-related distress during cancer treatment using an electronic health record–based tool and impact of social work intervention.

207 Background: Cancer-related distress affects 35-45% of patients. 2020 ASCO-QOPI standards require baseline and ongoing psychosocial assessments, with interventions as needed. We examined the feasibility and outcomes of integrating the NCCN Distress Thermometer (DT) into the oncology electronic health record (EHR) for distress monitoring. Methods: A flowsheet containing NCCN DT questions was created in Epic EHR (Epic Systems, Verona, WI). Oncology nursing staff administered the electronic DT as part of normal patient ‘rooming’ protocol and alerted providers when distress level was ≥ 4 (DT4). This in turn generated a social work (SW) referral. SW interventions were documented in a SW dashboard. Results: Between May 1 st 2023, and April 30 th 2024, our Epic EHR DT was used to screen 6,270 distinct oncology patients, 1,852 scored &gt;=4. 19.7%, 14.2%, 20.4% and 5.4% of the responses were in the emotional, practical, physical, and familial domains respectively. 447 (24.1%) of these patients were referred to SW. When contacted by SW, worry/anxiety in 37.5%, finance in 34.9% and transportation in 29.4% were the top three concerns. Access to grants, free-care, lodging and gas cards was made available to 37.4%, 14.5%, 20.5% and 13.1% of patients respectively. Additionally, in accordance with QOPI certification requirements, 947 patients with active oncology treatment plans were serially screened during successive cycles of chemotherapy generating 6,330 responses. 398 (42%) of these responses indicated DT4. SW referral was placed in 163 (41%) of patients with DT4. Serial distress monitoring revealed a trend towards improved distress in later cycles of chemotherapy, with DT4 percentage decreasing from 27.7% in cycle 1 to 7.9% in cycle 6. Process improvement efforts informed by this data increased DT use from 42.7% to 50% between May-October 2023 and November 2023-April 2024. Conclusions: Electronic capture of cancer related distress as part of routine care is feasible in a community-based oncology program and resulted in a variety of meaningful SW interventions. Cumulatively, distress caused by emotional, social, and practical problems are more frequent than distress caused by physical problems, underscoring the need for comprehensive cancer care. Distress tends to diminish during successive cycles of chemotherapy, possibly due to lower cancer related morbidity due to therapy, or increased patient familiarity with chemotherapy and improved use of supportive care.

Health-Related Quality of Life of Adolescents With Non-transfusion-Dependent Thalassemia in Basrah, Iraq.

Thalassemia is a chronic inherited disease with the potential for serious clinical and psychological effects. In the case of thalassemia, a cure is not currently accessible, and lifelong treatment is required. Health-related quality of life (HRQoL) is considered a crucial health outcome. This study aims to assess the HRQoL of children and adolescents with non-transfusion-dependent thalassemia (NTDT) and compare it with that of beta-thalassemia major (β-TM) and healthy subjects. This case-control study included 88 patients with NTDT and 153 age- and gender-matched healthy children and adolescents. In addition, we included 70 registered patients with β-TM. We used the short-form health survey questionnaire to assess HRQoL. Of the 88 patients, 41 were diagnosed with alpha-thalassemia intermedia (α-TI; hemoglobin H disease), and 47 were with beta-thalassemia intermedia (β-TI). HRQoL domains were significantly higher in healthy children and adolescents compared to NTDT patients (P<0.001); the role emotion domain was the most affected in NTDT patients (51.92 ± 3.37), followed by general health (52.72 ± 3.05) and role physical (53.59 ± 3.13). α-TI patients had significantly higher HRQoL domains than patients with β-TI. The study also indicated that NTDT patients had significantly better QoL scores compared to β-TM patients (P<0.001) across all domains. NTDT patients have a lower HRQoL compared to healthy controls. However, their HRQoL scores are significantly better than those of patients with β-TM. Among NTDT patients, those with α-TI have significantly better HRQoL scores compared to patients with β-TI.

Understanding the social and emotional domains of physical literacy in post‐secondary education: A scoping review

AbstractWhile a variety of definitions persist, a common definition of physical literacy is that it encompasses the motivation, confidence, physical competence, knowledge and understanding to value and take responsibility for engagement in physical activities over the lifespan. While this perspective to physical literacy is broad, a great deal of curricular outcomes still focus on the physical competence, knowledge and understanding aspects of the framework leaving a gap in the holistic nature of the construct. This scoping review explores the construct of physical literacy within post‐secondary education, focusing on how social and emotional dimensions are integrated in teaching, delivery and assessment. This scoping review followed PRISMA‐ScR guidelines. Five online databases were used to identify papers published that used physical literacy in combination with post‐secondary as the educational setting with a focus on curriculum. The findings underscore a substantial gap in the literature. It was identified that the physical aspects of physical literacy were predominant with limited attention to the social and emotional domains. The gap implies that the comprehensive construct of physical literacy, which encompasses non‐physical facets, is often omitted in post‐secondary curricula. The review highlights an unexplored opportunity for post‐secondary institutions to intentionally construct more comprehensive physical literacy programmes. By incorporating social and emotional dimensions into these programmes, students gain a more holistic understanding of physical literacy. Subsequent research can delve into effective integration strategies and the potential benefits of such an approach.

Linguistic Manifestation of Concept of HEALTH in Contemporary Domestic Discursive Practices (Newspaper Corpora)

This study addresses the issue of the linguistic explication of the concept of HEALTH within contemporary domestic media discourse. An investigation has been conducted into the functioning of the conceptual name — the lexeme ‘health’ — through linguistic material derived from contexts extracted from newspaper corpora within the National Corpus of the Russian Language. A corpus-based discursive analysis methodology was employed. Conceptual-metaphorical models that enrich the meaning of the concept and expand its semantic scope have been identified. It is demonstrated that the semantic transformations of the lexeme ‘health’ in its discursive realization reveal reflections on the understanding of the abstract concept of HEALTH as a resource, substance, physical object, mechanism, container, living entity, and more. It has been established that the augmentation of the semantic volume of the concept in contexts of attributive and genitive compatibility illustrates the dissemination of notions regarding health as a normal state or functioning of various entities across a wide array of spiritual, moral, psychological, emotional, social, political, economic, financial, industrial, natural, and cultural domains, including the operational sphere of devices, household items, instruments, and mechanisms. The study concludes with the assertion that the analyzed concept possesses a representative value potential linked to the cognitive dominance of normativity.

La psicología integrativa personalista: hacia un nuevo paradigma de intervención clínica

The article takes modern ontological personalism as a reference as an anthropological paradigm from which an exercise of integration with psychotherapy is carried out. Likewise, it proposes some axes of psychotherapeutic conceptualization derived from this personalist base, as well as a possible mode of therapeutic intervention that takes into account the behavioral, cognitive, emotional, interpersonal and spiritual domains with the objective of achieving greater effectiveness in the exercise of seeking the personal well-being that patients usually seek when they come to therapy.

A systematic review of self-regulation measures in children: Exploring characteristics and psychometric properties

Self-regulation, which encompasses cognitive, behavioural, and emotional domains, poses challenges in consistent measurement due to diverse definitions and conceptual complexities. In recognition of its profound impact on long-term mental health and wellbeing in children, this systematic review examined available self-regulation measures for children and young people between 1 and 18 years of age. The systematic review followed the COSMIN taxonomy and reported on the measurement tools’ characteristics and psychometric properties. The methodology and reporting were guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and checklist. The protocol for this review was registered with PROSPERO (Number CRD42020155809). A search of six databases (Embase, MEDLINE, PsycINFO, Scopus, CINAHL and ERIC) was performed, and grey literature was searched to identify studies on the psychometric properties of measures assessing all three domains (cognitive, behavioural, and emotional) of self-regulation. The types of psychometric properties were examined against the COSMIN taxonomy of measurement properties. A total of 15,583 studies were identified, and 48 of these met the criteria that reported psychometric properties of 23 self-regulation measures assessing all three domains of self-regulation. Most measures relied on self-reports for ages 11–17, and all had limited psychometric evaluation. The Emotion Regulation Checklist was the most studied measure. Notably, none of the studies evaluated measurement error. The content validity was inadequately evaluated, particularly in terms of comprehensiveness and comprehensibility. Future research should focus on developing measures for young children, evaluating measurement error, and enhancing content validity for comprehensive understanding and effective intervention.

Impaired somatosensory habituation in older adults with chronic pain during an affective oddball task.

Chronic pain is one of the most common health conditions among older adults, triggering various disruptions in information processing across attentional, emotional, and somatosensory domains. However, there is insufficient information about how these aspects interact and their potential contribution to the vulnerability of older adults to chronic pain. This study aimed to investigate potential alterations induced by chronic pain during aging in attentional aspects of tactile stimulation and to observe the influence of affective context. Twenty-six older adults with chronic pain (70.00 ± 5.07 years; 11 males), 28 pain-free older adults (69.57 ± 3.96 years; 13 males) and 27 healthy younger adults (21.48 ± 1.80 years; 14 males) participated in the study. We compared the somatosensory evoked potentials elicited by frequent and deviant stimulation (probability 14%) applied when participants were viewing blocks of pleasant, unpleasant, and neutral images from the International Affective Picture System. During frequent stimulation, older adults with chronic pain showed higher P50 and N100 amplitudes compared to pain-free older adults and younger individuals. Furthermore, the older group with pain exhibited higher P300 amplitude during emotional contexts compared to neutral scenarios. During deviant stimulation, older adults with chronic pain exhibited higher P50 and N100 amplitudes compared to pain-free older adults but displayed typical age-related flattening during P300. These findings indicate that chronic pain leads to a decline in the ability to habituate to non-painful irrelevant somatosensory stimuli, especially when it is presented in an emotional context. In the present study, we have observed how older individuals suffering from chronic pain exhibit a decline in the habituation capacity of irrelevant somatosensory information. Furthermore, we have observed how the affective context in which these individuals are situated leads to an exacerbation of this deficit. Enhancing our comprehension of how aging and chronic pain interact to impact somatosensory processing could facilitate the tailoring of novel intervention strategies.

Indulgent Parenting and Adolescents' Maladjustments: The Roles of Cultural Context and Parental Gender.

Background/Objectives. Adolescence is a critical developmental stage marked by the exploration of independence and self-identity. In this study, we aimed to examine the association between indulgent parenting (characterized by high responsiveness and low demandingness) and adolescents' maladjustments across emotional, behavioral, and social domains. Methods. Using a cross-cultural sample of high school students from the U.S. (n = 268) and China (n = 189), we tested the hypotheses that indulgent parenting was associated with adolescents' maladjustments, and that such association varied by cultural context (U.S. vs. China) and parental gender. Results. The results from Bayesian structural equation modeling supported the hypotheses, showing significant associations between indulgent parenting and adolescents' maladjustments and differences in the associations across cultures and parental gender. Conclusions. The findings highlighted the need for culturally informed parenting programs to foster healthy adolescent development.

Impact of Acquired Brain Injury on Quality of Life.

An injury to the brain affects a person in some or all cognitive, emotional, behavioural and physical domains impacting quality of life. Quality of life is essential to well-being and optimum functioning of a person in daily life. It is influenced by various individual and social aspects like physical, psychological, social relationships and environment. This article discusses an overview of impact of acquired brain injury on quality of life. This article aims to create an awareness of the nature of brain injury, factors impacting quality of life, and inter-relationships amongst them which can have implications for clinical rehabilitation. An acquired brain injury is a life-changing event for the affected person and the family. It is globally considered a national burden. As compared to the developed countries, the availability and access to social determinants of health is low in the underdeveloped, and developing countries. An awareness of the nature of brain injury, the prognosis, available approaches to treatment can enable simple cost-effective psychosocial interventions to complement overall rehabilitation plan.

Comparative analysis of Health-Related Quality of Life, anxiety and depression in patients with alopecia areata, atopic dermatitis and with association of these diseases

Introduction. Alopecia areata (AA) and atopic dermatitis (AtD) are associated with significant psychosocial burden, emphasizing the importance of quality of life (QoL) assessment due to potential psychological distress and treatment hindrance.Aim. To conduct a comparative analysis of QoL, anxiety and depression in patients with AA, AtD and their combination, according to diseases severity.Materials and methods. The study included 91 patients of both sexes (18–52 years old). All patients were divided into 3 groups: group 1 – 25% patients with AA, group 2 – 28% with AtD, group 3 – 47% patients with both diseases; the groups were subdivided by dermatoses severity. The DLQI, Skindex-29 and HADS questionnaires were used. Mann-Whitney U-test was conducted to compare the mean values of quantitative data (М ± n) (p &lt; 0.05).Results. Group 1 had moderately decreased QoL according to DLQI (6.5 ± 0.67); total Skindex-29 score was 23.55 ± 2.46 (low impact) with the highest value in the emotion domain. In group 2 DLQI score was 12.5 ± 1.51, total Skindex-29 score was48.41 ± 3.76; in group 3 DLQI was 11.5 ± 0.58, Skindex-29 – 50.46 ± 2.14. These values corresponded to very negative impact on QoL, increasing with diseases severity. There was a reliable difference in DLQI and Skindex-29 values between groups 1 and 2 and groups 1 and 3. Mean HADS scores in all groups were generally comparable and correlated with AtD and AA severity.Conclusion. Compared to AA, AtD has a greater impact on QoL, involving all areas of social health; AA predominantly affects emotional sphere. The presence of both diseases worsens QoL as well as AtD alone, especially in aspects “emotions” and “functions”.

Age-Related Variations in Clinical Profiles for Children with Sports- and Recreation-Related Concussions.

The purpose was to examine clinical profiles in concussed children aged 5-9 and 10-12 years and compare them with those of adolescents >12 years. This study included patients aged 5-18 years presenting to a specialty care concussion program with a sports- and recreation-related (SRR) concussion ≤28 days postinjury. Demographics, injury mechanisms, symptoms, and clinical features were assessed. Chi-squared tests, one-way ANOVA, and Kruskal-Wallis were used for comparisons across age groups. A total of 3280 patients with SRR concussion were included: 5.0% were 5-9 years, 18.4% were 10-12 years, and 76.6% were 13-18 years. Younger age groups had more males than females (5-9 years: 70.7% vs. 29.3%) and more commonly sustained their injury during limited- (28.7%), and non-contact (7.9%) activities compared to other age groups (p < 0.01). Younger children presented less symptoms frequently (p ≤ 0.042), but higher symptom severity in somatic and emotional domains (p ≤ 0.016). Fewer 5-9-year-olds reported changes in school (25.6%), sleep (46.3%), and daily habits (40.9%) than adolescents (p < 0.001). Among SRR-concussed children and adolescents, we found significant age-related variations in demographics, injury mechanism, symptoms, and clinical features. Recognizing these unique features in younger children may facilitate targeted management and treatment.

Research on the soothing Liver - Qi stagnation method in the treatment of postoperative papillary thyroid carcinoma patients' concomitant depression: A randomized controlled clinical trial.

Postoperative papillary thyroid carcinoma (P-PTC) patients often grapple with depression fueled by the looming threat of recurrence. While the Liver-Qi stagnation method is frequently employed for depression management, a notable scarcity of clinical trials exists regarding its application in patients with P-PTC and concurrent depression. This study presents a randomized controlled clinical trial, aiming to establish the efficacy of the Liver-Qi stagnation method in alleviating depression in patients with P-PTC. In this randomized controlled clinical trial, P-PTC patients diagnosed with concomitant depression were systematically enrolled. Subjects were randomly assigned to either the control or test group, both receiving standard treatment comprising Levothyroxine sodium tablets and decoction of benefiting Qi and nourishing Yin. Additionally, the test group received supplementation with bupleuri radix-paeoniae alba radix (CH-BS) alongside the baseline therapy. The intervention spanned 12 weeks. Pre- and post-treatment evaluations were conducted using the Hamilton Depression Scale (HAMD), European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and Traditional Chinese Medicine (TCM) syndrome score scale. Concurrently, blood inflammatory factors and serum 5-hydroxytryptamine (5-HT) levels were measured to comprehensively assess treatment outcomes. During the 12-week intervention, the test group demonstrated a significant reduction in HAMD scores compared to the control group (P < .05). Moreover, post-treatment serum 5-HT levels were significantly elevated in the test group compared to the control group (P < .05). Findings gleaned from the EORTC QLQ - C30 revealed a noteworthy improvement in social function and overall quality of life scores within both groups post-treatment in comparison to baseline (P < .05). Concurrently, post-treatment scores for fatigue and insomnia symptoms witnessed a significant decrease compared to baseline (P < .05). Notably, the test group exhibited superior scores in the emotional domain in contrast to the control group (P < .05). Both groups exhibited a substantial decrease in TCM syndrome scores from baseline (P < .05). Noteworthy increases were found in IFN-γ < 2.44 rate (62.86%) and IL-6 < 2.44 rate (74.29%) in the test group compared to pretreatment levels (P < .05). The soothing Liver-Qi stagnation method induces a rise in serum 5-HT levels, reducing depression-related inflammatory factors, culminating in the alleviation of depression for P-PTC.

B - 42 Evaluating the MMPI-3 Somatic/Cognitive Scales in Service Members and Veterans with Mild Traumatic Brain Injury (mTBI)

Abstract Objective Research on the Minnesota Multiphasic Personality Inventory, 3 (MMPI-3) Somatic/Cognitive scales is limited, but primarily focused on their relationships with symptom and performance validity tests. This study expands prior literature by providing extensive Somatic/Cognitive Scale correlates with symptom validity tests and neurocognitive measures in a sample of active-duty personnel and veterans. Method The study included Active-duty Service Members (n = 22) and Veterans (n = 31). Various measures of cognitive abilities and symptom validity were examined as a function of the Cognitive Complaints (COG) scale. Results Moderate to large differences were observed between COG groups across all MMPI-3 overreporting scales and all somatic/cognitive scales, save the NUC scale (g = 0.66–1.31 [excluding NUC]). Groups differed on three Memory Complaints Inventory memory scales: General (g = 0.89), Visuo-spatial (g = 0.62), and Verbal (g = 0.97). No significant differences were observed across cognitive tests (e.g., WAIS, CVLT). COG was moderately associated with all MMPI-3 overreporting and most somatic/cognitive scales (r = 0.30–0.72). Small to moderate correlations were observed between COG and most external validity and neurocognitive measures (r = 0.05–0.60). Conclusions Results suggest the COG scale primarily captures subjective distress rather than objective neurocognitive performance, consistent with prior work (Gervais et al., 2009). These patterns are especially pronounced in emotional, social, and somatic symptom domains. Additionally, COG scores were associated with MMPI-3 overreporting scores, but COG had weaker associations with external neurocognitive and symptom validity measures. These results suggest that COG has weak convergent validity with other self-report measures of cognition (e.g., Neurobehavioral Symptom Inventory).

Assessing the health-related quality of life of cutaneous Leishmaniasis patients in Draa-Tafilalet, southeastern Morocco

Cutaneous leishmaniasis is a significant public health concern globally. This study aims to evaluate the impact of cutaneous leishmaniasis on the quality of life of patients in the Draa-Tafilalet region of Morocco. In this cross-sectional study, data were collected from 87 patients between December 2022 and July 2023 using the Skindex-16 questionnaire. The results revealed that cutaneous leishmaniasis has a mild to moderate impact on health-related quality of life, with 26.4 % of participants reporting a low impact and 73.6 % reporting a moderate impact. A significant gender difference was observed in Skindex-16 scores, with moderate impact being more prevalent among females (60.90 % vs. 30.10 %, p = 0.002). Furthermore, facial lesions were associated with a statistically significant reduction in quality of life, particularly in the emotional (p < 0.001) and functioning (p = 0.01) domains. These findings highlight the need for targeted management strategies that address the substantial impact of cutaneous leishmaniasis on patients' quality of life. Future studies with larger sample sizes and extended follow-up periods are warranted to further elucidate the effects of cutaneous leishmaniasis on patients' well-being.

Developing the quality of life in pregnancy scale (PREG-QOL)

AimThis study aims to develop the Quality of Life in Pregnancy Scale (PREG-QOL) as a new instrument to evaluate the quality of life during pregnancy and test its psychometric properties.DesignAn instrument development study and psychometric testing of the content and construct validity, factor structure and reliability.MethodsThe study was conducted in three stages: (1) creating an item pool, (2) preliminary evaluation of items, and (3) refining the scale and evaluating psychometric properties. Instrument development guidelines were used to evaluate content validity, construct validity, internal consistency and stability of the instrument over time. Data to evaluate psychometric properties of the PREG-QOL were collected between April and August 2021.ResultsItems were developed using in-depth interviews with pregnant women and extensive literature review. Scale-content validity index was 0.98. Exploratory factor analysis revealed a 26-item instrument with 6 factors, which explained % 56.2 of variance. Confirmatory factor analysis (CFA) showed that factors 3 and 5 should be combined into the factor of physical domain since they included items about the same theme. Fit indices obtained by CFA were at sufficient levels. Parallel test method was employed to evaluate the correlation of the PREG-QOL with the SF-36. The findings indicated that the PREG-QOL had high internal inconsistency and stability over time.ConclusionThe PREG-QOL is a valid and reliable instrument in terms of its psychometric characteristics. The 26-item instrument was composed of the five factors of perception of general satisfaction, emotional domain, physical domain, health support systems and social domain.ImpactDisplaying good psychometric properties, the PREG-QOL may be used to evaluate multiple dimensions of the quality of life during pregnancy.

After-school Clubs: Fostering Protective Factors

Background: Affiliation to gangs becomes analogous to the need for belongingness; a leader or member of the gang can substitute a primary caregiver, or act as a parent figure or a role model. Children and youth associated with gangs lean toward antisocial activities compared to their nongang counterparts. After-school clubs (ASCs) probably demote gang membership providing support in various aspects of self-growth and thereby compassing the need for affiliation. Objectives: The aim of the study was to assess the relationship between risky behavior and gang membership in children and compare the gender differences for the same. Materials and Methods: This cross-sectional, observational study was conducted using purposive sampling approaching the children enrolled in an ASC run for children who had dropped out of the school. The participants were 97 children (male and female) attending the ASC between the age range of 6–18 years. They were assessed on sociodemographic and academic profiles; Social, Academic, and Emotional Behavior Risk Screener (SAEBRS); and Gang Membership Inventory (GMI). Results: It was observed that the SAEBRS score range of female participants implied “not at risk,” while male participants scored “at risk” scores on social and emotional domains. On GMI, only male participants’ scores showed gang affiliation. The model explained that 76% of the variance in GMI was contributed by the SAEBRS. Conclusion: ASC contributed valuably in integrating a vulnerable population into the productive national mainstream. Affinity with ASC can enhance the protective factors and minimize the risk of gang membership. Studies in the future can explore parental factors and resilience of this population along with socioeconomic factors to delve into risky as well as protective behaviors.

Self-perceived quality of life, cognitive and behavioural impairment in amyotrophic lateral sclerosis

BackgroundSelf-perceived quality of life (QoL) is important in amyotrophic lateral sclerosis (ALS). Although caregiver burden and strain have been related to cognitive and behavioural impairment, there has been no comprehensive research looking at these impairments and how they may influence self-perceived QoL subdomains.AimsTo explore how cognitive and behavioural impairment are related to different areas of self-perceived QoL using disease-specific measures.MethodsThis was a quantitative, cross-sectional, observational cohort study, utilising existing specialist ALS clinic data. Clinical and demographic variables were available as well as multidimensional measures, ALS-specific QoL Short Form (ALSsQoL-SF) results and the data from the Edinburgh Cognitive and Behavioural ALS Screen (ECAS). Group comparison and regression analyses were performed.ResultsData from 121 participants with ALS were analysed. 61.2% (N = 74) had either cognitive and/or behavioural impairment, with 28.9% (N = 35) with cognitive impairment (ALSci), 14.1% (N = 17) with behavioural impairment (ALSbi) and 18.2% (N = 22) with both (ALScbi). 38.8% (N = 47) were classified as having no impairments (ALSni). Those with ALSbi had significantly lower QoL in the domains of negative emotions and the interaction with people and the environment compared to those with ALSci and ALSni (ps < 0.05). Further, those with ALScbi had significantly lower QoL in the intimacy domains than those with ALSci and ALSni (ps < 0.05). Regression analysis showed specific cognitive and behavioural (inclusive of psychosis) predictors associated with specific QoL subdomains.ConclusionsBehavioural impairments effect QoL in specific subdomains, namely relating to internalising (negative emotions) and externalising (interaction with people and the environment subdomains, intimacy).

Nationwide cost-effectiveness and quality of life analysis of minimally invasive distal pancreatectomy

BackgroundThis study analyzed the Quality of Life (QoL) and cost-effectiveness of laparoscopic (LDP) versus robotic distal pancreatectomy (RDP).MethodsConsecutive patients submitted to LDP or RDP from 2010 to 2020 in four high-volume Italian centers were included, with a minimum of 12 months of postoperative follow-up were included. QoL was evaluated using the EORTC QLQ-C30 and EQ-5D questionnaires, self-reported by patients. After a propensity score matching, which included BMI, gender, operation time, multiorgan and vascular resections, splenic preservation, and pancreatic stump management, the mean differential cost and Quality-Adjusted Life Years (QALY) were calculated and plotted on a cost-utility plane.ResultsThe study population consisted of 564 patients. Among these, 271 (49%) patients were submitted to LDP, while 293 (51%) patients to RDP. After propensity score matching, the study population was composed of 159 patients in each group, with a median follow-up of 59 months. As regards the QoL analysis, global health and emotional functioning domains showed better results in the RDP group (p = 0.037 and p = 0.026, respectively), whereas the other did not differ. As expected, the median crude costs analysis confirmed that RDP was more expensive than LDP (16,041 Euros vs. 10,335 Euros, p < 0.001). However, the robotic approach had a higher probability of being more cost-effective than the laparoscopic procedure when a willingness to pay more than 5697 Euros/QALY was accepted.ConclusionRDP was associated with better QoL as explored by specific domains. Crude costs were higher for RDP, and the cost-effectiveness threshold was set at 5697 euros/QALY.