Inventory-Short Form Research Articles

Exploring the link between parents' differentiation of self and children's externalizing behavior problems: the mediating role of need-supportive vs. need-frustrating parenting practices.

Externalizing behavior problems (EBPs) are common in children, with significant long-term impact on the child and family members. Parents, particularly mothers, of children with EBPs often experience heightened emotional distress. One crucial factor affecting parents' ability to manage this distress is their level of differentiation-of-self (DOS). Differentiated parents are more likely to engage in practices that meet their child's psychological needs, thus supporting the self-determination theory principles vital for a child's well-being. This study examined the impact of parental DOS on parenting practices and subsequently on the child's EBPs, exploring possible differences between mothers and fathers. Thirty-two mother-father dyads with children aged 6-14, diagnosed with EBPs participated. Parents completed the Differentiation of Self Inventory-Short Form, the Revised Parents as a Social Context Questionnaire, and the Strengths and Difficulties Questionnaire to assess parental DOS, practices, and child's EBPs, respectively. Adjusted parallel mediation models examined the mediating role of parental practices in the relationship between parental DOS and a child's EBPs. While no direct link between parental DOS and child's symptoms was found, a complete mediation model indicated need-frustrating practices mediating between parental DOS and a child's EBPs, for both mothers and fathers. Additionally, fathers' need-supportive practices, but not mothers', were negatively associated with the child's symptoms. These findings highlight the interaction between parental traits, need-frustrating practices, and a child's psychopathology. Notably, fathers' supportive behaviors emerged as potential protective factors against child's EBPs, suggesting promising directions for future research and interventions targeting fathers.

Patient-reported outcomes (PROs) from a randomized, phase 3 trial of enfortumab vedotin plus pembrolizumab (EV+P) versus platinum-based chemotherapy (PBC) in previously untreated locally advanced or metastatic urothelial cancer (la/mUC).

108 Background: EV+P nearly doubled median progression-free survival and overall survival vs PBC in patients (pts) with previously untreated la/mUC in the phase 3 EV-302 trial. PROs are reported here. Methods: In EV-302 (NCT04223856) pts were randomized 1:1 to EV+P or PBC (gemcitabine with cisplatin or carboplatin). PRO assessments included the EORTC Quality of Life Questionnaire (EORTC QLQ-C30), and the Brief Pain Inventory Short Form (BPI-SF) completed at baseline, weekly for 12 weeks (wks), then every 3 wks through survival follow-up, inclusive of the time post-progression. Time to pain progression (TTPP) and mean change from baseline in worst pain at wk 26 using the BPI-SF were prespecified analyses statistically tested using a gatekeeping strategy. Mean change from baseline through wk 26 and time to confirmed deterioration (TTCD) of EORTC-QLQ-C30 and BPI-SF domains were prespecified descriptive analyses. TTPP and TTCD were assessed using Kaplan-Meier methods. Results: Of 886 pts randomized, 731 (376 received EV+P; 355 PBC) completed baseline PRO questionnaires. Compliance rates differed between arms and remained >70% through wk 29 for EV+P and through only wk 17 for PBC. Median TTPP was 14.2 months (mos) with EV+P and 10.0 mos with PBC (hazard ratio [HR]=0.92; 95% CI=0.72, 1.17; 2-sided p-value=0.48). The least squares (LS) mean reduction in worst pain at wk 26 was numerically greater with EV+P vs PBC (-0.61 vs -0.03, LS mean difference [95% CI]: -0.58 [-1.05, -0.11] [nominal 2-sided P = 0.015]). Pts with moderate to severe pain at baseline who were treated with EV+P (n=128, 34%) had a meaningful (>2 pt) improvement from baseline in BPI worst pain from wk 3 through 26. In EORTC QLQ-C30 Global Health Status/Quality of Life [GHS/QoL], EV+P demonstrated a transient worsening at week 3 (-6.3) that returned to baseline from weeks 4 through 26, while patients treated with PBC demonstrated deterioration from week 1 through week 17 (range -1.2 to -7.1) where scores returned to baseline. TTCD for EORTC QLQ-C30 GHS/QoL was 5.9 mos with EV+P vs 3.2 mos with PBC (HR = 0.98 [95% CI]: 0.79 – 1.2). Conclusions: Pts treated with EV+P have improved survival compared with PBC without detriment to quality of life and functioning, further supporting the value of EV+P for pts with la/mUC. Compliance, especially after progression, was lower than expected (particularly in the PBC arm) and may have impacted the results. Clinical trial information: NCT04223856 .

A Comparison of Pain Before and After Transfusion in Adult transfusion-dependent thalassemia (TDT) Using BPI-SF.

Background Pain is a complication in patients with transfusion-dependent thalassemia (TDT). There are several mechanisms underlying pain in people with thalassemia and low hemoglobin at the end of the transfusion cycle was the most etiology. Pain can develop into chronic pain and interfere with the quality of life. The Brief Pain Inventory Short Form (BPI-SF) can help identify pain in people with TDT. The present study aimed to compare pain before and after transfusion in adult TDT patients. Methods It was an analytical observational study using a cross-sectional design on adult TDT patients with pain who came to the Haemato-Oncology Clinic of Dr. Hasan Sadikin Hospital Bandung. This study was conducted from December 2020 to July 2021. All subjects were assisted in filling out the Indonesian version of the BPI-SF questionnaire hemoglobin levels were examined and before and after transfusion, then paired test analysis was performed using the Wilcoxon Test. Results This study is conducted on 60 adult TDT patients with symptoms of pain. The median value of pain intensity and pain interferes with life obtained from the Indonesian version of the BPI-SF score after transfusion decreased significantly compared to before transfusion (NRS 5 vs. 0 and 2.8 vs. 0; p=0.0001). Conclusion There is a significant difference in pain intensity and pain interfere with life in adults with TDT before and after transfusion. It is necessary to carry out pain assessments for thalassemia patients.

Self-differentiation as an intermediate variable between anger management and neurotic perfectionism among high achievers “a psychological study of the rights of special education”

PurposeThis study aims to explore the intermediate role of self-differentiation in anger management and neurotic perfectionism for a sample of high achievers at some public universities in Egypt and Saudi Arabia. This increases the chances of these students obtaining their rights.Design/methodology/approachThe researcher used the microcopy of Drake, Murdock, Marszalek and [(the Differentiation of Self Inventory—Short Form (DSI-SF)] scale, differentiation of self child-adolescent perfectionism scale and Davidson and Munro (2000) scale of neurotic perfectionism in addition to the anger management scale of the current study. The researcher used the appropriate statistical methods and the descriptive design to find the results.FindingsThe results showed that there is no statistically significant difference among male and female students in the positive anger management while three was a statistically significant difference among them in the negative anger management favoring male students. Further, there were no statistically significant differences among the study sample according to the country (Egypt and Saudi Arabia) in anger management (positive and negative). Moreover, there was a correlation matrix between the study variables as shown in the study; The statistical analysis was conducted to identify the suggested constructive model and variables of the study, anger management (positive-negative) as an independent variable, self-differentiation as an intermediate variable and neurotic perfectionism as a dependent variable among high achievers, This explains the necessity of preparing the environment for these students to become more healthy, through which they can enjoy all their rights as a category of special education, where most of the focus is on the handicapped groups from special education more than the high achievers’ students.Originality/valueThe study recommended that higher education courses should focus on anger management skills and the development of self-differentiation and the positive part of perfectionism. Also, the current study provided the educators of higher education with some suggestions to promote it and develop high achievers, which may lead to positive mental and physical health for high achievers and raising awareness of society and obtaining their rights in education and life.

Enhancing the autologous fascial sling procedure: A novel fixation method for treating stress urinary incontinence in female patients.

Synthetic mid-urethral sling surgery has long been the standard surgical treatment for stress urinary incontinence (SUI) worldwide. Using an autologous fascial sling is an alternative to reduce adverse events. We evaluated the treatment outcomes of a novel fixation method applied to the autologous transobturator fascial (TOF) sling procedure for female patients with SUI. A retrospective study was conducted between 2017 and 2020, including 33 patients with SUI who underwent mid-urethral TOF sling surgery with the novel fixation method. We used a self-locking feature (V-LOC™) that was fixed to each side of skin layer above the obturator foramen, and the tension of the fascia sling was adjusted by manipulating the V-LOC™ suture. We analyzed all data collected through questionnaires, including Urinary Distress Inventory-Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7), Overactive Bladder Symptom Score (OABSS), and Clinical Global Impressions of Improvement (CGI-I). Adverse events were also recorded. This study included 33 female patients aged 39-79 (mean 59.76 years). Following the procedure, there was a significant reduction in the total scores of UDI-6, IIQ-7, and OABSS (preoperative 9.73±4.35, 10.21±5.79, 6.06±4.03 and postoperative 3.52±3.41, 0.85±3.67, 3.06±2.90, respectively) (p < 0.001). Further analysis of each sub-score of the questionnaires revealed significant improvement in certain symptoms. The mean total score of CGI-I was 2.00 ± 0.80. The maximum flow rate was documented for 18 patients, and no significant reduction was observed after the procedure (p = 0.804). Complications reported included voiding dysfunction in two patients (6.1 %), inguinal pain in one patient (3.0 %), and mild delayed wound healing in one patient (3.0 %). This modified TOF sling surgery with a novel fixation method by V-LOC™ suture offers feasibility and adjustability as its main advantages. Our study demonstrated significant improvements in patient outcomes.

Assessing how individuals conceptualize numeric pain ratings: validity and reliability of the Pain Schema Inventory (PSI-6) Short Form.

While numeric scales to represent pain intensity have been well validated, individuals use various conceptualizations when assigning a number to pain intensity, referred to as pain rating schema. The 18-item Pain Schema Inventory (PSI-18) quantifies pain rating schema by asking for numeric values for multiple mild, moderate or severe pain conditions. This study aimed to assess the validity and reliability of a shortened form of the PSI, using only 6 items (PSI-6). A secondary analysis was performed on two existing datasets. The first (n = 641) involved a community-based population that completed the PSI-18. The second (n = 182) included participants with chronic pain who completed the PSI-6 twice, one week apart. We assessed face validity, convergent validity, offset biases, test-retest reliability, and internal consistency of the PSI-6 compared to the PSI-18. Both the PSI-18 and PSI-6 demonstrated excellent face validity. The PSI-6 demonstrated excellent convergent validity relative to the PSI-18, with correlations from r = 0.88 to 0.92. Bland-Altman plots revealed offset biases near zero (< 0.22 on 0-10 scale) across all categories of mild, moderate, severe and average pain. Internal consistency was excellent, with Cronbach's Alpha = 0.91 and 0.80, for PSI-18 and PSI-6 respectively. Test-retest reliability of the PSI-6 was high with correlations from r = 0.70-0.76. The PSI-6 is a valid and reliable tool to assess pain rating schema with reduced subject burden, to better interpret individuals' pain ratings and adjust for inter-individual variability.

Reliability and validity of the French Five-Factor Narcissism Inventory–Short Form.

Reliability and validity of the French Five-Factor Narcissism Inventory–Short Form.

Quality of life after anterior vaginal wall suspension for incontinence and prolapse repair with mixed, urge, or stress urinary incontinence

Purpose:To compare qualify of life outcomes in women with mixed urinary incontinence (MUI), urge (UUI) or stress (SUI) urinary incontinence after treatment with an anterior vaginal wall suspension (AVWS) to correct urethral hypermobility and concomitant anterior compartment prolapse (ACP). Methods:Following IRB approval, a prospective long-term database of women who underwent an AVWS for urinary incontinence (UI) with early stage (stage ≤2) ACP was reviewed. Patients completed the Urogenital Distress Inventory short form (UDI-6 SF) and a one question visual analog scale (VAS) of quality of life (QoL) before and after AVWS. Indication for AVWS was based on demonstrable UI, with documented urethral hypermobility and cystocele on standing lateral cystogram comparing rest and straining views. Three groups (MUI, SUI, and UUI) were analyzed based on urge (Question 2) and stress (Question 3) predominant scores at baseline. Results:From 1997 to 2018, 104 patients met study criteria: 54 with MUI, 30 SUI predominant, and 20 UUI predominant. Total UDI-6 and QoL scores improved significantly from baseline to 1-year post-AVWS and to the last visit (median 3.5 years) in all three groups. Patients with MUI had the most improvement based on UDI-6 total and QoL scores. Conclusions:Regardless of the nature of baseline UI symptoms, restoring support of the anterior vaginal wall compartment can durably improve UI-specific quality of life scores in the short and long-term.

Psychometric properties of the French Infant-Toddler Working Alliance Inventory Short version (IT-WAI-S)

Objective Therapeutic alliance has been little investigated in infant and toddler therapy, with no tools specifically adapted to this population. However, we have developed the Infant-Toddler Working Alliance Inventory-Short form (IT-WAI-S) which is based on the Working Alliance Inventory. The aim of this study was to assess the psychometric properties of this original French tool, in its two versions: for parent (IT-WAI-SP) and for therapist (IT-WAI-STh). Method This study included 227 families consulting with their 18–48-month-old child for emotional or behavioral disorders. The scales were filled in at the first three therapy sessions. The IT-WAI-S acceptability, internal validity, reliability and predictive validity (association with child and mother’s outcomes) were evaluated. Results Confirmatory then exploratory factor analyses revealed a three-factor structure for the both scales: Negative Experience of Care Relationship, Positive Alliance and Alliance with the Child. Acceptability, reproducibility and construct validity were satisfactory for both versions. The two versions predicted the child's outcome. The IT-WAI-SP predicted also the mother’s outcome. The IT-WAI-STh gave more reproducible results, whereas the IT-WAI-SP was a better predictor of the child's progress. Conclusion The two IT-WAI-S versions showed good psychometric properties and could be used to study the therapeutic alliance in young children.

Caregiving Experiences as Mediators Between Caregiving Stressors and Anticipatory Grief in Severe Dementia: Findings From Longitudinal Path Analysis

ObjectivesFamily caregivers of older adults with severe dementia often experience anticipatory grief. We aimed to investigate the temporal association of caregiving stressors (older adults’ behavioral symptoms, and caregiver-older adult co-residence and emotional closeness) and caregivers’ anticipatory grief, and its mediation by positive and negative caregiving experiences. DesignProspective cohort. SettingSingapore. ParticipantsAbout 169 family caregivers of older adults with severe dementia were surveyed every 4 months for 4 years (up to 13 surveys). MeasurementsWe measured anticipatory grief using the Marwit Meuser Caregiver Grief Inventory-Short Form, negative caregiving experiences using the Caregiver Reaction Assessment scale, positive caregiving experiences using Gain in Alzheimer Care Instrument and behavioral symptoms using the Cohen-Mansfield Agitation Inventory. We implemented a cross-lagged panel model to test mediation, a form of longitudinal path analysis. ResultsAbout 35% of the caregivers reported high anticipatory grief at least once during the study period. Older adults’ behavioral symptoms had a significant direct effect (Standardized coefficient [95% confidence interval]: 0.12 [0.04, 0.21]) on caregivers’ anticipatory grief. Negative experiences mediated the significant indirect effect of older adults’ behavioral symptoms (0.16 [0.06, 0.25]) and coresidence (0.16 [0.07, 0.25]) on caregivers’ anticipatory grief. Positive caregiving experiences did not mediate any path. ConclusionsFindings indicate a temporal association between caregiving stressors and anticipatory grief, mediated by negative caregiving experiences. Routine screening for anticipatory grief, and interventions to address caregiver stressors and negative caregiving experiences may alleviate caregivers’ grief.

Opioid-Free Anesthesia and Analgesic Quality During the Postoperative Period of Oncological Breast Surgery

&amp;lt;i&amp;gt;Background: &amp;lt;/i&amp;gt;Pain is one of the most common symptoms in cancer patients. We can understand it as a multifactorial phenomenon. Breast cancer surgical treatment generates real damage to the structures and activates nociception which can generate persistent pain. Current anesthetic management is based on the use of opioids, which generate a large number of complications that can severely affect this group of patients, increasing morbidity and mortality. Opioid-free techniques have been shown to reduce complications and generate optimal anesthetic-analgesic management as well as decrease postoperative misuse. The purpose of this research is to compare both approaches and evaluate their impact on this population group. &amp;lt;i&amp;gt;Methods: &amp;lt;/i&amp;gt;Simple, prospective, randomized, controlled blind clinical trial in 30 patients undergoing oncological mammary quadrantectomy a. The patients were divided into two groups study, the first (group A) received balanced general anesthesia with opioids as an analgesic strategy, the other group (group B) received general anesthesia balanced opioid-free supplemented with a PECs II regional block and/or Serratus (BRILMA) according to the patient&amp;apos;s sonoanatomy, and ketamine-lidocaine as adjuvant drugs. Analgesia was assessed using the numerical pain scale at 2, 4, and 6 o&amp;apos;clock. The severity and impact of pain on the daily performance of patients were measured using the Brief Pain Inventory (BPI) short form in combination with clinical examination, the presence of postoperative complications, the length of stay in hours and the need for rescue with opioids. &amp;lt;i&amp;gt;Results: &amp;lt;/i&amp;gt;35% of the patients in group A required analgesic rescue with Tramadol to improve pain postoperative, while in group B only 10% needed it. 33% of the patients in group A completed their postoperative period with nausea and vomiting, while in the opioid-free group the percentage was only 1%. Referring to the length of hospital stay from surgery to discharge, group A was hospitalized for a period of 25 hours (SD=21.2), while group B was there for 15.2 hours (SD=8.7). &amp;lt;i&amp;gt;Conclusions:&amp;lt;/i&amp;gt;. Use of opioid-free anesthesia along with adjuvant strategies (drugs and nerve blocks) represent a safe and effective anesthetic strategy related with a lower incidence of complications from the use of opioids in the postoperative period, a lower consumption of analgesic rescues, a decrease in the length of hospitalization and a greater degree of comfort for the patient. This protocol represents an alternative when it comes to providing good intra and postoperative conditions for such a susceptible group of patients.

Effect of Self-Differentiation on Trait Anxiety and Authenticity of University Students

The aim of this study is to analyze the effect of self-differentiation on trait anxiety and authenticity in university students. The sample consists of a total of 333 university students (244 female and 89 male) studying in various departments of a state university who volunteered to participate in the study. Differentiation of Self Inventory—Short Form (DSI-SF) was used to measure self-differentiation levels; “Trait Anxiety Scale” was used to measure trait anxiety levels; and “Authenticity Scale” was used to measure the authenticity levels of university students. The results obtained were analyzed both with SPSS and AMOS programs. The correlation between variables was observed with SPSS analysis. The analyses were tested at .05 and .01 significance levels using SPSS 25.0 package programme. The PROCESS (Model 4) Macro was used in SPSS to examine the mediating effect of anxiety in the relationship between self-differentiation and authenticity. The findings of the research indicated that the relationship between self-differentiation and authenticity in university students was partially mediated. The study also demonstrated the positive predictive value of self-differentiation at the level of authenticity in university students. The findings were then discussed in relation to the existing literature, with some suggestions for future research made.

Psychometric examination of the Multidimensional Psychological Flexibility Inventory Short Form (MPFI-24) and the Psy-Flex Spanish versions in individuals with chronic pain.

Acceptance and Commitment Therapy (ACT) has been found to be beneficial for individuals dealing with chronic pain. The theoretical mechanisms of change proposed by ACT are based on the Hexaflex model. To comprehensively reflect this model, the Multidimensional Psychological Flexibility Inventory (MPFI) and Psy-Flex have been developed. The study aimed to adapt the MPFI-24 and the Psy-Flex for Spanish-speaking populations with chronic pain and to examine their dimensionality, internal consistency, convergent validity and incremental validity. This cross-sectional study involved 309 Spanish-speaking adults with chronic pain who completed an online survey. The majority of the participants were women (88.3%). The ages ranged from 18 to 79 years. Factor analysis showed that the Spanish version of the MPFI-24 has 12 factors, consisting of six flexibility and six inflexibility factors, similar to the original version, but lacking second-order general factors. The Psy-Flex demonstrated a single-factor structure, maintaining the general factor of psychological flexibility seen in the original version. The MPFI-24 showed good internal consistency and adequate convergent validity, with the exception of the Acceptance and Experiential Avoidance subscales. The Psy-Flex showed good internal consistency and convergent validity. Notably, both the MPFI-24 and Psy-Flex scores significantly explained additional variance in psychological distress beyond other ACT-related measures of Hexaflex processes; however, only the Psy-Flex explained pain interference. The Spanish adaptations of the MPFI-24 and Psy-Flex are valid and reliable instruments for assessing the Hexaflex model processes in Spanish-speaking adults with chronic pain. Practitioners and researchers in chronic pain will find the Spanish versions of the MPFI-24 and the Psy-Flex here, along with recommendations for their use and scoring based on a robust psychometric rationale. It should be noted that these measures surpass the Chronic Pain Acceptance Questionnaire (CPAQ) and the Psychological Inflexibility in Pain Scale (PIPS), which are considered gold standards in chronic pain assessment.

Wound-related Pain and Quality of Life in Patients with Chronic Wounds in a Metropolitan City in Nigeria: An Analytic Cross-sectional Study

Abstract Background: The prevalence of chronic wounds is expected to rise with the increasing elderly population in the society. This rise in prevalence of chronic wounds comes with its consequences such as wound pain and interference with activities of daily living. There’s a paucity of data on the impact of chronic wounds in our clime. Objective: This study was carried out to assess the prevalence of wound-related pain and the impact of wound-related pain on the quality of life of patients with chronic wounds. Materials and Methods: This was an analytic cross-sectional study of consecutive patients presenting with chronic wounds in plastic surgery clinic in a metropolitan city in Nigeria using the brief pain inventory-short form. Result: About 371 patients were seen, with a male-to-female ratio of 1.7:1. The mean age was 37.1 ± 15.5 years. Most chronic wounds (72.2%) occurred in the lower limbs. Nearly all patients (92.9%) experienced wound pain, with a correlation between wound location and pain severity, P = 0.000. Over 50% of the patients had low wound-related quality of life. Enjoyment of life, general activity, and walking were the domains with high interference. Wound pain (P = 0.000) and wound location (P = 0.001) are significant determinants of poor wound-related quality of life. Conclusion: Patients with chronic wounds have a high prevalence of wound-related pain and low wound-related quality of life.

Selfies, narcissism and oral health a cross - sectional study among adolescents and young adults in Mangaluru - India.

Background Selfies have been defined as “a photograph that one has taken of oneself, and are a continuing growing trend among Millennials. Narcissism refers to the personality trait of an extraordinary self-awareness and adoration. Studies have shown a close relationship between selfie-taking behaviour, narcissism and oral health. Hence, a study was conducted with aim of the influence of selfie-taking behavior and narcissism on oral health. Methods An analytical cross-sectional questionnaire study was designed using relevant literature for collating information on sociodemographic characteristics, frequency of dental visits, selfie-taking behavior and perceived oral health. Oral health examination was performed to assess decay and plaque. Narcissism was assessed using The Five-Factor Narcissism Inventory Short Form Results The study included a sample of 163 participants. The associations between selfies taken per day and perceived oral health was statistically significant (p value 0.047*). Binary logistic regression models were constructed, which were significant for perceived oral health and grandiose fantasy. Plaque Scores showed significant corelations between indifference, manipulativeness, thrill seeking and age. Step forward binary regression demonstrated a significant odds ratio for grandiose narcissism followed by selfie-taking behavior Conclusion This study revealed a correlation between perceived oral health and selfie-taking behaviour. Further studies are required to assess selfie-taking behaviour and oral health.

The Complex Relationship Between Pain, Mental Health, and Quality-of-Life in Patients With Cirrhosis Undergoing Liver Transplant Evaluation.

Patients with cirrhosis undergoing liver transplant evaluation have high rates of pain and mental health comorbidities; both may significantly impair health-related quality of life (HRQL). We investigated the association between pain, anxiety/depression, and HRQL in this population. In 62 patients with cirrhosis undergoing liver transplant evaluation, we performed 4 validated assessments to characterize: pain (Brief Pain Inventory-Short Form, BPI-SF), anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-8), and liver-specific HRQL (Chronic Liver Disease Questionnaire). The presence of pain was determined using the BPI-SF screening question. Linear regression was used to identify demographic or clinical factors predictive of pain severity (PS) and interference (PI) and to evaluate the association between pain, anxiety/depression, and HRQL. Seventy-one percent of patients reported pain, 26% had clinical depression, and 24% had moderate-severe anxiety. Neither liver disease severity, nor its complications were associated with pain (PS or PI), but anxiety and depression were predictors of pain on bivariate analysis. Only depression remained a significant predictor of PS (b=0.28, P<0.05) and PI (b=0.30, P<0.05) in multivariable models. HRQL was inversely associated with PS, PI, depression, and anxiety, but only anxiety (b=-0.14, P=0.003) remained associated with HRQL in the adjusted model. Pain is present in over 70% of patients with cirrhosis undergoing liver transplant evaluation. Anxiety and depression were highly correlated with pain and appeared to be key drivers in predicting poor HRQL. Evaluating and managing mental health comorbidities should be explored as a strategy to improve HRQL in patients with cirrhosis and pain.

An investigation of sleep problems, gastrointestinal symptoms, comorbid psychopathology and challenging behavior in children and adolescents with Down Syndrome

BackgroundDown syndrome (DS) is one of the most common chromosomal abnormalities, and children with DS have increased risks of receiving diagnoses of specific comorbidities. AimsThis study aimed to assess the frequencies and relationships between sleep problems, gastrointestinal (GI) symptoms, comorbid psychopathology, and challenging behavior. Methods and proceduresThe Children’s Sleep Habits Questionnaire, Gastrointestinal Symptom Inventory, Autism Spectrum Disorder-Comorbid for Children, and Behavior Problems Inventory-Short Form were completed by 123 parents of children and adolescents with DS. Outcomes and resultsThe frequency of GI symptoms was 74.8 %, with high frequencies also found for: sleep problems (100 %), challenging behavior (100 %), and moderate to severe levels of comorbid psychopathology (tantrum=80 %; repetitive behavior=63 %; avoidant behavior=82 %; worry/depressed=61 %; conduct behavior=100 %; over-eating=100 %; under-eating=100 %). A significant moderate correlation was found between total GI symptoms and self-injurious behavior frequency. Children who presented with abdominal pain engaged in self-injurious behavior more frequently than those with no abdominal pain. Conclusions and implicationsFindings indicated a high frequency of sleep problems, comorbid psychopathology, GI symptoms, and challenging behavior and demonstrated a relationship between GI symptoms and self-injurious behavior in children and adolescents with DS. This research illustrated the importance of investigating comorbid conditions in individuals with DS. What this paper adds?Down Syndrome (DS) is a genetic condition characterized by trisomy 21 and is a leading cause of intellectual disability worldwide. The prevalence of DS is commonly associated with advanced maternal age and is associated with multiple comorbid conditions. The current study aimed to investigate the frequency of and relationship between sleep problems, gastrointestinal symptoms, comorbid psychopathology, and challenging behavior in children and adolescents with DS. High-frequency levels were found for sleep problems (100 %), challenging behavior (100 %), gastrointestinal symptoms (74.8 %), and moderate to severe levels of the different comorbid psychopathologies (tantrum=80 %; repetitive behavior=63 %; avoidant behavior=82 %; worry/depressed=61 %; conduct behavior=100 %; over-eating=100 %; under-eating=100 %). Results indicated a significant difference in self-injurious behavior frequency between individuals who presented with abdominal pain and those who did not. This study is the first to investigate the relationship of multiple comorbid conditions in a sample of children with DS. This paper adds to the literature by demonstrating the frequency of a number of comorbid conditions in children and adolescents with DS. The paper also adds novel findings to the literature by investigating the relationships between comorbid conditions in this population. The findings of this paper highlighted the frequency and comorbidities that exist between gastrointestinal symptoms, sleep problems, comorbid psychopathology, and challenging behavior. Analyses indicated that those who presented with abdominal pain, engaged in self-injurious behavior more frequently.Sleep problems, gastrointestinal symptoms, comorbid psychopathology, and challenging behavior in children and adolescents with Down Syndrome.

Rebound Exercises in Rehabilitation: A Scoping Review.

The term "trampoline" was coined in 1969, introducing a dynamic feedback mechanism for exercise. Rebounding exercise on a mini-trampoline utilizes an elastic surface supported by springs and gravity, potentially reducing cumulative trauma from repetitive loading. This type of physical activity provides enjoyable and engaging exercise for adolescents, especially those who are overweight, thereby reducing the likelihood of injuries associated with exercise. Mini-trampoline exercises enhance blood circulation, oxygen delivery, and bone health, impacting lower limb strength, balance, motor performance, blood glucose levels, executive function, physiological markers, and overall quality of life. The study focused on examining the overall impact of rebounding exercises in the field of rehabilitation. Its main goal was to assess how these exercises affect the rehabilitation process and different health measures. By investigating the comprehensive influence of rebounding exercises, the study aimed to determine their effectiveness in aiding physical and functional recovery, targeting specific rehabilitation goals, and enhancing overall health outcomes. We systematically reviewed medical literature databases such as PubMed, MEDLINE, Scopus, Google Scholar, and EBSCO. We included research articles, systematic reviews, meta-analyses, clinical trials, case studies, and observational studies published in English up to 10 years before the review's cutoff in December 2023. We considered participants across all age groups. Articles not in English were excluded from the review. The outcome measures were body composition, waist-hip ratio, Bruininks-Oseretsky test for motor proficiency, reaction time, insulin resistance, lipid profile, blood cholesterol level, forced expiratory volume in one second, and forced vital capacity, bone health indicators, blood lactate level, balance, strength: repetitive maximum, brief pain inventory (short form). A total of 11 reports met these criteria. In conclusion, this review provides a thorough look into the use, challenges, and future potential of rebound exercises in rehabilitation and fitness. Despite their wide-ranging applications, issues such as insufficient research, equipment variability, and safety concerns persist. Advancement requires more research for evidence-based guidelines, improved equipment design and safety measures, and collaboration among researchers, clinicians, and manufacturers. Overcoming challenges and fostering innovation can establish rebound exercises as a valuable tool in rehabilitation and fitness.

Efficacy and Safety of 177Lu-PSMA-617 in Combination with Radical Prostatectomy and Bilateral Orchiectomy in Men with Castrate-Sensitive Metastatic Prostate Cancer: A Pilot Study.

To investigate the efficacy and safety of 177Lu-PSMA-617 in combination with radical prostatectomy and bilateral orchiectomy in adult male patients with castrate-sensitive metastatic prostate cancer. This pilot study included 12 men with metastatic prostate cancer who underwent radical prostatectomy and received 177Lu-PSMA-617 in combination with hormonal therapy. The primary endpoint was the proportion of patients who achieved a PSA response, defined as a ≥50% reduction in PSA levels at first follow up from baseline. Secondary endpoints were the proportion of patients who achieved a PSA response, defined as a ≥50% reduction in PSA levels at second follow up from first one and progression in pain severity that was defined as an increase in score of 30% or greater from baseline without decrease in analgesic use based on Brief Pain Inventory-short Form (PBI-SF). The PSA levels of 9(75.0%) patients are reduced after first course of 177Lu-PSMA-617, additional reduction was observed in 7(58.3%) patients after receiving the 2nd course of treatment. Of the 12 patients, 3(25.0%) achieved a PSA response (≥50% reduction in PSA levels) at first follow up visit and 3(25.0%) patients had PSA response at second follow up, 6 patients (50.%) had a pain response. The most common adverse events were Mouth dryness and fatigue, which were manageable with supportive care. This pilot study suggests that radical prostatectomy and hormonal therapy in combination with 177Lu-PSMA-617 is a safe and effective treatment option and may have a role in the management of select patients with castrate-sensitive metastatic prostate cancer. Further studies are needed to confirm these findings and determine the optimal use in this setting.

The efficacy of an eight-week exercise program for the management of chronic low back pain in the equestrian population.

Equestrians (horse riders) are more susceptible to low back pain than the general population due to loads placed on their bodies during the activity. A specific eight-week exercise intervention program targeting the muscles used during horse riding was implemented for a group of equestrians with low back pain. Volunteers were invited to participate in the study through social media posts in Melbourne, Australia. The participants were required to complete an exercise screening test prior to enrolment in the study to ensure they were suitable to participate in the iteration program. Participants then completed the Brief Pain Inventory (BPI) (Short Form) and Patient Specific Functional Scale (PSFS) before commencing the exercise program. These outcome measures were completed again by participants after completing the 8-week exercise program. Nine equestrians (23-65 years of age; mean=43±14: average worst back pain on riding=7/10 with a range of 3-10/10) completed all outcome measures and the 8-week exercise intervention. Data indicate that all achieved improved pain severity, pain interference and riding functionality (P<0.01). An eight-week exercise program may be beneficial in improving a sample of equestrians' chronic LBP symptoms. From a practitioner's perspective, the findings provide an indication as to suitable exercises to prescribe to an equestrian to help reduce their LBP.