Screening Measures Research Articles

Systematic review of cost-effectiveness studies on cervical cancer screening across Europe

IntroductionCervical cancer (CC) is a type of cancer with poor prognosis when diagnosed in advanced stage with a big socioeconomic burden. The incidence rates have wide variations among European countries depending on the implementation or not of screening, vaccination programs and the human development index (HDI). Most studies on cost-effectiveness of CC screening programs are carried out in countries with a high HDI, however more recent reviews of screening approaches are coming from countries with lower HDI aiming to identify the best screening strategies. Our study aims to identify which are the currently applied and most cost-effective strategies of CC screening in Europe. Materials and methodsThis is a systematic review conducted in three different databases (PubMed, Scopus and ScienceDirect) and reported following the PRISMA guidelines. General key terms for all databases were the following: cost-effectiveness, cervical cancer, screening, Europe. We included studies in English, Italian, Spanish and Bulgarian, published in the last 25 years, reporting data on cost-effectiveness of CC screening, costs and outcome measures. The methodological quality of the articles was evaluated with a standardized tool. ResultsA total of 262 studies were identified and 22 studies were included in the final analysis. In 90.1 % of the economic studies, the new screening strategy was shown to be more cost-effective compared to the current one or compared to no screening. The optimal strategy mostly involved primary HPV testing, combined with cytology or as stand-alone screening technique. Several scenarios differing on starting age and periodicities for CC screening, combination of techniques and triage, were found to be cost-effective and below the willingness to pay (WTP) threshold. The methodology of all included studies was assessed from 10 to 11 on the JBI standardized tool and Drummond 11-point checklist. ConclusionNumerous cost-effective options for CC screening in different European countries were identified in this systematic review. HPV testing, with or without cytology, mainly starting at 30 years of age and repeated every 5 years or more was the most cost-effective technique. Future studies should focus on the most appropriate CC screening approach for each context and setting, also considering HPV vaccination in Europe.

Management of vancomycin-resistant Enterococcus faecium in Dutch healthcare institutes: a nationwide survey

Vancomycin-resistant Enterococcus faecium (VREfm) is an opportunistic pathogen, which can cause outbreaks in hospitals. In the Netherlands, several national guidelines and guidance documents on different aspects of VREfm-management are available. Most available guidelines are written towards the hospital setting and only few on long-term care facilities (LTCFs). Moreover, not all aspects of VREfm-management are covered, recommendations differ and the level of compliance to these guidelines is unknown. The aim of this study was to get insight into the routine VREfm-policies in Dutch healthcare facilities with regard to screening, diagnostics and infection control measures. Online questionnaires were sent to representatives of Dutch hospitals and long-term care facilities (LTCFs). The questionnaire included questions regarding the definition of VRE, screening, diagnostics, patient isolation, cleaning procedures, VREfm-clearance and VREfm-outbreaks. The questionnaire was completed by 61 hospitals with a response rate of 84.1% and 57 LTCFs, mostly nursing homes. Most hospitals reported VRE-outbreaks in the previous decade, whereas only one LTCFs reported an outbreak. Of the hospitals, 87% perform VREfm-screening versus 50% of the LTCFs. VRE-positive patients are isolated in 98% of hospitals and 83% of LTCFs. Protocols regarding how to unlabel VRE-positive patients are in place in 84% of the hospitals and in 51% of LTCFs. The details of these measures differ substantially between healthcare facilities. This study has shown that most hospitals and some LTCFs in the Netherlands have standard procedures for VREfm-management to some level, although the comprehensiveness and details of the measures differ per hospital. More uniform policies would improve comparability of VREfm data on a regional/national level.

Melanoma as a detection-dependent cancer: proxy measures of screening and surveillance associated with 3-year incidence of detection procedures for skin cancer in a national prospective study

Abstract Background Increased levels of skin detection activities are suspected of driving recent rapid increases in melanoma incidence. While ecological studies report rising rates of skin biopsies in many industrialised populations, few studies have accessed individual-level clinical data to test the hypothesis that people exposed to skin screening and surveillance go on to experience higher levels of biopsies and excisions, and higher incidence of melanoma. Objective To measure the incidence rates of detection events and melanoma diagnoses in a national cohort during follow-up, stratified according to screening or surveillance activities in the index year. Methods We conducted a prospective cohort study of 10,674,200 men and women using linked data from Australia’s universal health insurance scheme (2011-2016). Participants who underwent biopsies or who were diagnosed in skin cancer in 2011/2012 were excluded. We then defined participants as surveilled, screened, or unscreened for skin cancer based on medical claims occurring in 2013. We compared rates of biopsies, excisions for suspected melanoma, and excisions for histologically confirmed melanoma during follow-up (2014-2016). Results After adjusting for socio-demographic factors, screened people were significantly more likely than unscreened people to undergo skin biopsies (RR 2.59, 95% CI 2.56-2.63), excisions for suspected melanoma (RR 2.57, 95%CI 2.53-2.60), and excisions for confirmed melanoma (hazard ratio 3.32, 95% CI 3.24-3.40) during follow-up. Similarly elevated rates of subsequent diagnostic events were observed for the surveilled group. Importantly, rates of detection and rates of melanoma remained elevated in each of the subsequent years of follow-up among those who were screened or surveilled in the index year. Conclusions People undergoing skin screening or surveillance subsequently experience higher rates of diagnostic scrutiny and higher rates of melanoma.

Development and validation of the premenstrual dysphoric disorder scale in Indian females

Background: Premenstrual dysphoric disorder is a mood disorder that has been recognized in the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5) as a subcategory of depressive disorders. The disorder has a high prevalence rate, and yet no uniform measure is standardized on the Indian population. Aim: This study aimed to develop a scale to assess premenstrual dysphoric disorder that can be used for screening and for clinical use and that is standardized on the Indian population. Methods: This study used cross-sectional research design and collected data through social media platforms from a sample of 300 females, out of which 38 were excluded for pregnancy, mental health conditions, substance use, and oral contraceptive use. Results: The scale was analyzed using SPSS 21.0 for descriptive statistics, internal consistency, and convergent, content (factor analysis), and divergent validity. Results showed a high reliability of 0.90 and a concurrent validity of 0.76 and 0.64 against PSTT and BDI. Factor analysis revealed four factors, namely, affective and cognitive functioning, daily life and occupational functioning, somatic symptoms, and interpersonal anger. The sensitivity and specificity of the scale were found to be 86 (86%) and 66 (66%), respectively. Conclusion: The scale developed in this study was found reliable and valid for use on the Indian population. It has high sensitivity and can be used as a screening measure for premenstrual dysphoric disorder.

Prevalence and Risk Factors Associated with Depressive Symptoms Among Healthcare Professionals at a Tertiary Care Hospital in Mogadishu, Somalia: A Cross-Sectional Study.

Depression, a prevalent mental health issue, can significantly impact healthcare workers (HCWs), leading to decreased productivity, increased turnover, and high medical errors. However, there is a dearth of information regarding depression among healthcare professionals in Somalia. Therefore, this study aimed to assess the magnitude and risk factors associated with depressive symptoms among healthcare professionals in Mogadishu, Somalia. A hospital-based cross-sectional study was conducted among HCWs at Erdogan Hospital, in the capital city of Somalia. Data was collected using questionnaires on socio demographic, work-related characteristics and Patient Health Questionnaire-9 (PHQ-9). Bivariate and multivariate logistic regression analyses were conducted to identify variables associated with depressive symptoms. A p-values of 0.05 as a cutoff for a significant association. The prevalence of depressive symptoms among healthcare professionals was 48.9% (95% CI: 45.4-56.9%). In multivariable analysis, being female (AOR = 2.05; 95% CI: 1.17-3.60), being a nurse (AOR = 3.11; 95% CI: 1.14-8.48), unmarried (AOR = 1.83; 95% CI: 1.04-3.21), having insufficient sleep (AOR = 2.61; 95% CI: 1.45-4.70), a family history of mental illness (AOR = 3.31; 95% CI: 1.49-7.36), lack of physical activity (AOR = 2.59; 95% CI: 1.19-5.62), and having low social support (AOR = 3.06; 95% CI: 1.17-7.98) were all associated with increased odds of experiencing depressive symptoms. The study showed that nearly half of healthcare professionals experienced depressive symptoms. The study underscores the importance of efficient screening methods for identifying psychological symptoms in healthcare professionals, which is essential for enhancing their mental health and patient care. Therefore, we recommend that healthcare institutions and policymakers develop and implement screening measures to identify and improve the mental health well-being of HCWs, as well as provide high-quality patient care.

Correlation of a single-item measure of financial toxicity with overall score.

351 Background: Financial toxicity (FT) refers to the financial burden experienced by patients due to direct and indirect costs associated with their medical care. It has been linked to higher symptom burden, poorer clinical outcomes, quality of life, and psychological well-being and has been shown to extend beyond diagnosis and treatment. Despite the availability of validated tools to measure FT, no single-item screening measure has been validated yet. In the context where time constraints are the most cited reason for patients declining FT surveys, it is crucial to develop efficient tools that allow us to routinely screen patients for FT at different stages of their care. We, therefore, sought to establish item 12 (“My illness has been a financial hardship to my family and me”) of the Comprehensive Score for Financial Toxicity (COST) measure as a well-functioning screening item for FT. Methods: In this secondary analysis of 579 patients who completed a survey on financial toxicity screening preferences, items 1-11 were scored (including reversing 7 items per the version 2 scoring guidelines), with lower scores indicating worse FT. Analyses focused on establishing a correlation with the total score as well as examining item properties. Item 12 was also reverse scored, so lower scores mean greater hardship. Results: Item 12 had an item-total correlation of r = 0.63 (adjusted item-total correlation = .531). Similarly, a linear model with item 12 score as a predictor and total score as the outcome showed that increases of 1 point on item 12 is associated with around 3 total points on the full scale (b = 3.35, p < .001, adjusted R 2 = 0.28. Finally, item analysis with the graded-response item response theory (IRT) model showed very good discrimination (a = 2.10) for item 12, indicating that it can reliably distinguish between low and high FT in patients. IRT results also showed that the item functions as a nearly binary item with responses of “quite a bit” and “very much” corresponding to a high probability of high FT, while responses of “somewhat,” “a little bit,” and “not at all” corresponding to a high probability of low FT. Conclusions: This is the first validation of a single-item screening measure for RT. Overall, these results illustrate that item 12 is a good candidate for a single-item screener, with “quite a bit” and “very much” responses indicating a high likelihood of high FT.

Evaluating Respiratory Muscle Strength in Sarcopenia Screening among Older Men in South Korea: A Retrospective Analysis.

To evaluate the potential of incorporating respiratory muscle strength, specifically maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP), along with traditional sarcopenia screening measures such as hand grip strength (HGS) and skeletal muscle mass index (SMI), to identify sarcopenia in older men. A retrospective analysis was conducted involving male patients aged 65 years and older who underwent measurements of respiratory muscle strength, HGS, and muscle mass at a general hospital in Korea from July 2016 to May 2022. Statistical analysis utilized independent t-tests and receiver operating characteristic (ROC) curves to assess the sensitivity and specificity of MIP, MEP, HGS, and SMI in sarcopenia screening. The cut-off values for sarcopenia screening were determined based on the area under the ROC curve (AUC). The analysis of 282 study participants revealed the following cut-off values for sarcopenia based on the AUC: for MIP, the cut-off value was 65.50 cmH2O (AUC=0.70, sensitivity: 0.63, specificity: 0.61), while for MEP, it was 84.50 cmH2O (AUC=0.74, sensitivity: 0.66, specificity: 0.68). This study showed the utility of respiratory muscle strength in screening for sarcopenia among older men. We suggest the screening cut-off values as 65.50 cmH2O for MIP and 84.50 cmH2O for MEP. Even when HGS and SMI measurements are not feasible, sarcopenia can be reasonably predicted based on respiratory muscle strength.

The moderating role of sleep hours in the relationship between childhood trauma and depressive symptoms: A longitudinal investigation

Although childhood trauma has been identified as one of the major risk factors for depression, the potential mechanisms behind this relationship remain less clear. As sleep disturbances are associated with both childhood trauma and depression, this study examined the moderating effects of sleep hours on this relationship. The sample consisted of young adults from an international longitudinal survey project (N = 146). Participants completed validated screening measures of childhood trauma and depressive symptoms and reported their sleep hours at baseline (T1), and then reported their depressive symptoms again at follow-up (T2) after 3 months. Multiple regression and moderation analyses were used to analyze the data. T1 childhood trauma was positively correlated to depressive symptoms at both T1 (r = .26, p < .01) and T2 (r = .21, p < .05). After controlling for demographic variables and T1 depressive symptoms, T1 sleep hours significantly predicted T2 depressive symptoms (β = .136, p = .038). Furthermore, the number of sleep hours moderated the effects of T1 childhood trauma on T2 depressive symptoms. T1 childhood trauma predicted T2 depressive symptoms only when sleep hours were low (B = .2056, p = .0075). This study provided evidence that childhood trauma was significantly associated with aggravated depressive symptoms under sleep deprivation. Proactive management of sleep problems might be beneficial to people with childhood trauma. Future studies are needed to evaluate sleep-focused interventions for childhood trauma survivors.

The healthy habits questionnaire (HHQ): Validation of a measure designed to assess problematic influential behaviours amongst families of children living with obesity or a risk of developing obesity.

The 48-item Healthy Habits Questionnaire (HHQ-48) was developed to (1) monitor positive changes in family lifestyles following engagement in the Parents Plus Healthy Families (PP-HF) parent training programme and (2) be utilised as a standalone measure in clinical settings to identify and track problematic influential behaviours amongst families of children in weight-management services. This study aimed to develop and validate a brief version of the HHQ-48. The scale was administered to a cross-sectional community sample (n = 480), and on two occasions to a control sample (n = 50) and an experimental sample (n = 40) from a randomised controlled trial (RCT) of the PP-HF programme to assess test-retest reliability and sensitivity to change respectively. Exploratory and confirmatory factor analysis showed that a 23-item, 4-factor version of the HHQ (i.e., the HHQ-23) best fit the data. The scale and factor subscales had good internal consistency and test-retest reliability. They also had good concurrent and construct validity shown by significant correlations with another scale that assessed lifestyle issues, and scales that assessed parenting satisfaction, family functioning, and children's strengths and difficulties. The HHQ-23 was sensitive to change following parents completing the PP-HF programme. The HHQ-23 may, therefore, be used to monitor positive changes in family lifestyles following engagement in the PP-HF parent training programme. The HHQ-23 also shows promising potential as a standalone screening measure or as part of a larger battery of screening assessments in paediatric weight-management services.

A Psychometric Evaluation of the Revised Version of the Adult ADHD Self-Report Scale in Chinese Adolescents.

Adolescent-specific ADHD self-report screening measures can greatly increase the likelihood of correct diagnosis and timely treatment of ADHD in adolescents. This study provides preliminary evidence for evaluating the reliability and validity of the Adult ADHD Self-Report Scale-Revised (ASRS-R) in a school-based sample of Chinese adolescents. The ASRS-R and the Strengths and Difficulties Questionnaire (SDQ) were administered to 867 adolescents aged 12 to 16 years (Mage = 13.08 years). Construct validity was assessed using correlation analysis of the ASRS-R with the SDQ. Moreover, confirmatory factor analysis (CFA), internal consistency, retest reliability, and measurement invariance of the scales were examined by gender. CFA showed a two-dimensional factor structure of the ASRS-R, and the model fitted the data well (χ2/df = 4.370, RMSEA = 0.062, TLI = 0.932, CFI = 0.940, GFI = 0.927, AGFI = 0.907, and SRMR = 0.038). The ASRS-R scale was invariant across gender and had satisfactory internal consistency (Cronbach's alpha = .934) and test-retest reliability (intraclass correlation coefficient = .874). The construct validity, as calculated using the SDQ, was also acceptable. The ASRS-R can be a psychometrically reliable self-report instrument and provide preliminary support as a simple tool for identifying ADHD symptoms in Chinese adolescents. The findings provide evidence for extending the application of the ASRS, previously limited to adults, to the adolescent populations.

Early Detection For Better Results In The Treatment Of Asymptomatic Cases Of Valvular Heart Disease

Valvular heart disease (VHD) often progresses asymptomatically, leading to delayed diagnosis and treatment, which worsens patient outcomes. Early detection of VHD in asymptomatic cases is crucial to improve treatment effectiveness and long-term prognosis. This study aims to investigate the impact of early detection on treatment outcomes in asymptomatic VHD patients. A cross-sectional study was conducted involving 200 patients diagnosed with VHD, categorized into two groups: those diagnosed early through screening and those diagnosed later after the onset of symptoms. Data were collected through medical records, echocardiograms, and patient interviews. Statistical analysis revealed that early detection significantly improved patient outcomes, with lower rates of complications, better valve repair success, and reduced mortality compared to those diagnosed later. Discussion centers on the importance of routine screenings in at-risk populations and the need for better diagnostic protocols to catch asymptomatic cases early. The conclusion highlights that early detection of asymptomatic VHD leads to better treatment outcomes, underlining the necessity of proactive screening measures to manage VHD effectively.

Association of inpatient postpartum recovery with patient-reported outcome measures following hospital discharge: a prospective cohort study

BackgroundThe relationship between the quality of inpatient versus outpatient obstetric postpartum recovery is under-explored. We examined the association between inpatient reported quality of recovery with outpatient global recovery, pain severity, pain interference, anxiety, and depression screening scores postpartum.MethodsWe conducted a multicenter observational cohort study of women in labor who underwent vaginal, operative vaginal, or intrapartum cesarean birth. Subjects completed baseline assessments of pain, social support, anxiety, and depression in early labor. We assessed the Obstetric Quality of Recovery-10 (ObsQoR-10) on the day of discharge and the ObsQoR-10, Global Health Scale (GHVAS; 0–100), Brief Pain Inventory (BPI), and the Edinburgh Postnatal Depression Scale (EPDS) on postpartum day seven. We hypothesized that the ObsQoR-10 scores at discharge would be useful in predicting postpartum day seven measures of recovery and postpartum depression screening scores.ResultsWe consented 558 subjects, 551/558(98%) completed baseline assessments, 400/551(72%) completed the ObsQoR-10 tool, and 344/551(62%) completed an EPDS assessment. Median (1st, 3rd quartile) ObsQoR-10 scores were 78 (63, 90) at discharge and 85 (68,93) on postpartum day seven, (difference of 7 [99% CI 2 to 13], P < 0.001). GHVAS on postpartum day seven identified 204/344 (59%) of subjects with good recovery. An ObsQoR-10 score of > 86 at discharge had a RR of 1.5 [95% CI 1.2 to 1.8], P < 0.001 for good recovery at postpartum day seven, the EPDS identified 20/344 (5.8%) respondents with a score ≥ 13 on postpartum day seven. The area under the curve between the ObsQoR-10 at discharge with an EPDS ≥ 13 was 0.74 (99% CI 0.61 to 0.86, P < 0.001). The RR for an EPDS ≥ 13 on postpartum day seven with an ObsQoR-10 < 77 on the day of discharge was 7.8 (95% CI 1.8 to 33.8; P = 0.001).ConclusionsObsQoR-10 scores at discharge and postpartum day seven demonstrated increased obstetric recovery in the post-discharge period. The observed association between the ObsQoR-10 and the EPDS, suggests that the ObsQoR-10 might facilitate identification of women at increased risk of postpartum anxiety or depression. Identification of high-risk women at discharge may allow early interventions to reduce morbidity secondary to postpartum depression.

Consensus-based recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy: A report from the Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy.

The Psychiatric Pediatric Issues Task Force of the International League Against Epilepsy (ILAE) aimed to develop recommendations for the diagnosis and treatment of anxiety and depression in children and adolescents with epilepsy. The Task Force conducted a systematic review and identified two studies that assessed the accuracy of four screening measures for depression and anxiety symptoms compared with a psychiatric interview. Nine studies met the eligibility criteria for treatment of anxiety and depressive disorders or symptoms. The risk of bias and certainty of evidence were assessed. The evidence generated by this review followed by consensus where evidence was missing generated 47 recommendations. Those with a high level of agreement (≥80%) are summarized. Diagnosis: (1) Universal screening for anxiety and depression is recommended. Closer surveillance is recommended for children after 12 years, at higher risk (e.g., suicide-related behavior), with subthreshold symptoms, and experiencing seizure worsening or therapeutic modifications. (2) Multiple sources of ascertainment and a formal screening are recommended. Clinical interviews are recommended whenever possible. The healthcare provider must always explain that symptom recognition is essential to optimize treatment outcomes and reduce morbidity. (3) Questioning about the relationship between symptoms of anxiety or depression with seizure worsening/control and behavioral adverse effects of antiseizure medications is recommended. Treatment: (1) An individualized treatment plan is recommended. (2) For mild depression, active monitoring must be considered. (3) Referral to a mental health care provider must be considered for moderate to severe depression and anxiety. (4) Clinical care pathways must be developed. (5) Psychosocial interventions must be tailored and age-appropriate. (6) Healthcare providers must monitor children with epilepsy who are prescribed antidepressants, considering symptoms and functioning that may not improve simultaneously. (7) Caregiver education is essential to ensure treatment adherence. (8) A shared-care model involving all healthcare providers is recommended for children and adolescents with epilepsy and mental health disorders. We identified clinical decisions in the management of depression and anxiety that lack solid evidence and provide consensus-based guidance to address the care of children and adolescents with epilepsy.

Epidemiological Characteristics and Spatiotemporal Clustering of Pulmonary Tuberculosis Among Students in Southwest China From 2016 to 2022: Analysis of Population-Based Surveillance Data.

Pulmonary tuberculosis (PTB), as a respiratory infectious disease, poses significant risks of covert transmission and dissemination. The high aggregation and close contact among students in Chinese schools exacerbate the transmission risk of PTB outbreaks. This study investigated the epidemiological characteristics, geographic distribution, and spatiotemporal evolution of student PTB in Chongqing, Southwest China, aiming to delineate the incidence risks and clustering patterns of PTB among students. PTB case data from students monitored and reported in the Tuberculosis Information Management System within the China Information System for Disease Control and Prevention were used for this study. Descriptive analyses were conducted to characterize the epidemiological features of student PTB. Spatial trend surface analysis, global and local spatial autocorrelation analyses, and disease rate mapping were performed using ArcGIS 10.3. SaTScan 9.6 software was used to identify spatiotemporal clusters of PTB cases. From 2016 to 2022, a total of 9920 student TB cases were reported in Chongqing, Southwest China, with an average incidence rate of 24.89/100,000. The incidence of student TB showed an initial increase followed by a decline, yet it remained relatively high. High school students (age: 13-18 years; 6649/9920, 67.03%) and college students (age: ≥19 years; 2921/9920, 29.45%) accounted for the majority of student PTB cases. Patient identification primarily relied on passive detection, with a high proportion of delayed diagnosis and positive etiological results. COVID-19 prevention measures have had some impact on reducing incidence levels, but the primary factor appears to be the implementation of screening measures, which facilitated earlier case detection. Global spatial autocorrelation analysis indicated Moran I values of >0 for all years except 2018, ranging from 0.1908 to 0.4645 (all P values were <.05), suggesting strong positive spatial clustering of student PTB cases across Chongqing. Local spatial autocorrelation identified 7 high-high clusters, 13 low-low clusters, 5 high-low clusters, and 4 low-high clusters. High-high clusters were predominantly located in the southeast and northeast parts of Chongqing, consistent with spatial trend surface analysis and spatiotemporal clustering results. Spatiotemporal scan analysis revealed 4 statistically significant spatiotemporal clusters, with the most likely cluster in the southeast (relative risk [RR]=2.87, log likelihood ratio [LLR]=574.29, P<.001) and a secondary cluster in the northeast (RR=1.99, LLR=234.67, P<.001), indicating higher reported student TB cases and elevated risks of epidemic spread within these regions. Future efforts should comprehensively enhance prevention and control measures in high-risk areas of PTB in Chongqing to mitigate the incidence risk among students. Additionally, implementing proactive screening strategies and enhancing screening measures are crucial for early identification of student patients to prevent PTB outbreaks in schools.

Illness cognitions and parental stress symptoms following a child's cancer diagnosis.

This research aims to explore parents' cognitive beliefs, specifically illness cognitions, in response to their children being diagnosed with cancer. This study is an initial step toward providing regular psychosocial assessment as a standard for psychosocial care for children with cancer and their families in Latvia. Data were collected from 120 parents (mostly mothers, n = 109) as an initial evaluation of the psychosocial risks faced by families participating in the support program "Holistic and Multidisciplinary Support for Children with Functional Disabilities and Their Family Members," which was managed by the Children's Hospital Foundation at the Children's Clinical University Hospital in Riga (Latvia) from 2020 to 2023. The patients comprised 66 boys and 54 girls (M age = 7.1, SD = 4.7, range: 0-17 years) with diverse cancer diagnoses. The parents completed the Latvian version of the Psychosocial Assessment Tool [adapted from PAT 3.1], with five subscales included in the data analysis (Social Support, Child Problems, Family Problems, Stress Reactions, and Family Beliefs). The Family Belief subscale was adjusted specifically to address the unique objectives and research questions of the current study. Significant correlations were found between children's psychological problems (e.g., getting upset about medical procedures, hyperactivity, excessive use of electronic devices, etc.) and parental stress reactions after diagnosis and with self-reported symptoms of anxiety and depression. The associations were statistically significant, even after controlling for sociodemographic and medical factors such as diagnosis. The relationship between children's problems and parental stress reactions was partly mediated by Family Beliefs about illness. The most informative beliefs associated with parental stress symptoms and the family's psychosocial risk level were identified, and significant results were found according to the main component of beliefs (catastrophic vs. optimistic) that explained 42% of the variance in the Family Beliefs subscale. Understanding the habitual responses to stress and identifying the thinking patterns of parents that lead to distorted views and maladaptive coping are essential for customizing personalized interventions to enhance treatment compliance. The Latvian version of PAT is a useful psychosocial screening measure in pediatric oncology settings.

Clinical utility of brief screening measures during neuropsychological consultation for pediatric onset multiple sclerosis.

Pediatric-onset multiple sclerosis (POMS) accounts for approximately 2 to 5% of all individuals with MS and is associated with an increased risk for cognitive impairment. In recent years, neuropsychological screening questionnaires have been increasingly utilized for pediatric populations in multidisciplinary settings. This study examines the clinical utility of the Colorado Learning Difficulties Questionnaire (CLDQ) and Pediatric Perceived Cognitive Functioning (Peds PCF) screening measures for identifying cognitive impairment in persons with POMS during a target neuropsychological evaluation. Retrospective data was gathered from electronic medical records at a single pediatric hospital. Forty-nine participants were included (69% female; 43% Hispanic/Latinx; mean age = 16.1 years old, range = 9.9 to 20.6 years old). Correlation analyses demonstrated strong interrelatedness between caregiver ratings on screening measures and performance on traditional neuropsychological measures. Effect sizes were medium across comparisons (CLDQ: Spearman's rho = -.321 to -.563; PedsPCF: Spearman's rho = .308 to .444). Exploratory cut-points using receiver operating characteristic analysis and Youden indices are also discussed. Comparison of scores across caregiver rating questionnaires and on a targeted neuropsychological battery suggests that the screening surveys alone may not be sensitive enough to identify children with cognitive impairments, but ratings may provide qualitatively meaningful information along with neuropsychological testing. This study illustrates how pediatric neuropsychologists can leverage screening tools to focus consultative interviews and effectively triage referrals for evaluation within an academic medical setting.

Social cognition and healthy aging: Cross-sectional associations of emotion perception, theory of mind, and emotional empathy

Abstract Objective: Older adults are identified to have reduced social cognitive performance compared to younger adults. However, few studies have examined age-associations throughout later life to determine whether these reductions continue with advancing age. Method: This study assesses cross-sectional associations of emotion perception, cognitive and affective theory of mind (ToM), and emotional empathy in a healthy sample of 157 adults aged 50–89 years (M = 65.31, SD = 9.00, 68% female sex). Emotion perception, cognitive ToM, and affective ToM were measured using The Awareness of Social Inference Test Short Form (TASIT-S), while affective ToM was also measured using Reading the Mind in the Eyes Revised (RME-R). Emotional empathy was measured using the Empathy Quotient. Results: Multiple regression analyses, adjusting for multiple comparisons, revealed a moderate negative association between age and emotion perception for all emotions combined, as well as for sad and revolted expressions, but not happy, neutral, anxious, or angry expressions. Age had a negative, moderate association with first-order cognitive, second-order cognitive, and affective ToM measured using TASIT-S, but not RME-R. Age was not significantly associated with emotional empathy. Conclusions: This study contributes to the limited understanding of age-related associations of social cognitive performance throughout later life. This knowledge can inform future research examining the clinical utility of including social cognitive measures in neuropsychological screening and diagnostic tools for later-life neurological disorders.

Handgrip Strength and Dehydroepiandrosterone Sulfate in a Frailty Unit: A Retrospective Study.

Frailty is characterized by vulnerability and decline in physical, mental, and social activity, significantly contributing to adverse health outcomes. Frailty encompasses nutritional status, muscle strength, inflammation, and hormones. Dehydroepiandrosterone sulfate (DHEAS) is one of the hormones hypothesized to play a role in frailty. Handgrip strength (HGS) correlates with overall muscle strength. The fatigue, resistance, ambulation, illnesses, and loss of weight(FRAIL) scale can be used to readily screen frailty. Identifying markers associated with frailty can facilitate its early diagnosis, risk stratification, and target interventions to prevent or mitigate its negative consequences. This study sought to evaluate the associations between frailty, HGS, and DHEAS in a Portuguese frailty unit (FU). We developed an observational retrospective study in an FU. Patients admitted to the FU underwent a rehabilitation program. We assessed frailty with the FRAIL scale. We assayed DHEAS upon admission to the FU. We measured HGS at admission (i-HGS) and discharge (f-HGS). We also considered HGS variation (∆ HGS) and length of stay. Out of 119 subjects, 97 fulfilled the eligibility criteria (mean age 78.35 ± 9.58 years; 44.33% men). Overall, 88 (90.72%) patients had a FRAIL scale score of 3 or more. DHEAS values were not significantly different in either the categories of the FRAIL scale or frailty status. DHEAS values were also not significantly correlated with either i-HGS, f-HGS, ∆ HGS, age, or FU length of stay. Frail patients had a significantly lower i-HGS (p = 0.002) and f-HGS (p = 0.001) and a significantly higher length of stay (p = 0.006). Also, the i-HGS and f-HGS significantly decreased with the increase of the FRAIL scale score (p < 0.0001 for both). The cut-off values of the i-HGS and the f-HGS for detecting frail patients in our study were 13.3 kg and 19.1 kg, respectively (p < 0.0001 for both). The i-HGS was significantly and independently associated with the frailty status of frail (p = 0.001), with a 15% probability reduction of a patient being frail for every kilogram increase in the i-HGS. Frail patients assessed with the FRAIL scale had a significantly lower i-HGS and f-HGS and a higher length of stay. In this study, we found frailty and DHEAS to be not associated and DHEAS values to be not correlated with i-HGS or f-HGS. In our opinion, the creation of an FU with an initial FRAIL scale screening and HGS measurement might have a significant impact on identifying frail people and ensuring the implementation of a multimodal multidisciplinary approach.

The efficacy of mobile applications for reducing depression in adolescents and young adults: A meta-analysis of randomized control trials.

Mobile applications for mental health have the potential to aid people with mental health disorders, especially depression, by providing them with tools and coping mechanisms. Adolescents and young adults, being at risk of depressive symptoms and leading mobile users, are among the main targets of using mobile applications to alleviate symptoms. This study aimed to evaluate the impact of mobile application-based psychological interventions in reducing depression symptoms in adolescents and young adults compared to those not exposed to the intervention. We conducted a meta-analysis focusing on mobile applications for reducing depressive symptoms. We searched two databases: MEDLINE and EMBASE and included randomized controlled trials conducted in English among participants aged 18-35 years old who were assessed for depressive symptoms using a validated screening measure and used mobile applications-based psychological interventions. Two of six independent reviewers conducted study selection, data extraction, and bias assessment. A pooled mean standardized difference (Cohen's d) and 95% CI were calculated using random-effects meta-analysis. Risk of bias was assessed using I2 statistics and forest plot. Egger's test was used for assessing publication bias. After screening 740 references, we identified 12 trials with 1869 participants, with a mean age of participants ranging from 14.70 to 25.1 years. The interventions ranged from cognitive behavioral therapy (CBT)-based mobile apps to interactive story-telling apps and apps delivering a mix of CBT, interpersonal psychotherapy for adolescents, and dialectical behavior therapy elements. Control groups included information-only, waitlist, no intervention, and treatment as usual. Seven studies used Patient Health Questionnaire-9 (PHQ-9) to assess the severity of depressive symptoms, while the other five used different scales. There was no evidence of publication bias (p = 0.325). The mobile applications reduced depression score by 0.08 units of standardized difference more than the control, with a 95% CI of -0.19 to 0.03 (p = 0.294, I2 = 15.4%) using standardized mean difference (SMD) as the effect estimate. In a sensitivity analysis including only studies that used PHQ-9, we found a similar trend, SMD -0.72 (95%CI -1.48 to 0.03). However, both findings were not significant. Current evidence is insufficient to support mobile applications to relieve depression symptoms in adolescents and young adults. Further trials with larger sample size are needed to confirm our findings of a positive trend. With emerging technologies and the high exposure of apps in this population, mobile applications for depression hold promise for the future of treatment and awareness of mental health disorders in this population.

The mediating role of perceived stress in the association between family resilience and psychological distress among gynecological cancer patients: a cross-sectional study

BackgroundGynecological cancer patients face various stressors and suffer from severe psychological distress. The activation of family resilience supports patients to overcome daily stressors, yet the relationship between family resilience and psychological distress is poorly understood. The purpose of this study is to investigate the degree of psychological distress in patients diagnosed with gynecological cancer, and whether perceived stress mediate the relationship between family resilience and psychological distress.MethodsA cross-sectional study was undertaken on 358 gynecological cancer patients in China from September 2021 to November 2022. The participants completed surveys that included the Chinese Version of the Family Resilience Assessment Scale, the Perceived Stress Scale, the Hospital Anxiety and Depression Scale, the Distress Management Screening Measure, and socio-demographic questions. Using Pearson’s correlation analysis to investigate the association between variables, and the bias corrected bootstrapping method was utilized to establish perceived stress as a mediator.ResultsChinese patients with gynecological cancer experienced a moderate psychological distress. In addition, psychological distress exhibited a negative correlation with family resilience and a positive correlation with perceived stress in gynecological cancer patients (both P < 0.01). Perceived stress partially mediated the correlation between family resilience and psychological distress (β=-0.182; 95% CI: -0.224 to -0.140; P < 0.001). The total indirect effect value was − 0.182, and the total effect value was − 3.060.ConclusionsThe findings indicate that higher family resilience and lower perceived stress can reduce psychological distress in gynecological cancer patients, and family resilience also tends to reduce perceived stress in cancer patients. Clinical staff and psychologist should consciously cultivate patients’ family resilience to reduce psychological distress. Meanwhile, identifying potential mediators between family resilience and psychological distress are able to promote the development and assessment of interventions in the future.