Psychological Assessment Research Articles

Measuring impact: a prospective evaluation of a mentoring scheme for aspiring clinical psychologists from black, Asian and Minority Ethnic backgrounds

ABSTRACT Mentoring schemes for aspiring BAME clinical psychologists, are being introduced in universities across the UK. The aim of this study was to conduct a mixed-methods prospective evaluation of the 2021/2022 mentoring scheme. Mentees (n = 8) and mentors (n = 20) completed an online questionnaire at the beginning (T1) and end (T2) of the 2021/2022 mentoring scheme. Quantitative data was analysed descriptively and using a mixed ANOVA. Content analysis was conducted on qualitative contributions. Mentees reported having the confidence and knowledge necessary to apply for the clinical psychology doctorate and assessments of mentoring skills were high. Participants provided their goals and expectations for the scheme, as well as constructive feedback. The findings suggest an overall modest, positive impact of the mentoring scheme. Wider implications include ensuring mentoring pairs establish regular contact and providing additional support for mentors to mitigate self-doubt.

Alexithymia Increases Pericranial and Cervical Muscle Tenderness in Women with Migraine

Background/Objectives: Alexithymia is characterized by a deficit in identifying and communicating feelings. Emerging evidence suggests that alexithymia is highly prevalent in migraine, in a complex interplay with psychiatric comorbidity. Pericranial/cervical muscle tenderness is a remarkable clinical feature in a large proportion of migraine patients. This pilot study aimed at investigating the relationship between alexithymia and pericranial/cervical muscle tenderness in female migraineurs. Methods: A total of 42 female patients fulfilling the diagnostic criteria for migraine were enrolled into this pilot, observational, cross-sectional study after informed consent was obtained. Each patient underwent a psychological assessment to identify any alexithymia by means of TAS-20, anxiety/mood comorbidity (by means of STAI-Y1 STAI-Y2, BDI-II), and migraine-related disability (by means of HIT-6), and a physical cranial/cervical musculoskeletal examination. Palpation of pericranial and cervical muscles was carried out in the standardized manner. A Cumulative Muscle Tenderness (CUM) score (0–6) was calculated for each patient. A multivariate analysis was performed to investigate any association amongst the TAS-20 score, the CUM score, and the following covariates: BDI-II, STAI-Y1, STAI-Y2, and HIT-6 scores, age, disease duration, monthly migraine days, and average head pain intensity in the previous three months. Results: Overall, 35.6% of the sample had alexithymia. The multivariate analysis detected a linear and independent relationship between the TAS-20 and CUM scores, with a statistically significant (p = 0.017) association. Conclusions: This pilot study suggests that alexithymia plays a role in increasing pericranial/cervical muscle tenderness in migraine, independently from psychiatric comorbidity. A novel therapeutical approach, targeting alexithymia, may well reduce muscular tenderness in female migraineurs.

Human placental lactogen (human chorionic somatomammotropin) and oxytocin during pregnancy: Individual patterns and associations with maternal-fetal attachment, anxiety, and depression

Previous studies support links among maternal-fetal attachment, psychological symptoms, and hormones during pregnancy and the post-partum period. Other studies connect maternal feelings and behaviors to oxytocin and suggest that an increase in oxytocin during pregnancy may prime maternal-fetal attachment. To date, researchers have not examined a possible association between maternal-fetal attachment with human placental lactogen although animal models are suggestive. In the current study, we sought to describe oxytocin and human placental lactogen levels as related to psychological constructs across pregnancy. Seventy women participated in the study. At each of three time-points (early, mid, and late pregnancy), the women had their blood drawn to assess oxytocin and human placental lactogen levels, and they completed psychological assessments measuring maternal-fetal attachment, anxiety, and depression. Our results indicate that oxytocin levels were statistically similar across pregnancy, but that human placental lactogen significantly increased across pregnancy. Results did not indicate significant associations of within-person (comparing individuals to themselves) oxytocin or human placental lactogen levels with maternal-fetal attachment. Additionally, results did not show between-person (comparing individuals to other individuals) oxytocin or human placental lactogen levels with maternal-fetal attachment. Oxytocin levels were not associated with anxiety; rather the stage of pregnancy moderated the effect of the within-person OT level on depression. Notably, increasing levels of human placental lactogen were significantly associated with increasing levels of both anxiety and depression in between subject analyses. The current study is important because it describes typical hormonal and maternal fetal attachment levels during each stage of pregnancy, and because it suggests an association between human placental lactogen and psychological symptoms during pregnancy. Future research should further elucidate these relationships.

A Case Study on the Integrated Rehabilitation of Chemotherapy-Induced Peripheral Neuropathy in a Patient with Stage IV Breast Cancer

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a significant complication of cancer treatments, affecting a substantial proportion of patients and severely impacting their quality of life. Current management strategies often fall short in addressing the multifaceted nature of this condition, highlighting the need for integrated approaches that encompass physical, psychological, and social elements. Objective: This study aimed to evaluate the efficacy of a multimodal rehabilitation program in improving physical function and psychological well-being in a patient with Stage IV breast cancer experiencing moderate CIPN. Methods: A 40-year-old female with Stage IV breast cancer underwent a 5-week multimodal rehabilitation program, including physical therapy, psychosocial support, and mobility therapy. Assessments of grip strength, knee and shoulder flexion, neuropathic pain (DN4), anxiety and depression (HADS), and overall quality of life were conducted pre- and post-intervention using a hand dynamometer, goniometer, and standardized psychological scales. Results: Post-treatment results demonstrated significant improvements: grip strength increased from 10 kg to 13 kg (right hand) and 9 kg to 14 kg (left hand); knee flexion improved from 120° to 129° (right) and 125° to 132° (left); shoulder flexion increased from 149° to 160° (right) and 152° to 159° (left). Psychological assessments showed a reduction in anxiety (HADS) scores from 12 to 8 and depression from 10 to 5. The DN4 score decreased from 7 to 4, indicating a reduction in neuropathic pain. Quality of life assessments also noted significant enhancements. Conclusion: The integrated rehabilitation program was effective in significantly improving both the physical and psychological parameters in a patient with severe CIPN. This case supports the potential benefits of multidisciplinary approaches in managing CIPN, suggesting wider applicability for similar comprehensive care models in oncological rehabilitation.

A Pilot Study of a Trauma Resiliency Protocol for Law Enforcement Officers with Posttraumatic Stress Disorder (PTSD) Symptoms.

To test the efficacy of the 22ZERO Trauma Resiliency Protocol (TR-P) on PTSD symptom severity among current and former law enforcement officers. Uses a retrospective, pre/post intervention design to test the effects of the TR-P on measures of self-reported symptom severity. 128 current and former law enforcement officers were exposed to the TR-P treatment. All participants were administered the PCL-5 PTSD Checklist and other psychological assessments before and after exposure. Participants experienced a significant reduction in symptom severity, suggesting that exposure to the TR-P reduced the effects of PTSD in this sample of law enforcement officers. The 22ZERO Trauma Resiliency Protocol may be an efficacious mechanism for reducing PTSD symptom severity among current and former law enforcement officers. It should be tested using a randomized trial and a longer follow-up period.

Studying Lyrics as the True State of Subconscious Devotement to the God with a Special Reference to Rabindranath Tagore’s Gitanjali, Song 1, 2 and 3

Rabindranath Tagore produced his literary manifestation through art, and vice versa. His artistic creation and literature are known in every corner of the literary world for their sublimity, mirth, vigour, rejuvenation, mourning, despair, death, connection with mankind, God, and nature, as an ensemble ecstasy of experiencing shades of life. Those ecstatic qualities of ultimate demonstration published Gitanjali in life in the year 1910 with 156 songs in togetherness, which brought Tagore the honour in 1913 of becoming the first Nobel laureate as an Asian in literature. Tagore has shown the world his musical devotion towards nature, love, humanity, and God. In every aspect of life, it has become relevant to its core and hidden subconsciousness. The true inspiration of Bhakti Andolon (Bhakti Movement), which made its resonance in the 16th century, especially in Bengal, was inculcated in the verses of Gitanjali, which murmur the sole devotee of Tagore at the feet of Lord Krishna, the incarnation of Lord Vishnu, the one who preserves the creation. The hearty samarpan (surrender) of a poetic persona like Rabindranath Tagore thoroughly influences readers, scholars, and researchers for the study of literary and psychological assessment simultaneously over the years. His choice of rendition through the words and gradual escalation towards the almighty signify the subconscious state of his core devotion as worship. It clearly seems Tagore’s conscious and deliberate movement from his own body to the cosmic devotion of Lord Krishna. This article aims to assess a brief study of the subconscious state of Tagore’s spiritual mind through his lyrics in Gitanjali, specifically in songs 1, 2, and 3. The descriptive research method is taken as the methodological approach for the study. For the expected substantiation of the stated facts, this article has taken a few references from anonymous sources as a secondary study of research.

Female obesity: clinical and psychological assessment toward the best treatment

Obesity is a heterogeneous condition which results from complex interactions among sex/gender, sociocultural, environmental, and biological factors. Obesity is more prevalent in women in most developed countries, and several clinical and psychological obesity complications show sex-specific patterns. Females differ regarding fat distribution, with males tending to store more visceral fat, which is highly correlated to increased cardiovascular risk. Although women are more likely to be diagnosed with obesity and appear more motivated to lose weight, as confirmed by their greater representation in clinical trials, males show better outcomes in terms of body weight and intra-abdominal fat loss and improvements in the metabolic risk profile. However, only a few relatively recent studies have investigated gender differences in obesity, and sex/gender is rarely considered in the assessment and management of the disease. This review summarizes the evidence of gender differences in obesity prevalence, contributing factors, clinical complications, and psychological challenges. In addition, we explored gender differences in response to obesity treatments in the specific context of new anti-obesity drugs.

The screening of cannabis addiction using machine learning, MoCA, and anxiety/depression tests

A new cannabis addiction screening approach is developed based on the use of Machine Learning (ML) alongside with psychological and cognitive assessment tests. The Hospital Anxiety and Depression (HAD) test is used to determine the Absence of Anxiety and Depression “No Disorder” or the presence of “Anxiety Only”, “Depression Only”, and both “Anxiety and Depression”. These features are considered to evaluate the psychological effects of cannabis use. In addition to that, the Montreal Cognitive Assessment (MoCA) test is chosen as a feature to assess the cognitive state of the participants. Also, the Age of First Cannabis Use (AFCU) is included as a feature to incorporate participants with no prior cannabis use alongside with those who have used cannabis before. The portion of participants with prior experience consuming cannabis comprises a subset containing passive users and a subset of users that have developed cannabis addiction. This 6-month study was conducted in Marrakech, Morocco in a center affiliated to the National Association of Drug-Risk Reduction of Morocco known as RdR-Maroc with the participation of 146 subjects. The participants in this study are grouped into two groups of 73 participants each. Both case and control groups were clinically assessed by a professional. In this paper, the classical statistical data analysis for the AFCU (M=15.6; SD=2.4), MoCA (M=25.0; SD=2.4), and HAD (58 cases with no disorder, 88 cases with disorder) failed to separate between the two classes. Also, the feature selection for modeling is performed using Spearman correlation, Kendall correlation, and the Odds Ratio (OR). These statistics showed that the selected features were associated to addiction except for “Anxiety Only”. Moreover, ML models such as Logistic Regression (LR), Support Vector Machine (SVM), Artificial Neural Network (ANN), kth-Nearest Neighbor (KNN), and Decision Tree (DT) were used to classify participants into two categories (Addict vs. Non-Addict) based on the selected features mentioned earlier. The Receiver Operating Characteristic (ROC) curve is used to overview the quality of the models and showed that they all captured the nonlinearities underlined in the data. On the other hand, the Area Under the Curve (AUC) allowed the ranking of these models and indicated that the SVM model outperformed all other models with an AUC of 0.97. After that, the SVM model was compared to the Cannabis Use Disorder (CUD) based screening method issued by the fifth edition of the Diagnostic and Statistical Manual of mental disorders (DSM-5). The SVM model's accuracy of 96.6 % outperformed the CUD questionnaires accuracy of 87.7 %. The validity of the proposed approach was investigated where the SVM model presented high validity characteristics (sensitivity=1, specificity=0.93) compared to the CUD questionnaire (sensitivity=0.75, specificity=1). Hence, the proposed approach provided satisfactory results compared to current adopted CUD based screening test. Our findings expand current research on the development of simple and powerful tools for cannabis addiction screening with the purpose of early detection in order to establish preventive and therapeutic strategies that could potentially mitigate the prevalence of cannabis addiction.

Stress and cardiovascular disease: an update.

Psychological stress is generally accepted to be associated with an increased risk of cardiovascular disease (CVD), but results have varied in terms of how stress is measured and the strength of the association. Additionally, the mechanisms and potential causal links have remained speculative despite decades of research. The physiological responses to stress are well characterized, but their contribution to the development and progression of CVD has received little attention in empirical studies. Evidence suggests that physiological responses to stress have a fundamental role in the risk of CVD and that haemodynamic, vascular and immune perturbations triggered by stress are especially implicated. Stress response physiology is regulated by the corticolimbic regions of the brain, which have outputs to the autonomic nervous system. Variation in these regulatory pathways might explain interindividual differences in vulnerability to stress. Dynamic perturbations in autonomic, immune and vascular functions are probably also implicated as CVD risk mechanisms of chronic, recurring and cumulative stressful exposures, but more data are needed from prospective studies and from assessments in real-life situations. Psychological assessment remains insufficiently recognized in clinical care and prevention. Although stress-reduction interventions might mitigate perceived stress levels and potentially reduce cardiovascular risk, more data from randomized trials are needed.

An Intelligent Assessment Method of Criminal Psychological Attribution Based on Unbalance Data

Criminal cases often exhibit imbalance and cannot be extended by data augmentation when classified into attribution types. To solve the problem of unbalance data in offenders’ attribution classification, this paper proposes a criminal psychological attribution assessment model by an improved Balanced TF-Distinguishing IDF method (B-TF-dIDF) and constructed a hybrid network with attention method to fuse numerical and text features for improving the accuracy. First, as a statistical method, B-TF-dIDF is presented to reduce the impact of class-imbalance for extraction of numerical features, in which a balanced element is added to reduce the effects of incorrect type keywords on classification, and a distinguishing element is added to discriminate the types of keywords. Then, an improved hybrid network model composed of Long Short-Term Memory (LSTM) and Convolutional Neural Network (CNN) is constructed to balance the influence of different lengths of text samples for extracting the semantic features of criminal texts. For evaluating different feature weights by their importance, Spatial Attention is used to improve CNN in the feature maps. Moreover, the self-attention is also performed to re-evaluate the mixed features. Finally, the softmax classifier provides a scientific basis for developing a hierarchical treatment mechanism further. Additionally, we build a criminal data set with labels from real cases for testing. The experiment proved that the proposed model is better than other related methods in various evaluation indicators, including the micro and macro scopes. Moreover, the F1 of minority samples has increased by 6%-8%, indicating that the proposed method can reduce the impact of class-imbalance.

Psychological assessment of patients on the heart transplant waiting list: A single center experience.

To analyze the data of the psychological assessment, focusing attention on the quality of life and the psychological status of patients who are listed for heart transplant. All heart failure patients listed for heart transplant at the Cardiac Surgery Unit of Bari University, Italy, were evaluated from September to November 2023, by administering the Symptom Checklist-90-R (SCL-90-R) and the Short Form Health Survey 36 (SF-36). Overall, 27 patients were studied. Mean age was 60years, 88% were males. One third of the patients showed a clinically significant overall mental distress. The symptoms leading to domains such as somatization (55.55%), anxiety (40.74%) and depression (33.33%) were frequently observed. The majority of the population studied (96.30%) showed low levels of perceived physical health status, while 59,62% of them presented levels of perceived physical health status below normal ranges. Heart transplant candidates show elements of overall mental distress and low quality of life related to physical health status.

Enhancing sports education through big data analytics: Leveraging models for improved teaching strategies

The incorporation of big data analytics into the realm of sports education marks a pioneering shift towards leveraging advanced technological tools to refine teaching methodologies and elevate student performance to unprecedented levels. This article delves into the application of data-driven models that meticulously analyze a multitude of facets within sports education, ranging from student engagement and skill acquisition to comprehensive performance assessments. Utilizing sophisticated quantitative analysis techniques alongside robust mathematical models, this research meticulously evaluates the impact of embedding big data analytics into the core practices of sports education. The essence of this investigation lies in its rigorous analysis of how data-driven insights can be harnessed to inform and enhance coaching strategies, tailor training programs to individual athlete needs, and objectively evaluate performance metrics. By systematically analyzing large datasets that encompass performance statistics, physiological data, and even psychological assessments, educators and coaches can gain a deeper understanding of each student-athlete's unique profile, thereby facilitating more personalized and effective training interventions. The findings from this study highlight the transformative potential of big data analytics in sports education, illustrating how such technological integration can lead to more scientifically informed teaching strategies, optimized training regimens, and significantly improved outcomes for student-athletes. This research not only underscores the benefits of adopting a data-centric approach in sports education but also sets the stage for future innovations that could further revolutionize the field, making it more data-informed, precise, and tailored to the needs and potential of each individual athlete. Through this exploration, it becomes evident that the future of sports education and training lies in the effective integration of big data analytics, promising a new era of enhanced performance and educational excellence.

Research on a machine learning-based adaptive and efficient screening model for psychological symptoms of community correctional prisoners.

Community correction institutions in China frequently employ the Symptom Checklist-90 (SCL-90) and the health survey brief (SF-12) as primary tools for psychological assessment of community correctional prisoners. However, in practical application, the SCL-90 Checklist faces issues such as complex item numbers, overall low cultural level of the subjects, and insufficient professional level of the administrators. The SF-12 health survey brief, as a preliminary screening tool, although only has 12 questions, to some extent simplifies the evaluation process and improves work efficiency, it is prone to missed screening. The research team collected 17-dimensional basic characteristic data and corresponding SCL-90 and SF-12 data from 25,480 samples of community correctional prisoners in Zhejiang Province, China. This study explored the application of multi-label multi-classification algorithms and oversampling techniques in building machine learning models to delve into the correlation between the psychological health risks of community correctional prisoners and their characteristic data. Inspired by computerized adaptive testing (CAT), we constructed an adaptive and efficient screening model for community correctional prisoners through experimental comparisons, based on the binary relevance algorithm with sample oversampling. This screening model personalize the assessment process by dynamically matching participants with the most relevant subset (s) of the nine dimensions of the SCL-90 based on their individual characteristics. Thus, adaptive dynamic simplification and personalized recommendation of the SCL-90 scale between question groups were achieved for the specific group of community correctional prisoners. As a screening tool for psychological symptoms of community correctional prisoners, this model significantly simplifies the number of questions compared to SCL-90, with a simplification rate of up to 65%. However, it achieves this simplification while maintaining excellent performance. The accuracy reached 0.66, with a sensitivity of 0.754, and an F1 score of 0.649. This innovation simplified the assessment process, reduced the assessment time, improved work efficiency, and enhanced the ability to judge the specificity of community correctional prisoners population. Compared to the SF-12, although the simplification rate and accuracy of the model are slightly lower than those of the SF-12, the sensitivity increased by 42.26%, and the F1 score improved by 15.28%. This means the model greatly reduces the possibility of missed screening, effectively preventing prisoners with abnormal psychological or mental states from losing control due to missed screening, and even committing suicide, self injury, or injuring others.

Биологические механизмы тревожности: генетические ассоциации генов BDNF и AMPD1 с ситуативной и личностной тревожностью

<p style="text-align: justify;">This article delves into the genetic underpinnings of anxiety, indicating that both state and trait anxiety have heritable components. However, there is no consensus on the degree of heritability, and much remains to be understood about the specific genetic variants involved and their mechanisms of action. The study explores the role of the <em>BDNF </em>gene, which is involved in the synthesis and transportation of brain-derived neurotrophic factor protein, and the <em>AMPD1 </em>gene, which facilitates the conversion of inosine monophosphate to adenosine monophosphate, the intracellular precursor for adenosine in the pathophysiology of anxiety. The methodology of this study involved a combination of genetic testing, psychological assessments, and statistical analysis. Participants were recruited from diverse demographic groups to ensure the findings were broadly applicable. DNA samples were collected for genetic testing, and participants completed the STAI questionnaire to measure their state and trait anxiety levels. The genetic data were analyzed to identify associations between variants in the <em>BDNF</em> and <em>AMPD1</em> genes and levels of anxiety; specifically, the frequency of these variants in participants with high anxiety scores was compared to those with low anxiety scores. The study provided evidence of the association between <em>BDNF </em>variants and levels of trait anxiety and <em>AMPD1 </em>variants with levels of state anxiety, implicating different biological mechanisms underlying these components of anxiety.</p>

The "V-I penoscrotal reconfiguration": A simple technique for the surgical treatment of congenital webbed penis.

To describe a new penoscrotal reconfiguration technique, named "V-I penoscrotal reconfiguration" for the surgical reconstruction of a congenital webbed penis (CWP). Twenty-one patients who underwent the "V-I penoscrotal reconfiguration technique" were included in this retrospective study. The CWP severity was assessed according to El-Koutby's classification. Demographic and clinical data, surgical data, and postoperative outcomes were scheduled and analyzed. Specifically, the postoperative follow-up included both physical and psychological assessments at 2 weeks, 1, 6, and 12 months after surgery. Parents' satisfaction degree was quantified by the Likert scale. CWP was grade 3 in 11 (52%) patients, 2 in five (24%), and 1 (24%) in five. Five (24%) CWP were isolated malformations, 11 (52%) were associated with phimosis, three (14%) with hypospadias, and two (10%) with hypospadias and phimosis. There were no postoperative complications and no cases of redo surgery. The cosmetic outcomes were excellent in all cases: the parents' satisfaction score was 4 in 17 (81%) cases and 3 (9%) in the other four cases. CWP may cause psychological distress and functional problems, especially during sexual intercourse. Its correction in childhood is advocated to prevent psychological and sexual issues. The "V-I reconfiguration technique" is simple, and easy with excellent cosmetic and functional outcomes.

Screening psychological symptoms in Filipino university students during the COVID‐19 pandemic: Translation and structural validation of the Filipino version of the DASS‐21

AbstractCulturally appropriate tools are necessary to aid in objective screening for psychological symptoms among students in university settings. This study aimed to translate and validate the Depression Anxiety and Stress Scale‐21 (DASS‐21). The instrument underwent forward translation and was reviewed by representatives from the target population, field experts, and an external auditor. The translated version of the DASS‐21, together with the International Positive and Negative Affect Schedule Short Form (I‐PANAS‐SF), Patient Health Questionnaire (PHQ‐9), Generalized Anxiety Disorder‐7 (GAD‐7), Satisfaction with Life Scale (SWLS), was administered to 681 university students. Through confirmatory factor analysis, results supported the intercorrelated three‐factor model with correlated errors for the DASS‐21 Filipino. Results also demonstrated the criterion validity of the depression and anxiety subscales through significant correlations with PHQ‐9 and GAD‐7, respectively, and a stringent z‐score test to examine the difference between two dependent correlations with one variable in common. The convergent validity of all three subscales was established through significant correlations with I‐PANAS‐SF and SWLS. All DASS‐21 Filipino subscales which includes depression (α = .89), anxiety (α = .84), and stress (α = .85), showed high internal consistency. The current findings offer initial evidence on the structural validity of the DASS‐21 Filipino, which can be utilized as a tool to screen for depression, anxiety, and stress symptoms among Filipino speakers during a global health crisis. Implications for psychological assessment and school and clinical interventions are discussed.

Effect of Ayambil (A Type of Jain Intermittent Fasting) on Plasma Glucose, Lipid Profile, Anthropometric and Psychological parameters: An Observational Study

The practice of voluntary abstinence from food and drink for 16 to 48 hours is known as intermittent fasting (IF). Jain Ayambil is, a type of intermittent fasting, where a special meal of boiled grains without spice, oil, milk, ghee, sugar, curd, fruits, or raw vegetables is taken once during the daytime. The aim of the study was to find out safety and its effect on plasma glucose, lipid profile, anthropometric and psychological parameters. We are reporting first ever scientific study on effect of Aymabil intermittent fasting on health parameters. The present study was carried out on 52 volunteers who did 9 days Ayambil fasting. Physical, and psychological assessment were done on the pre-fasting day (day 0), 4th day, and 9th day whereas biochemical examinations were carried out on pre-fasting (day 0) and 9th day of Ayambil fasting. Out of the total 52 participants (mean age of 52.77 ± 13.51 years), there were 28 (53.85%) females (51.54 ± 12.94) and 24 (46.15%) males (54.21 ± 14.30). A statistically significant reduction was observed for fasting blood glucose (p=0.002), HbA1c (p=0.002), body weight (p=0.001), BMI (p=0.001), diastolic BP (p=0.005), serum creatinine (p= 0.036), and a positive correlation was noted for Hamilton Depression Rating Scale (HDRS) (p=0.001) noted during Ayambil fasting. However, there was no significant change in lipid profile. Our findings suggest that Ayambil fasting is beneficial to metabolic, psychological, and holistic health with no health-related hazards. It is a safe fasting method and exploration of more clinical studies on this can open newer futuristic directions as one of the therapeutic options for a variety of clinical situations.

Ambulatory pediatricians: how to bridge the gaps in diagnosis and care coordination for neurodevelopmental disorders in France.

The organization of healthcare pathways for neurodevelopmental disorders (NDD) relies on different levels of expertise depending on the complexity of these disorders. NDDs affect between 8% and 15% of children. Historically, national recommendations and healthcare planning measures were initially devoted to autism spectrum disorders and were gradually extended to Attention deficit hyperactivity disorder (ADHD) and specific learning and development disorders. Private doctors play an increasing role in these pathways at different levels of care due to difficulties in organization, particularly in the health and social sector. The aim of this work was to evaluate the contribution of second-line private doctors in the diagnosis and care of children affected by NDD. A first series of surveys in 2016 evaluated the level of commitment of primary care pediatricians; this online national survey was repeated in 2023 among 1,430 members of the French Association of Ambulatory Pediatrics (Association Française de Pédiatrie Ambulatoire: AFPA) to assess their training, current and future involvement, and activity in NDD care. Analysis was performed by the main author using Epi-Info software. The study identified in 2023 214 second-line private doctors (14% of all pediatricians in activity), of which 185 agreed to appear in a directory published the same year by the AFPA to facilitate referrals from other professionals. Sex ratio of responders is usual for paediatricians: 79.5%/20.5% (F/M), with a distribution among ages showing a slight increase of the age range between age 51-60 (30.5%). Our data indicate that in France in 2022, second-line private doctors made 48%-53% of NDD diagnoses, 24%-26.4% of follow-up consultations and declare to be accountable for 21% of initial prescriptions for Methylphenidate. Among these second-line doctors, 40% had completed a post-university degree on NDD, 74.3% had completed professional development training (PDT) and 85.2% had completed either or both types of training. Most doctors participating in the survey wanted to improve their level of practice, suggesting that in five years, the number of second-line private doctors will increase by 20% to 244 despite 24 planned retirements within the same period. This data probably underestimates the role of private doctors in NDD diagnosis, follow-up, and initial Methylphenidate prescriptions given the unfavourable working conditions (no financial compensation for long appointments, difficulty accessing paramedical and psychological assessments). Our data confirms that diagnosis and care coordination in the various presentations of NDD may rely on different types of practices and specializations: medical and social professionals, mental health professionals, but also a growing body of medical doctors involved in developmental and behavioural pediatrics. This data and reflection will be helpful for organizing healthcare in France or in other countries. Main study limitation relies in the self-declaration of MD's involvement in NDD and could not evaluate the activity of employed MD's from the social and medico social sector, nor be based on the national databases for prescription. It remains however the first attempt of characterization of medical activity at the national level in France for NDD.

Efficacy of electroacupuncture therapy in patients with functional anorectal pain: study protocol for a multicenter randomized controlled trial

Abstract Background Some Chinese scholars have initially explored the efficacy of electroacupuncture at Baliao acupoint in patients with functional anorectal pain (FAP). However, their studies are performed in a single center, or the sample size is small. Therefore, we aim to further explore the efficacy of electroacupuncture at Baliao acupoint on the treatment of FAP. Methods In this multicenter randomized controlled trial, 136 eligible FAP patients will be randomly allocated into an electroacupuncture group or sham electroacupuncture group at a 1:1 ratio. This trial will last for 34 weeks, with 2 weeks of baseline, 4 weeks and 8 weeks of treatment, and 1, 3, and 6 months of follow-up. Outcome assessors and statisticians will be blind. The primary outcome will be clinical treatment efficacy, and secondary outcomes will be pain days per month, quality of life, psychological state assessment, anorectal manometry, pelvic floor electromyography, and patient satisfaction. Discussion Results of this trial will be contributed to further clarify the value of electroacupuncture at Baliao acupoint as a treatment for FAP in the clinic. Trial registration This trial has been registered in Chinese Clinical Trial Registry https://www.chictr.org.cn/ (ChiCTR2300069757) on March 24, 2023.

Gaining Insight into Teenagers' Experiences of Pain after Laparoscopic Surgeries: A Prospective Study.

There is an anecdotal impression that teenage patients report exaggerated postoperative pain scores that do not correlate with their actual level of pain. Nurse and parental perception of teenagers' pain can be complemented by knowledge of patient pain behavior, catastrophizing thoughts about pain, anxiety, and mood level. Two hundred and two patients completed the study-56.4% were female, 89.6% White, 5.4% Black, and 5% were of other races. Patient ages ranged from 11 to 17 years (mean = 13.8; SD = 1.9). The patient, the parent, and the nurse completed multiple questionnaires on day one after laparoscopic surgery to assess patient pain. Teenagers and parents (r = 0.56) have a high level of agreement, and teenagers and nurses (r = 0.47) have a moderate level of agreement on pain scores (p < 0.05). The correlation between patient APBQ (adolescent pain behavior questionnaire) and teenager VAS (visual analog scale) and between nurse APBQ and teenager VAS, while statistically significant (p < 0.05), is weaker (r range = 0.14-0.17). There is a moderate correlation between teenagers' pain scores and their psychological assessments of anxiety, catastrophic thoughts, and mood (r range = 0.26-0.39; p < 0.05). A multi-modal evaluation of postoperative pain can be more informative than only assessing self-reported pain scores.