Assessment Questionnaire Research Articles

Специфика психических состояний осужденных женщин, содержащихся в местах лишения свободы с малолетними детьми

Introduction. The aim of the empirical study was to research the mental states of convicted women with young children. The study sample consisted of 153 convicted women with young children serving their sentences in a correctional institution. The study was conducted on the basis of the State Department of the Federal Penitentiary Service of Russia for the Kemerovo Region, the Federal Penitentiary Service of Russia for the Moscow Region, the Federal Penitentiary Service of Russia for the Vladimir Region, the Federal Penitentiary Service of Russia for the Republic of Mordovia. The scientific problem is to study the mental states of convicted women with young children. Research methods and techniques. The following set of methods was used to study mental states: ‘16-factor personality questionnaire - 16 PF’, form C (R. Kettell), “Depression scale” (A. Beck), clinical questionnaire for identification and assessment of neurotic states (K. K. Yakhin, D. M. Mendelevich), methodology for determining the dominant mental state “Dominant state” (L. V. Kulikov), questionnaire for studying the level of aggression (A. Bass and A. Darkey). The results of the conducted research were the identification of mental states of convicted women in prison with young children. It was established that negative mental states (tension, emotional instability, frustration, anxiety, irritation, depression, anxiety) prevail among these women.They are expressed fatigue, hysteria, vegetative disorders, which are manifested in unpleasant or painful somatic sensations. A high level of aggression and hostility has been diagnosed. The revealed negative mental states need timely psychological correction.

An intervention to determine the effectiveness of the Sanubari optimal health program (OHP) in improving mental well-being among junior doctors in Malaysia: a quasi-experimental study

BackgroundMental health problems among junior doctors in Malaysia pose a significant concern, as they not only adversely affect their overall well-being but also impact the quality of health services they provide. Therefore, it is important to implement interventions aimed at preserving their mental health. This study aimed to evaluate the effectiveness of the Sanubari Optimal Health Program (OHP) intervention in enhancing the mental well-being of junior doctors in Malaysia.MethodsThe study utilised a quasi-experimental design involving 204 junior doctors who participated in the intervention. The Sanubari OHP Intervention Package was employed alongside self-administered questionnaires for mental health and well-being assessment. To evaluate the effects over time, repeated measures ANOVA was employed to analyse within-group and between-group changes in various endpoints, as measured at different assessment time points.ResultsThe study revealed that self-efficacy and adaptive coping behaviours scores increased over time among the intervention group and decreased among the control group. Yet, depression and anxiety scores decreased significantly over time among the intervention group but not in the control group. No significant differences were observed in well-being and maladaptive coping strategies among the groups.ConclusionsThis study showed promising results regarding the effectiveness of Sanubari OHP in improving mental well-being among junior doctors.

Assessment of Teachers’ Job Commitment in Public Senior Secondary Schools in Sokoto State, Nigeria

This study aimed to assess teachers' job commitment in public senior secondary schools in Sokoto State, Nigeria. A descriptive survey was conducted with 183 school principals from 447 schools. The researcher's instrument titled Assessment of Teachers' Job Commitment Questionnaire (ATJCQ) was used to collect data. Descriptive statistics was used to analyze the data collected for this study. The study reveals that teachers' job commitment in public senior secondary schools in Sokoto State, Nigeria is moderate. The average mean is 2.97 on the appropriate use of instructional materials, 2.99 on punctuality, and 2.83 on classroom management. Dimensions used have influenced the job commitment of teachers in public senior secondary schools in Sokoto State, Nigeria. It is recommended that teachers ensure appropriate instructional materials are used when teaching students to improve their participation in the teaching and learning process.

The Association of Mental Health Disorders with the Effectiveness of Treating Facial Synkinesis with Chemodenervation Using Botulinum Toxin A.

Background: Studies suggest that mood disorders may affect perception of facial synkinesis, though none have analyzed effects on perceived benefit from chemodenervation. Objective: To measure the effect of depression, appearance anxiety, and other variables on chemodenervation benefit among patients with post-paralytic facial synkinesis. Design Type: Prospective cohort. Methods: Patients volunteered and completed: Synkinesis Assessment Questionnaire (SAQ), Facial Clinimetric Evaluation Scale (FaCE), Center for Epidemiological Studies Depression Scale (CES-D), and Fear of Negative Appearance Evaluation Scale (FNAES). Multivariate regression was used to analyze the effect of CES-D, FNAES, and demographics on pre- and post-chemodenervation SAQ and FaCE. Results: In total, 100 patients participated, 90% were female. Mean age was 56.4 (SD 12.3) years. The most common paralysis etiology was idiopathic (47%). Average synkinesis duration was 7.6 (6.2) years and treatment duration 4.9 (4.8) years. Older age and prior treatment (p < 0.05) were associated with reduced SAQ improvement; worse CES-D approached significance (p = 0.09). Reported history of anxiety was associated with greater SAQ improvement (p = 0.05). Factors associated with reduced FaCE improvement included higher baseline CES-D and prior treatment (p < 0.05). Conclusions: Older age, worse depression scores, and prior treatments may be associated with reduced patient-graded improvement following chemodenervation. History of anxiety may be associated with greater improvement.

Association between lung function and sleep disorder symptoms in a community-based multi-site case-finding study.

Obstructive airway disease is associated with sleep disturbances. We aimed to assess the relationship between lung function and sleep disorder symptoms using cross-sectionally collected data between March 2017 and August 2021 from the Undiagnosed Chronic Obstructive Pulmonary Disease and Asthma Population study, a prospective community-based multi-site case-finding study. Undiagnosed Chronic Obstructive Pulmonary Disease and Asthma Population study participants with respiratory symptoms but without diagnosed lung disease who completed spirometry and the Global Sleep Assessment Questionnaire were included. We conducted multivariate linear regression models for forced expiratory volume in 1 s, forced vital capacity and forced expiratory volume in 1 s/forced vital capacity by Global Sleep Assessment Questionnaire responses adjusted for confounders. The same models were employed to examine respiratory symptoms, as reported on the St George's Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test, by Global Sleep Assessment Questionnaire responses. Logistic regression models were used to assess the association of undiagnosed obstructive airway disease with sleep symptoms. Amongst 2093 adults included in the study, 48.3% were female and the median age was 63 years (interquartile range 53-72). Two-hundred and five (9.79%) subjects met spirometry criteria for undiagnosed chronic obstructive pulmonary disease, and 191 (9.13%) for undiagnosed asthma. There were no significant associations between spirometry measures and sleep symptoms (p > 0.5), controlling for age, sex, body mass index, smoking and comorbidities. Those with undiagnosed asthma were more likely to report insomnia "at least sometimes" versus "never" (odds ratio 2.58, 95% confidence interval: 1.27-6.19, p = 0.02). Respiratory symptoms were associated with sleep symptoms, with significant (p < 0.05) increases in St George's Respiratory Questionnaire and Chronic Obstructive Pulmonary Disease Assessment Test scores in those reporting most sleep symptoms. Overall, we found an association between undiagnosed asthma and insomnia, and between respiratory and sleep disorder symptoms.

A novel analysis of interoceptive underpinnings of anxious psychopathology in COVID-19 survivors

IntroductionSARS-CoV-2 affects brain, body, and their interchange. We investigated interoceptive mechanisms in COVID-19 survivors focusing on their potential link with psychopathology and inflammatory biomarkers. MethodsWe assessed interoceptive accuracy (IAc) and time-perceiving (TA) skills of 57 COVID-19 survivors one month after hospital discharge through, respectively, a heartbeats perception task and a time duration task. Each participant was assessed about his interoceptive awareness (IAw) through Multidimensional Assessment of Interoceptive Awareness questionnaire (MAIA) and then, screened for post-traumatic (Impact of Events Scale – IES-R), anxious (State-Trait Anxiety Inventory – STAI-Y1) and depressive (Zung Self-Rating Depression Scale - ZSDS; Beck Depression Inventory - BDI-13) symptoms.Biomarkers of inflammation (platelet count, PC; mean platelet volume, MPV and systemic immune-inflammation index, SII) were obtained in a subsample of 40 survivors by a blood sampling conducted at admission and discharge time from the hospital. Correlational, GLM, GLMZ, and mediation analyses were performed. ResultsIAc did not correlate with TA confirming the reliability of interoceptive measure. IAc positively predicts MAIA’s Trusting subscale and negatively predicts anxious psychopathology which fully mediates the effect of IAc on Trusting.PC at hospital admission predicts anxiety at one month after recovery. Again, a higher decrease of SII during hospitalization predicts higher IAc skill and lower anxiety state at one month. The link between SII change and anxiety is fully mediated by IAc. ConclusionsOur results unveil a potential key role of interoception and brain-body interchange in the exacerbation and maintenance of anxiety psychopathology in COVID-19 survivors.

Biopsychosocial factors affected by muscle dysmorphia: to what extent do clinical assessment questionnaires cover them?

Background: muscle dysmorphia (MD) affects several health-related aspects. Assessing how MD questionnaires cover biopsychosocial domains helps clinicians to better describe health status and set treatment goals. Aim: to identify clinical questionnaires for MD and link their content with the International Classification of Functioning, Disability and Health (ICF). Methods: a literature review identified MD questionnaires. The instruments’ items were linked to the ICF. Results: four questionnaires were identified: ACQ, MASS, MDDI and MDI. Forty-four significant concepts were identified from the seventy-two questionnaire items and linked to twenty-six ICF categories, with predominance of body functions (42,4%, n = 11 categories), activities and participation (34,6%, n = 9), environmental factors (19,2%, n = 5), and body structures (3,8%, n = 1). Conclusion: All instruments focused on body functions, and they poorly covered body structures and environmental factors. MASS and ACQ presented the most diverse coverage of categories, enabling broader assessment of health aspects.

Cross-Cultural Adaptation and Clinical Validation of the Mini Sarcopenia Risk Assessment Questionnaire in Community-Dwelling Spanish Older Adults

(1) Background: The aim was to analyze the reliability and validity of the Spanish version of the Mini Sarcopenia Risk Assessment (MSRA) in older adults. (2) Methods: A total of 136 participants (72.24 ± 5.21 years, 68.38% women) took part in the study. The MSRA includes two questionnaires with seven (MSRA-7) and five items (MSRA-5). First, reliability (inter-rater and test–retest) of the Spanish MSRA was studied, and then the total scores were compared with the presence of sarcopenia according to three different diagnostic criteria and with other parameters related to sarcopenia (clinical validation). (3) Results: The analysis showed excellent inter-rater and test–retest reliability. As for the clinical validation, and regardless of the criteria, both questionnaires had a high sensitivity (81.82–88.89% for the MSRA-5 and 90.91–94.44% for the MSRA-7), while the MSRA-5 showed a better specificity (32.00–33.90%) than the MSRA-7 (20.80–22.88%). Predictive positive values ranged from 9.57–17.02% (MSRA-5) and 9.17–15.54% (MSRA-7), while predictive negative values were high for both the MSRA-5 (95.24%) and the MSRA-7 (96.30–96.43%). The accuracy was better for the MSRA-5 (36.03–41.18%) than the MSRA-7 (26.47–32.35%), as well as the area under the curve (0.67–0.76 vs. 0.65–0.73, respectively). Higher MSRA-5 and MSRA-7 total scores significantly correlated with greater muscle strength, quantity and gait speed. (4) Conclusions: The adaptation of the Spanish MSRA questionnaires was successfully performed, and they are reliable and clinically valid tools for assessing sarcopenia.

The complexity of interpersonal physiology during rupture and repair episodes in the treatment of borderline personality disorder: a proof-of-concept multimethod single case study of verbal and non-verbal interactional dynamics.

The aim of this proof-of-concept multimethod exploratory single case study is to increase knowledge of the underlying mechanisms of alliance ruptures and repairs in Borderline Personality Disorder treatment across and within the psychotherapeutic treatment process. The multimethod includes outcome assessment of patient self-reporting questionnaires (the Affect Integration Inventory, the Hopkins Symptom Checklist), observation-based ratings of sessions with the Rupture Resolution Rating System, quantitative analysis of heart rate variability using recurrence quantification analysis, and a qualitative multimodal interaction analysis of within-session dynamics. Results reveal how patterns of heart rate synchrony between patient and therapist reflect periodical patterns of emotional interaction corresponding to key therapeutic alliance processes throughout the treatment process. Particularly, heart rate synchronization and desynchronization correspond with increasing rupture resolution ratings and positive outcome measures in the last part of the therapy process, indicating increased productivity, affectivity, and positive change. The qualitative microanalysis highlights context sensitivity to alliance management within sessions. Physiological arousal is found to underlie important alliance processes, including emotion regulation, relatedness, security, empathic responding, sense-making, and validation in correspondence with different therapist verbal and non-verbal markerbs. Clinical implications and study limitations are discussed. Recommendations are made for future directions in relation to applying multimethod approaches when studying rupture and repair processes in psychotherapy.

The effect of fibromyalgia syndrome on female patients diagnosed with chronic migraine

ObjectiveTo compare pain, quality of life, sleep, anxiety and depression, central sensitization, and functionality between chronic migraine (CM) patients with comorbid fibromyalgia syndrome (FMS) and patients with CM alone. MethodThirty three female patients with CM and thirty three female patients with CM+FMS were enrolled in the study. Demographic and clinical characteristics of the patients were recorded. FM was diagnosed based on the 2016 American College of Rheumatology diagnostic criteria. All participants were evaluated with Allodynia Symptom Checklist, Short Form-36 (SF-36), Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Migraine Disability Assessment (MIDAS) and Headache Impact Test (HIT-6) questionnaires, and Central Sensitization Inventory (CSI). FM patients were also evaluated with Fibromyalgia Impact Questionnaire (FIQ). ResultsThe average number of headache days was significantly higher in patients with CM+FMS (p = 0.006). Among migraine accompanying symptoms, the number of patients with phonophobia was significantly higher in patients with CM+FMS (p = 0.008). While CSI score was 39.0 ± 11.7 in CM patients, it was 52.2 ± 9.2 in CM+FMS patients. CSI scores were higher in CM+FMS patients (p < 0.001). SF-36 sub-cores, including physical function, energy/fatigue, emotional well-being, and general health scores, were lower in CM+FMS patients (p < 0.05). Sleep duration was significantly lower and use of medication to sleep was more common in same group (p < 0.05). FIQ score in CM+FMS patients was associated with quality of life scores, sleep quality, anxiety, and central sensitization scores (p < 0.05). ConclusionIn patients with chronic migraine, FMS comorbidity negatively affects the quality of life and significantly increases central sensitization.

Effect of theme game-based learning on psychiatric violence risk assessment and response knowledge, skills, and self-confidence of nursing students: A randomized controlled trial

BackgroundTheme game-based learning has the potential to enrich student learning experiences, leading to improved learning outcomes. Yet, there remains a research gap regarding its application in addressing psychiatric violence, leaving uncertainties about the comparative advantages of theme game-based learning over situational simulation learning strategies. ObjectivesThe goal was to measure the effect of integrating theme game-based learning into psychiatric violence risk assessment and response training on nursing student psychiatric violence-related knowledge, skills, and self-confidence. DesignThis study was a randomized controlled, pre-test, and post-test trial. SettingThe study was conducted at a medical university in Guangzhou, Guangdong, China. ParticipantsThere were 103 third-year nursing undergraduates (intervention group = 51, control group = 52) in the study. MethodsAn Objective Structured Clinical Exam and the Workplace Violence Management Ability Assessment Questionnaire for Intern Nursing Students were used to assess student skills. The knowledge test and the Confidence in Coping with Patient Aggression Instrument were used to measure student knowledge and self-confidence level before and after intervention. ResultsNursing students in the theme game-based group demonstrated significantly superior skills and confidence in violence risk assessment and response compared with students in the situational simulation group (p < 0.001, p = 0.039, p = 0.006, respectively). However, there was no significant difference in knowledge of violence risk assessment and response between the two groups (p = 0.510). ConclusionTheme game-based learning in psychiatric violence risk assessment and response training appeared effective in enhancing the violence management abilities of nursing students.

Unravelling the genetic landscape of cervical insufficiency: Insights into connective tissue dysfunction and hormonal pathways

Background The intricate molecular pathways and genetic factors that underlie the pathophysiology of cervical insufficiency (CI) remain largely unknown and understudied. Methods We sequenced exomes from 114 patients in Latvia and Lithuania, diagnosed with a short cervix, CI, or a history of CI in previous pregnancies. To probe the well-known link between CI and connective tissue dysfunction, we introduced a connective tissue dysfunction assessment questionnaire, incorporating Beighton and Brighton scores. The phenotypic data obtained from the questionnaire was correlated with the number of rare damaging variants identified in genes associated with connective tissue disorders (in silico NGS panel). SKAT, SKAT-O, and burden tests were performed to identify genes associated with CI without a priori hypotheses. Pathway enrichment analysis was conducted using both targeted and genome-wide approaches. Results No patient could be assigned monogenic connective tissue disorder neither genetically, neither clinically upon clinical geneticist evaluation. Expanding our exploration to a genome-wide perspective, pathway enrichment analysis replicated the significance of extracellular matrix-related pathways as important contributors to CI’s development. A genome-wide burden analysis unveiled a statistically significant prevalence of rare damaging variants in genes and pathways associated with steroids (p-adj = 5.37E-06). Rare damaging variants, absent in controls (internal database, n = 588), in the progesterone receptor (PGR) (six patients) and glucocorticoid receptor (NR3C1) (two patients) genes were identified within key functional domains, potentially disrupting the receptors’ affinity for DNA or ligands. Conclusion Cervical insufficiency in non-syndromic patients is not attributed to a single connective tissue gene variant in a Mendelian fashion but rather to the cumulative effect of multiple inherited gene variants highlighting the significance of the connective tissue pathway in the multifactorial nature of CI. PGR or NR3C1 variants may contribute to the pathophysiology of CI and/or preterm birth through the impaired progesterone action pathways, opening new perspectives for targeted interventions and enhanced clinical management strategies of this condition.

Effects of amultimodal inpatient treatment for patients with fibromyalgia syndrome at the Rhineland-Palatinate Acute Rheumatology Center

Fibromyalgia syndrome (FMS) is acomplex condition that is often refractory to therapy and is associated with impaired quality of life. In some studies, multimodal rheumatological treatment has been shown to be an effective therapy option for patients with systemic-inflammatory and degenerative rheumatic diseases. However, the effects of this therapeutic approach have not been sufficiently investigated in patients with FMS. Therefore, the aim of this study was to examine the effect of aconcise 9‑ to 10-day inpatient multimodal fibromyalgia treatment (MFT) using patient-reported outcomes in aGerman cohort. The effects of MFT were assessed using visual analog scales (VAS) for pain(P) and subjective disease activity (DA), questionnaires measuring everyday functional capacity (Health Assessment Questionnaire [HAQ], Funktions-Fragebogen-Hannover [FFbH, Hannover Functional Ability Questionnaire]), and pharmacotherapy at three time points (Visit1: beginning of multimodal therapy, Visit2: end of MFT, and Visit3: 3months after Visit2). Sixty-one patients were enrolled in the study at the Rhineland-Palatinate Acute Rheumatology Center. Under MFT, asignificant improvement in VAS (P) and VAS (DA) was observed between the start and end of treatment (Visit2 versus Visit1: median decrease from 7to 5, p < 0.001, for both VAS [P] and VAS [DA]). Additionally, comparison of the other two assessment points showed achange in VAS (P) (Visit3 versus Visit1: median decrease from 7to 6, p = 0.041, and Visit3 versus Visit2: median increase from 5to 6, p = 0.004). However, there were no significant differences in FFbH and HAQ parameters among the three visits. Examination of the subgroup of patients whose medication therapy was not intensified during hospitalization also showed significant improvements in VAS (P) and VAS (DA) between the start and end of MFB (Visit2 versus Visit1: median decrease from 7to 4, p < 0.001, for VAS[P] and median decrease from 6.25 to 4, p = 0.002, for VAS [DA]). These findings indicate ademonstrable benefit to patients of MFT regarding both pain and subjective disease activity. Furthermore, pain relief was even observed 3months after the end of therapy. This shows the high value of this therapeutic approach to treating patients with FMS.

Analyzing the Relationship between Cultural Identity and Health Professional Perspectives

Having a systematicseize of cultural diversity is necessary for health professionals to present culturally competent treatment, enhance patient satisfaction and recover healthcare outcomes. To better recognize how cultural identity (CI) affects the attitudes, communication preferences and decision-making processes of health professionals, this research looks at how cultural competency is integrated into healthcare education and strategy.This study examines the influence of CI on the perspectives and practices of health professionals and its impact on patient care. People's behaviors and self-perceptions are greatly influenced by their concept of culture, which is defined by shared norms, language, and ethical principles. This research includes 281 health professionals from diverse contexts utilizing the Cultural Competence Assessment Questionnaire (CCAQ). Interpersonal relationships, professional development, communication skills, cultural sensitivity, competence and patient-centered care are all significantly correlated, according to the data. This finding suggests that for improved patient relationship and liberty of health, there should be specialized cultural competency training. Implications for practice: promote continued professional development about cultural sensitivity in health events, and conferences. This article also puts forward the use of CI as one method to guide and support the approach of health professionals and capture the attention of communications and cultural competencies to help develop patient results.

Elevated neopterin and decreased IL-4, BDNF levels and depression in lymphoma patients receiving R-CHOP chemotherapy.

Depression is the most commonly observed psychological manifestation experienced by individuals diagnosed with cancer. The purpose of the study was to investigate the association between levels of IL-4, BDNF, neopterin, and depressive symptoms in lymphoma patients receiving consecutive cycles of chemotherapy. Newly diagnosed lymphoma patients scheduled to receive R-CHOP chemotherapy were enrolled. Effects of R-CHOP on circulatory biomarkers and depressive symptoms were assessed at three-time points [baseline assessment 7 days before the first dose of chemotherapy (TP1), interim assessment after the third cycle of chemotherapy (TP2), and follow-up assessment after the 6th cycle of chemotherapy (TP3)]. Seventy lymphoma patients, with a mean age of 44.17 ± 13.67 years, were enrolled. Patients receiving R-CHOP were found significantly increased neopterin levels between given time points TP1 vs. TP2, TP1 vs. TP3, and TP2 vs. TP3 (p < 0.001). However, IL-4 and BDNF levels significantly decreased with consecutive cycles of chemotherapy (p < 0.001). On Patient Health Questionnaire assessment (PHQ-9), scores of items like loss of interest, feeling depressed, sleep problems, loss of energy, and appetite problems were found significantly affected with consecutive cycles of chemotherapy (p < 0.001). The study found weak negative correlations between IL-4, BDNF, and neopterin levels and changes in PHQ-9 scores at both TP2 and TP3, suggesting a potential inverse relationship between these markers and depression symptoms. In conclusion, the present study suggests a potential link between elevated neopterin levels, decreased IL-4, and BDNF levels, and the presence of depression in lymphoma patients receiving R-CHOP chemotherapy. This study provides valuable insights into understanding the emotional challenges faced by cancer patients, offering information for more personalized interventions and comprehensive support approaches within the oncology setting.

Psychometric Properties of questionnaires for assessing musculoskeletal disorders in the ankle: a systematic review protocol

Introduction: Ankle musculoskeletal disorders are common among various populations, including athletes and the elderly. However, there’s a lack of specific instruments in the literature that address factors influencing the progression of these disorders. Objective: This review aims to identify and describe questionnaires focusing on these factors, emphasizing their psychometric characteristics, feasibility, and applicability across different populations. Methods: This study is a systematic review protocol developed according to PRISMA-P recommendations. Searches were conducted in various databases, including Medline, Embase, LILACS, PEDro, SCOPUS, CENTRAL, CINAHL, and Web of Science, without time limitation. The results will be analyzed using the Rayyan®️ software, where two researchers will conduct the identification and removal of duplicates, selection, and screening of studies, with discrepancies resolved by a third examiner. Results: The first phase will comprise reading titles and abstracts, followed by a full manuscript analysis. Methodological quality will be assessed using the COSMIN checklist. Psychometric evidence will follow Terwee et al. criteria. The overall synthesis score will combine the consistency of psychometric evidence with methodological quality, categorizing studies according to levels of evidence proposed by the Cochrane Musculoskeletal Group. The article eligibility process will be represented through the PRISMA flowchart, and results will be presented in tables and figures accompanied by descriptive and narrative analysis. Dissemination will include peer-reviewed publication and conferences in rehabilitation-specific contexts. Conclusion: This study aims to compile existing research to streamline the analysis and application of ankle joint assessment questionnaires recommended for clinical use. It will focus on identifying high-quality questionnaires and examining their ability to explore barriers and facilitators in rehabilitation processes. Keywords: Ankle fractures; ankle injuries; patient-reported outcome measures; surveys and questionnaires.

Efficacy and safety of tocilizumab in Chinese patients with systemic juvenile idiopathic arthritis: a multicentre phase IV trial

ObjectivesGiven the limited tocilizumab (TCZ) treatment data for systemic juvenile idiopathic arthritis (sJIA) in China, we evaluated the long-term efficacy and safety of TCZ in Chinese patients with sJIA.MethodIn this multicentre, interventional Phase IV study, patients with sJIA and inadequate clinical response to non-steroidal anti-inflammatory drugs/corticosteroids received TCZ infusions every 2 weeks based on body weight (< 30 kg, 12 mg/kg; ≥ 30 kg, 8 mg/kg), over a 52-week open-label period and an 8-week safety follow-up period. The primary endpoint was the proportion of patients with a JIA American College of Rheumatology (ACR) 30 response and absence of fever at Week 12.ResultsSixty-two patients were enrolled and treated (12-mg/kg group, 34; 8-mg/kg group, 28). At Week 12, 87.1% (95% confidence interval 78.8%–95.4%) of patients had JIA ACR 30 response and absence of fever; Week 52 results were similar. The proportion of JIA ACR 30/50/70/90 responders rapidly increased at Week 12, up to Week 52. High-sensitivity C-reactive protein (hsCRP) levels decreased within 4 weeks; 44/58 patients (75.9%) with elevated baseline hsCRP recovered at Week 52. Childhood Health Assessment Questionnaire pain scores, disability index scores, and mean corticosteroid dose decreased over time. Height standard deviation score changes at Week 52 indicated catch-up growth. Most adverse events (AEs) were mild (serious AE incidence, 17.7%). No deaths or macrophage activation syndrome occurred.ConclusionThis is the first multicentre trial to report the efficacy and safety of TCZ in Chinese patients with sJIA at 52 weeks. No new safety concerns were found.Key points• This is the first multicentre trial providing strong evidence for tocilizumab (TCZ) treatment for systemic juvenile idiopathic arthritis (sJIA) in China.• The study reported TCZ had good efficacy and favourable safety profiles in Chinese sJIA patients in the long term (52 weeks).• TCZ treatment showed rapid disease control, which was maintained over time, catch-up growth benefits in patients, tapering and discontinuation of corticosteroids, and improved quality of life.

Progressive cervical cord atrophy parallels cognitive decline in Alzheimer’s disease

Alzheimer’s disease (AD) is characterized by progressive episodic memory dysfunction. A prominent hallmark of AD is gradual brain atrophy. Despite extensive research on brain pathology, the understanding of spinal cord pathology in AD and its association with cognitive decline remains understudied. We analyzed serial magnetic resonance imaging (MRI) scans from the ADNI data repository to assess whether progressive cord atrophy is associated with clinical worsening. Cervical cord morphometry was measured in 45 patients and 49 cognitively normal controls (CN) at two time points over 1.5 years. Regression analysis examined associations between cord atrophy rate and cognitive worsening. Cognitive and functional activity performance declined in patients during follow-up. Compared with controls, patients showed a greater rate of decline of the anterior–posterior width of the cross-sectional cord area per month (− 0.12%, p = 0.036). Worsening in the mini-mental state examination (MMSE), clinical dementia rating (CDR), and functional assessment questionnaire (FAQ) was associated with faster rates of cord atrophy (MMSE: r = 0.320, p = 0.037; CDR: r = − 0.361, p = 0.017; FAQ: r = − 0.398, p = 0.029). Progressive cord atrophy occurs in AD patients; its rate over time being associated with cognitive and functional activity decline.

Adaptation of the 12-item medication adherence scale ( the Questionnaire for assessment of adherence to Medication) on a Russian-speaking sample of patients with type 1 and type 2 diabetes mellitus

BACKGROUND: Poor adherence to treatment among patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) hinders the effective use of antidiabetic agents and the achievement of optimal glycemic control, reducing their quality of life and outcomes. Assessing adherence to treatment using a questionnaire can help identify and eliminate factors and barriers that negatively affect adherence to medical recommendations and satisfaction with treatment.AIM: To conduct linguistic and cultural adaptation of the 12-item Medication Adherence Scale (MAS-12) questionnaire and evaluate the psychometric properties of the Russian version of the MAS-12 questionnaire among patients suffering from T1DM and T2DM.MATERIALS AND METHODS: A survey of 198 patients with T1DM and T2DM was carried out, including self-completion of the MAS-12 questionnaire in Russian. Average age: 47.1±18.62 years, proportion of women — 76%. Average duration of the disease: 13.08±10.05 years. The construct validity of the MAS-12 questionnaire was assessed using confirmatory factor analysis. As an external criterion for assessing convergent validity, the KOP-25 method was used - the Russian Questionnaire for Quantitative Assessment of Treatment Adherence (KOP-25). Reliability of the MAS-12 was assessed using Cronbach’s α internal consistency and participant retest after 1 to 4 months.RESULTS: The factor structure of the MAS-12 questionnaire is reproduced for the first time on a Russian sample of patients with diabetes. Recommended fit indicators for the measurement model (CFI=0.983, RMSEA=0.049, TLI=0.968) were achieved by excluding two items (9 and 12) that did not demonstrate statistically significant contributions to their respective subscales. The internal consistency of the subscales (α ϵ [0.522; 0.857]) and the questionnaire as a whole (α=0.766) was assessed as sufficient. Significant correlations of the adapted methodology and its subscales with the scales of the KOP-25 questionnaire were obtained. The closest connections (r ϵ [0.333; 0.431], p&lt;0.010) are observed with the COP-25 scales related to drug therapy, which indicates good external validity of the adapted methodology.CONCLUSION: The Russian version of the MAS-12 questionnaire “Questionnaire for assessing adherence to medication treatment” (PML-10), consisting of 10 questions, has good psychometric properties, is a valid and reliable tool for assessing medication adherence among patients with T1DM and T2DM and can be recommended for use in clinical practice, including for monitoring treatment adherence in Russia.

Early Rheumatoid Arthritis Patients at Presentation Are Changing: A 24-Year Study of the Early Undifferentiated PolyArthritis (EUPA) Cohort.

To analyze changes in baseline characteristics of very early rheumatoid arthritis (RA) over 24 years in the Early Undifferentiated PolyArthritis (EUPA) cohort. Consecutive recent-onset polyarthritis patients fulfilling RA classification criteria recruited in EUPA were assessed at baseline. Three successive periods were defined: prior to the general availability of biologics (1998-2004; 245 patients), prior to the implantation of the 2010 classification criteria (2005-2010; 266 patients), and the most recent decade (2011-2022; 329 patients). At baseline, demographics, BMI, swollen and tender joint counts, proportion fulfilling 2010 ACR⁄EULAR criteria, Modified Health Assessment Questionnaire, shared epitope status, patient-reported outcomes except pain and Patient Evaluation of Disease Activity remained stable over the 3 periods. Despite a marked decrease in active smoking (22.2 to 12.1%), prevalence of cardiovascular comorbidities and prior cancer increased. While duration of symptoms increased from 2.9 to 4.1 months, seropositivity (53.9 to 42.2%), and CRP began decreasing in the 2005-2010 period. A large decrease in Erosive status (Sharp-van der Heijde erosion score ≥5; 18.3 to 9.4%) was only observed after 2011; this decrease occurred mostly in seronegative patients. DMARD use prior to inclusion remained low and stable (25.7%), but oral corticosteroids increased (18.0 to 33.4%). Baseline characteristics of RA patients evolved since 2005 towards less seropositivity and lower blood inflammation but with more comorbidities. Milder erosive damage at baseline became evident only since 2011, mostly in seronegative patients. These changes at baseline, before any intervention, suggest ongoing secular trends that may favorably impact early RA patients' outcomes.