Questionnaire Measures Research Articles

Multimodal Assessment of Adolescent Coping with Family Conflict Incorporating Video-Mediated Recall Methodology.

The strategies adolescents use to cope with stress are key determinants of psychological adjustment. Research has most often utilized questionnaire methods to assess coping, which can be limited by recall bias and broad time frames. This study used a novel application of video-mediated recall methodology to assess adolescent coping during discussion of a family conflict. We examined associations between coping, observed emotions and behavior, and internalizing and externalizing symptoms. Caregiver-adolescent dyads (N = 89; ages 10 to 15) completed questionnaires on adolescent coping, family conflict, and symptoms of psychopathology. Caregiver-adolescent dyads were videorecorded during a 10-min conflict task. Adolescents then participated in a video-mediated recall procedure to self-report their use of coping strategies while reviewing segments of the conflict task. In addition, video recordings were coded for adolescent emotions and behaviors. Bivariate correlations revealed modest correspondence between questionnaire and recalled reports of in-the-moment adolescent coping strategies. In-the-moment coping was associated with observed and reported emotional and behavioral problems across strategies. In multivariate analyses, questionnaire reports of coping were significantly associated with questionnaire reports of internalizing and externalizing psychopathology, while in-the-moment coping responses were uniquely associated with observed emotions and behaviors. Differences in questionnaire and laboratory measures of coping underscore the need for comprehensive assessment to capture the complexity of coping in adolescence and their unique influence on emotions and behaviors and suggest that questionnaire measures may be sufficient to understand associations with global reports of symptoms. The conceptual, methodological, and clinical implications of the present study are discussed.

Sleep Deficiency and Fatigue in Adults with Inflammatory Bowel Disease: A Systematic Review.

Fatigue is one of the most common and disabling symptoms experienced by people with inflammatory bowel disease; however, interventions to treat fatigue are limited. The purpose of this systematic review is to examine the relationship between sleep deficiency and fatigue in adults with inflammatory bowel disease and to describe the demographic and clinical factors associated with fatigue to inform future intervention work. We conducted a systematic review and reported the results using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search was conducted using MEDLINE, EMBASE, PsycINFO, CINAHL, and CENTRAL on 3/7/24. We included studies with adults (≥18 years of age) who had a diagnosis of inflammatory bowel disease (Crohn's disease, ulcerative colitis, or indeterminate colitis) and measured fatigue and sleep using a validated self-report questionnaire or objective measurement. Twenty-two studies met inclusion criteria for a total sample of 16 927, of whom 58.7% (n = 9937) had Crohn's disease, and 66.3% (n = 11 226) were female. 56.1% of the participants experienced fatigue and 66.3% experienced sleep deficiency. Sleep quality and insomnia were consistently associated with fatigue. Baseline poor sleep quality was associated with persistent and worsening fatigue over 12 to 24 months. Clinical but not objective assessment of disease activity, anxiety, depression, female gender/sex, and younger age were also associated with more severe fatigue. Sleep quality and insomnia represent important modifiable contributors to fatigue. Future research should explore whether sleep interventions can improve fatigue in this population.

Clinical course of spinal pain in adolescents: a feasibility study in a chiropractic setting

DesignProspective feasibility study.ObjectivesTo inform the design and conduct of a large-scale clinical cohort study investigating adolescents with moderate-to-severe spinal pain.SettingChiropractic care in Sydney, Australia.ParticipantsAdolescents aged 12–17 years with spinal pain...

Physical literacy among chinese elementary school students: the mediating role of physical knowledge and physical competency

BackgroundPhysical literacy (PL) is pivotal for improving sedentary behaviors, enhancing intrinsic motivation for physical activity, and supporting the growth and development of adolescents. This study aims to measure the current situation and internal pathway of PL among Chinese elementary school students.MethodsThis study was conducted from June to July 2022 and used multistage cluster sampling to select the study subjects. Questionnaire measurements were used to report the levels of PL among elementary school students and to explain the internal association among the various PL dimensions.ResultsThe average PL score among primary school students was 63.46 points. The qualification rates for PL in the three academic stages were 76.35%, 73.45%, and 59.17%, respectively. The study included 1499 boys (49.72%) and 1516 girls (50.28%). The average age was 9.04 ± 1.60 years. Physical motivation, physical competency and physical participation were positively associated with PL in each grade. Physical competency mediated the association between physical motivation and physical participation, explaining 56.40% of the effect.ConclusionThe qualification rates for PL in grades 5–6 was lower than those of students in grades 3–4 and grades 1–2. Physical competency explained 56.40% of the association between physical motivation and physical participation.Clinical trial numberNot applicable

Prevalence of overweight/obesity and its association with fast food consumption among adolescents in Southern Ethiopia, 2022: a community-based cross-sectional study

Overweight and obesity are body mass index (BMI) for age Z-score > +1SD and > +2SD, respectively. Despite its largest contribution to overweight/obesity, there is little attention in our country about fast-food consumption. Hence, this study aimed to assess the prevalence of overweight/obesity and its association with fast-food consumption among adolescents in Southern Ethiopia. From 14 June 2022 to 15 July 2022, a cross-sectional study design was conducted using a structured questionnaire and anthropometric measurements, with a sample size of 563. The data were coded, cleaned, and imported into EPI-INF version 7.2 before being exported to SPSS version 25 for analysis. All variables with p-values less than or equal to 0.25 in bivariate logistic regression were candidate variables for multivariable logistic regression. The response rate of this study was 97%. Based on BMI, the combined prevalence of overweight/obesity was 6.0% (95% CI: 4.2–8.4%). Adolescents who are female, come from high-income families, and eat fast-food frequently are more likely to be overweight or obese. Future health initiatives aimed at lowering the prevalence of overweight and obesity in adolescents should pay special attention to female adolescents and those from high-income families.

Assessing Hypertension Management in Peru's Peri-Urban Community in the Wake of the COVID-19 Pandemic.

Hypertension is a global health challenge, particularly in low- and middle-income countries. Peri-urban areas such as Pampas de San Juan de Miraflores, Peru, face challenges that the COVID-19 pandemic exacerbated. To assess the post-COVID-19 hypertension care cascade and mean systolic blood pressure (SBP) levels in Pampas de San Juan de Miraflores and to determine the proportion of individuals with hypertension who are diagnosed, treated, and have controlled blood pressure across age groups. A cross-sectional survey (October 2022-January 2023) including adults aged >35 years from the 2010 CRONICAS study and a geographically based sample of households nearby. Data collection included a hypertension awareness questionnaire and standardized blood pressure measurements. Descriptive analyses characterized the age-specific hypertension care cascade and calculated mean blood pressure in four groups: healthy, unaware, aware and untreated, and aware and treated. Among 2,856 adults, age-specific hypertension prevalence based on self-reported medication use and current blood pressure screening was 13.3 % (35-44 years) to 54.6 % (>75 years). Awareness was 85 %; of those, 85 % were treated, and 76.8 % of them had controlled blood pressure. Mean SBP was highest in the unaware group (n = 102, 146.0 mmHg) and lowest in the healthy group (n = 1,929, 111.0 mmHg). These values were comparable among diagnosed patients, whether treated (n = 333, 126.0 mmHg) or untreated (n = 492, 128.0 mmHg). Despite high awareness and relatively adequate control among untreated individuals, a substantial proportion remain undiagnosed or untreated after COVID-19. These findings underscore the need for interventions to improve early detection, treatment, and follow-up of hypertension.

Effect of Teachers’ Competencies on Students' Academic Achievement: A Comparative Analysis of Public and Private Universities, Lahore

Teachers' competencies encompass the essential skills, knowledge, and dispositions that enable educators to effectively enhance students’ learning and academic performance. These competencies play a crucial role in shaping the educational environment by directly influencing students' performances and their overall academic success. Therefore, this study aims to assess the effect of teachers' competencies on the academic performance of students enrolled in public and private universities located in Lahore, Pakistan. The sample surveyed comprised 313 respondents, with 166 being public university students and 147 private university students. Evaluation of Teaching Performance Questionnaire (CEID) measures several dimensions of instructional effectiveness to assess the respective students. A non-probability sampling technique was adopted and the data gathered were analyzed using inferential statistical methods. The results indicated that teacher qualifications and competencies are two of the main factors affecting the improved academic performance of students. Importantly, from a comparative perspective, there is no marked difference between public and private schools in terms of the competencies of instructors. Schools are encouraged to allocate more resources to professional development programs, focusing on enhancing teachers' instructional skills and disciplinary knowledge in areas requiring improvement. Additionally, further research is essential to track changes in teacher training and their potential impact on improving students' academic performance.

Negative interpretation bias and repetitive negative thinking as mechanisms in the association between insomnia and depression in young adults.

Despite evidence supporting sleep's role in the development and maintenance of depression, mechanisms underlying this association in young people are less established. Negative interpretation bias (the tendency to interpret ambiguous situations negatively) and repetitive negative thinking (RNT) are important candidate mechanisms. Whilst negative interpretation bias is implicated in depression development, it is a transdiagnostic process and may result from insomnia. Yet, research relating to these constructs is lacking. RNT is another transdiagnostic process implicated in association between negative interpretation bias, depression and insomnia. However, an elaborated model that includes both mechanisms is yet to be tested. It was hypothesised that negative interpretation bias and RNT would sequentially mediate the relationship between sleep/insomnia and depressive symptoms in young people. The associations predicted by this hypothesis were tested via cross-sectional mediation in a sample of 214 participants (Mage = 19.19 years, SD = 1.67, Rangeage = 17-24 years, 20% male). Participants completed questionnaire measures of insomnia symptoms, depression symptoms and RNT, an ambiguous scenarios task and a 1-week sleep diary. Results were consistent with negative interpretation bias and RNT as sequential mechanisms which partially account for the relationship between sleep (i.e., insomnia severity and sleep parameters) and depression. This study supports negative interpretation bias and RNT as mechanisms linking insomnia and depression in young people, as the predicted associations between these variables were observed. Future research should investigate the causal/directional associations. However, results support theoretical models, and suggest sleep, interpretation bias and RNT may be important processes to target in preventing and treating depression.

The Multifactorial Memory Questionnaire and Quality of Life: A Longitudinal Study in Parkinson's Disease.

Objective memory decline is associated with poor quality of life (QOL) in Parkinson's disease (PD, but it is unclear what role perception of memory (metamemory) plays. The Multifactorial Memory Questionnaire (MMQ) measures metamemory and is proposed to have a three-factor structure, but the factor structure of the MMQ in PD has not been explored. The current study examined (i) the factor structure of the MMQ in PD and (ii) the relationship between the metamemory and QOL in PD. This longitudinal, observational study involved 149 participants with PD (98 males, M age = 65.78 years, SD = 9.25). Participants completed the MMQ and the Unified Parkinson's Disease Rating Scale (disease severity) at baseline, and the Parkinson's Disease Questionnaire-39 (QOL) two years later. Confirmatory factor analysis revealed both the three-factor and four-factor models were inadequate. Exploratory factor analysis resulted in a four-factor solution. The contentment and ability subscales from the original factor structure remained, while the strategies subscale was divided into external strategies and internal strategies. Disease severity, ability, and internal strategies uniquely predicted QOL. Individuals who reported low subjective memory ability and high use of internal strategies reported worse QOL two years later. These findings indicate that metamemory predicts QOL in PD and suggest that improved perceived memory ability and strategy use could offer avenues for improved QOL.

Transdiagnostic Predictors of Health-Related Quality of Life in Children with Autism and Epilepsy: A Cross-Sectional Study.

Background/Objectives: Our understanding of the transdiagnostic factors that influence health-related quality of life (HRQOL) in individuals with neurodivergent conditions is very sparse and highly siloed by diagnosis labels. Research on transdiagnostic predictors of HRQOL across neurodevelopmental conditions is needed to enable care models that address shared needs of neurodivergent individuals beyond diagnostic boundaries. Our objective was to identify transdiagnostic factors associated with HRQOL in children with autism, epilepsy, or comorbid autism/epilepsy. Methods: This cross-sectional study included 37 autistic and/or epileptic children (mean age = 9.2; SD = 3.9; boys = 28). Parents provided sociodemographic information and completed the following measures: Social Communication Questionnaire (measure of severity of autistic symptoms); Parenting Stress Index, Fourth Edition; Pediatric Quality of Life Inventory; and the Behavioral Assessment System for Children, Third Edition. Child intellectual functioning was measured using age-appropriate scales: the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition: Canadian or the Wechsler Intelligence Scale for Children-Fifth Edition: Canadian. Results: Higher autistic symptom severity (OR = 0.851 95% CI: 0.732-0.988, p = 0.034) and parenting stress (OR = 0.687 95% CI: 0.493-0.959, p = 0.027) were associated with poorer HRQOL. Full Scale IQ and adaptive skills showed trend level associations with HRQOL. Sociodemographic factors including maternal education, child sex, and child age as well as child diagnosis were not associated with HRQOL. Conclusions: In this transdiagnostic sample of children, autism symptom severity and parenting stress were shared predictors of HRQOL. Interventions targeting child autistic symptoms and parents' levels of stress could result in improved HRQOL in neurodivergent populations.

Early childhood deprivation and the impact of negative life events on mental health in later life: a test of the stress sensitization hypothesis.

Early life exposure to adversity and stress has been shown to sensitize young people to later negative life events (LEs), leading to increased susceptibility to mental health problems. We explored this question by testing whether exposure to severe institutional deprivation moderated the effect of adolescent exposure to LE on early adult depression and anxiety. To test the specificity of these effects, we contrasted the effects on these outcomes with neuro-developmental problems (autism and disinhibited social engagement), known from previous studies to be associated with deprivation from early childhood. Participants were 170 adoptees from the English and Romanian Adoptees study. Of these, 124 (66 females) grew up as infants and small children in severely depriving Romanian orphanages before being adopted into UK families before the age of 43 months. The remainder were UK adoptees (16 females) with no history of deprivation who were placed before the age of 6 months. For this analysis, data on emotional problems, autism, and disinhibited social engagement were used at both age 15 years and in early adulthood (23-25 years) using standardized questionnaire and interview measures. Exposure to independent, dependent, and peer-related LE was measured at age 15 years. In all models, there were continuities in all outcomes between adolescence and adulthood (ps < .05). Dependent LE had a main effect on emotional symptoms, with higher exposure to dependent LE predicting an increase in emotional symptoms between age 15 and young adulthood. For independent and dependent LE, there were no interactions between deprivation and LE. For peer-related LE, the interaction was significant for emotional problems, but not deprivation-specific problems (i.e., autism/disinhibited social engagement)-the group of individuals exposed to early extreme deprivation and elevated peer-related LE had elevated emotional problems. There was no evidence that early severe institutional deprivation increased susceptibility to depression and anxiety following exposure to independent or dependent LE in general. However, it appeared to sensitize adolescents to the effects of peer-related LE specifically. We discuss possible mechanisms by which difficulties in peer relations might influence the emergence of depression and anxiety to already vulnerable individuals.

Endothelial Dysfunction in Acute Myocardial Infarction: A Complex Association With Sleep Health, Traditional Cardiovascular Risk Factors and Prognostic Markers.

Endothelial function (EndFx) is a core component of cardiovascular (CV) health and cardioprotection following acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). AMI patients experience endothelial dysfunction (EndDys), associated with traditional CV risk factors and sleep patterns. EndFx may also predict short and mid-term outcomes. EndFx was assessed in 63 patients (56.2 ± 7.6 years) using the Endothelium Quality Index (EQI). Sleep quality and quantity were evaluated using objective (actigraphy) and subjective (Pittsburgh Sleep Quality Index questionnaire) measures. Cardiorespiratory fitness was quantified through the 6-minwalking test. Cardiac function was assessed using the left ventricular ejection fraction. Following AMI, patients tended to experience EndDys (EQI = 1.4 ± 0.7). A severe EndDys was observed in 23.8% of patients (n = 15), while a mild EndDys was present in 63.49% (n = 40). Furthermore, EndDys was significantly associated with traditional CV risk factors (i.e., low physical activity level [12.8%], age [-4.2%], and smoking [-0.7%]) (R2 adjusted = 0.50, p < 0.001). Patients with EndDys had poor sleep quality (p = 0.001) and sleep efficiency (p = 0.016) compared to healthy persons. Patients with severe EndDys exhibited lower cardiorespiratory fitness compared to those with healthy EndFx (p = 0.017). Furthermore, during a follow-up period (nearly 4 months) following PCI, major adverse cardiac events were observed in four patients with severe EndDys. Our results emphasize the importance of adequate sleep and an active lifestyle, notably physical activity practice, as modifiable elements to enhance EndFx, which is regarded as a predictive tool following AMI. However, other factors remain to be elucidated as predictors of CV risk. The study protocol was registered in the Pan African Clinical Trial Registry under the trial ID: PACTR202208834230748.

Vegetarian and sustainable food consumption behavior: Exploring the relation to explicit and implicit attitudes toward vegetarian foods and dispositional mindfulness.

This study investigates the relation between explicit and implicit attitude measures toward vegetarian and meat-based foods and sustainable, specifically vegetarian food consumption behavior. Moreover, attitude preferences and differences between the nutrition groups of vegetarians/ vegans and omnivores were examined. In addition, the possible relationships between specific facets of dispositional mindfulness and explicit and implicit attitudes and nutrition behavior measures were explored. This is a cross-sectional online study. Two hundred sixty-one participants completed a dispositional mindfulness questionnaire, explicit and implicit nutrition attitude measurements, and nutrition behavior assessments. We found a strong correlation between explicit and implicit attitude measures. Both nutrition groups showed an implicit preference for vegetarian over meat-based foods. However, the group of vegetarians/ vegans explicitly preferred vegetarian foods and vegetarianism in almost all explicit attitude measures. In contrast, the findings in the group of omnivores were rather heterogeneous. Furthermore, the results showed that measures of explicit and implicit attitudes, together with two facets of dispositional mindfulness (Outer Awareness and Insight), predicted the vegetarian choice in the online supermarket scenario, indicating positive relationships, except for Insight. Our findings suggest a correspondence of explicit and implicit attitudes toward vegetarian foods and highlight their role in vegetarian nutrition behavior. In addition, we underscore the potential role of dispositional mindfulness and mindfulness interventions in promoting vegetarian consumption behavior. As there are attitude differences in the nutrition groups, the primary target group for mindfulness interventions should be individuals following an omnivorous diet.

FAKTOR PERSONAL UNTUK MENDUKUNG EFEKTIVITAS AUDIT INTERNAL

This research aims to determine and analyze the influence of internal auditors' personal factors: experience, education and independence on the effectiveness of internal audits in manufacturing companies. The research instrument uses a questionnaire and variable measurement with a 4 (four) point Likert Scale on 100 respondents as a sample with the characteristics of internal auditors in manufacturing companies. Experience, Education and Independence will be tested for their influence on Internal Audit Effectiveness. The research results state that experience, education and independence have a significant influence on the effectiveness of internal audit. The results of this research imply that companies have a responsibility to position the internal audit function to be organizationally independent so that it can carry out effective audit tasks. Companies are required to plan and develop internal auditor resources by providing work experience in fields other than audit, and encourage professionalism by providing continuous learning opportunities and certification for internal auditors.

Cross-Cultural Translation of the Adolescent Menstrual Bleeding Questionnaire (AMBQ).

Heavy menstrual bleeding (HMB) affects up to 37% of adolescents. Given the paucity of available tools to assess health-related quality of life (HRQoL) in adolescents with HMB, we developed the adolescent menstrual bleeding questionnaire (aMBQ), a valid and reliable measure of bleeding-related quality of life. The aim of this study was cross-cultural translation and adaptation of the English aMBQ into French to ensure accessibility for more Canadian adolescents who menstruate. A five-step process was followed: (1) forward translation from English to Canadian French; (2) backward translation from French to English; (3) review of source and translated aMBQ to create a reconciled version; (4) cognitive debriefing to ensure linguistic and clinical equivalence and (5) review of cognitive debriefings to produce the final version of the French aMBQ. Results of cognitive debriefings were reviewed after every three participants; items were revised if presented as an issue by ≥2 participants. These changes were implemented and tested in cognitive debriefings until saturation was reached. Linguistic changes were made to nine (33%) of the questions and one (3.7%) answer options. Major changes were made to four of the 27 questions (15%), and minor changes were made to five of the 27 questions (19%). Professional translators, clinical experts and patient input through cognitive debriefing are pivotal to successful cross-cultural translation. Results of cognitive debriefing interviews suggest the French aMBQ is easily understood and confirms its face validity.

The Fat Level in the Breast Milk and Its Association with Dietary Intake and Body Mass Index of Breastfeeding Mothers in Central Ethiopia, 2017

Human milk is not static; it is an invariant fluid that fluctuates in micro and macronutrient composition during feeding. The fat in human milk contributes above half the energy the infant demands. Moreover, fat is one of the most essential nutrients for brain tissue development during infancy. However, the effect of maternal nutritional status, including dietary intake, on human milk fat levels is not well investigated, particularly in developing nations. This study aimed to assess the level of human milk fat and its association with dietary consumption and BMI of the lactating mother in Burayyu Town, Oromia Region, Ethiopia. A community-based cross-sectional study was conducted among 206 lactating mothers with infants aged between 2-9 months in Burayu Town, Oromia Region, Ethiopia. Data collection was completed from April 1-April 28, 2017, using the multistage sampling technique. Data were collected using a structured questionnaire and standard measurement procedures, which included, among other things, nutritional status, BMI, and human milk, and repeated multiple pass 24-hour dietary recalls. The human milk sample was transported to the Holeta laboratory center by ice bag and stored at -20°C until Laboratory analysis. EPI data was applied for data entry, and 24-hour food recall was processed using Excel, Nutrition Survey, and IMAPP software. Then, it was exported to STATA version 14 for statistical analysis. A multivariable linear regression model was applied to determine the association between human milk fat level, dietary intake and BMI of lactating mothers by controlling other confounding factors. The mean (±SD) energy intake of lactating mothers was (1820.99 ± 399.98) Kcal, while the mean (±SD) of fat, protein, and carbohydrate intake of lactating mothers was found to be 43.49 ± 18.6 g/day, 89.95 ± 38 g/day and 275.58 ± 62.8 g/day respectively. The lactating mother's mean (±SD) human milk fat level was (3.03 ± 1.03) g/dl. This study did not find any significant association between human milk fat level with energy (β = 0.0002, 95% CI: -0.0004-0.0007), fat (β = -0.004, 95% CI: -0.018-0.009), protein (β = -0.0036, 95% CI: -0.011-0.0037), and carbohydrate intake (β = 0.003, 95% CI: -0.0003-0.006) respectively. Moreover, cesarean section delivery (β = -0.55825, 95% CI: -1.02954 - -0.08696) was inversely associated with human milk fat level. However, human milk fat level was positively associated with breastfeeding frequency (β = 0.074, 95% CI: 0.008-0.139), frequency of meat eating (β = 0.22123, 95% CI: 0.04681-0.39566), and early initiation of human milk (β = 0.19987, 95% CI: 0.03223-0.36751) respectively. Conclusion: Human milk fat content is pretty in the constant range (2-5 g/10 ml) and is not affected by maternal nutrition of energy intake, fat, carbohydrate, or BMI of the mother. It has a significantly positive association with the frequency of eating meat and feeding frequency. The mean human milk fat level is lower than that reported in other countries; however, it would fulfill most infant energy requirements.

Cognitive therapy for PTSD following multiple-trauma exposure in children and adolescents: a case series.

Cognitive therapy for PTSD (CT-PTSD) is an efficacious treatment for children and adolescents with post-traumatic stress disorder (PTSD) following single incident trauma, but there is a lack of evidence relating to this approach for youth with PTSD following exposure to multiple traumatic experiences. To assess the safety, acceptability and feasibility of CT-PTSD for youth following multiple trauma, and obtain a preliminary estimate of its pre-post effect size. Nine children and adolescents (aged 8-17 years) with multiple-trauma PTSD were recruited to a case series of CT-PTSD. Participants completed a structured interview and mental health questionnaires at baseline, post-treatment and 6-month follow-up, and measures of treatment credibility, therapeutic alliance, and mechanisms proposed to underpin treatment response. A developmentally adjusted algorithm for diagnosing PTSD was used. No safety concerns or adverse effects were recorded. Suicidal ideation reduced following treatment. No participants withdrew from treatment or from the study. CT-PTSD was rated as highly credible. Participants reported strong working alliances with their therapists. Data completion was good at post-treatment (n=8), but modest at 6-month follow-up (n=6). Only two participants met criteria for PTSD (developmentally adjusted algorithm) at post-treatment. A large within-subjects treatment effect was observed post-treatment and at follow up for PTSD severity (using self-report questionnaire measures; ds>1.65) and general functioning (CGAS; ds<1.23). Participants showed reduced anxiety and depression symptoms at post-treatment and follow-up (RCADS-C; ds>.57). These findings suggest that CT-PTSD is a safe, acceptable and feasible treatment for children with multiple-trauma PTSD, which warrants further evaluation.

Suitability of the DSM-5 social anxiety disorder severity scale for autistic adults.

Mental health measures used with autistic adults are often only evaluated for use with non-autistic adults, which may cause inaccurate measurement. This is important when measuring social anxiety disorder as some features overlap with social characteristics of autism. This study evaluated one self-report questionnaire measure of social anxiety disorder, the Severity Measure for Social Anxiety Disorder. The Severity Measure for Social Anxiety Disorder is based upon criteria for diagnosis of social anxiety disorder, and we aimed to understand its suitability for autistic adults. The Severity Measure for Social Anxiety Disorder was completed by 284 autistic adults and 80 non-autistic adults who were then asked five follow-up questions about ambiguous questions on the Severity Measure for Social Anxiety Disorder. We found that over half our sample of autistic adults, on at least one question, attributed their answer to something other than anxiety. Furthermore, in autistic adults, one underlying construct of social anxiety did not link their answers on the Severity Measure for Social Anxiety Disorder together, suggesting the Severity Measure for Social Anxiety Disorder might not be suited to capturing social anxiety disorder in autistic adults. To improve measurement, we rescored answers where participants said their response was due to something other than social anxiety, however, the rescored Severity Measure for Social Anxiety Disorder did not only capture social anxiety in autistic adults either. Finally, we analysed the reasons other than social anxiety autistic adults said influenced their answers. We grouped their responses into 10 categories, for example, 'fatigue', 'sensory overwhelm', and 'masking'. Overall, our findings suggest caution when using the Severity Measure for Social Anxiety Disorder with autistic adults, and the categories identified may suggest how to measure social anxiety more accurately in autistic adults.

Cost-effectiveness of prevention program for type 2 diabetes mellitus in high risk patients in the Republic of Srpska, Bosnia and Herzegovina.

The Republic of Srpska (RS), as a part of the Western Balkans (WB) region, has a higher diabetes prevalence than the EU. This study aims to assess the cost-effectiveness of early treatment of high-risk patients with pre-diabetes and undiagnosed diabetes in our setting. We designed a Markov chain Monte Carlo (MCMC) model which reflects the current International Diabetes Federation (IDF) three-step plan for the prevention of T2DM in those at increased risk. The model captures the evolution of the disease in FINDRISC high-risk patients from normal glucose tolerance (NGT) to impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) and then to T2DM and its complications. We developed two MCMC models, in order to follow the progression of the disease in high-risk cases, ie, when early treatment is undertaken or when it is not undertaken. The health costs and quality adjusted life years (QALY) were discounted at an annual rate of 3%. The key model parameters were varied in one-way and probabilistic sensitivity analysis. Early treatment resulted in increased life expectancy, postponement of the onset of diabetes and increased QALY for all patients. The discounted incremental cost-effectiveness-ratios (ICER) in NGT, IFG, IGT, and T2DM patients were -289.9, 9724.03, -1478.59 and 4084.67 €. In high-risk IGT patients, ICER was the most favorable, being both a cost saving and QALY gaining, with the consistent results confirmed by the sensitivity analysis. The results recommend the acceptance of a new health policy of identifying IGT patients with the use of FINDRISC questionnaire and plasma glucose measurements; providing them with a lifestyle change program; and implementing intensive diabetes treatment, as their disease progresses. Our results are especially significant for the Western Balkan countries, since this was the first cost-effectiveness study of T2DM prevention in this region.

Nutrition, Chewing Ability and Quality of Life in Older Adults With Implant Overdentures: A Prospective Clinical Study.

To evaluate the changes in nutritional status, chewing ability and oral health-related quality of life in edentulous individuals who have initially been rehabilitated with immediate complete dentures (CD) which are then transformed to implant-supported overdentures (IOD) after a period of osseointegration. Compared to those with conventional dentures, individuals with IODs exhibit improved patient-reported outcomes, chewing capacity and biting force. While prior research highlights differences in nutritional markers between these groups, there is limited investigation into intra-individual changes in nutritional status, chewing ability and oral health-related quality of life during the transition from CDs to IODs. Edentulous individuals aged 50 years or older and needing oral rehabilitation with IODs were eligible for this prospective study. The primary outcome measure was the nutritional status as measured by the Mini Nutritional Assessment (MNA). The Oral Health Impact Profile (OHIP-14) questionnaire and chewing ability questionnaire represented secondary outcome measures. These measures were assessed at baseline (T0), 3-month follow-up after application of the CD (T1), and 3- and 6-month follow-up after the CD had been transformed to IOD (T2 and T3). Statistical analyses used repeated measures ANOVA or the Friedman test for OHIP-14 and MNA scores, with logistic regression used for malnutrition risk. Thirty-five participants were included in the final analysis. MNA scores significantly worsened from the baseline to the 3-month follow-up after the application of the CD. There was no significant change in nutritional status between baseline and the IOD 3- and 6-month follow-up appointment. IODs led to significant improvements in the OHIP total score at both the 3- and 6-month follow-ups (p < 0.001, W = 0.60) with a strong effect size. Difficulty in chewing decreased significantly, affecting 91.4% of participants at baseline, which reduced to 51.4% (18/35) by the 6th month. Implant-supported overdentures do not influence nutritional status, but they improve chewing ability and oral-health related quality of life in older adults.