Representative Sample Research Articles

Prevalence and Correlates of Dry Eye in a German Population Sample.

In this cross-sectional survey, we assessed the prevalence of dry eye disease (DED) in a representative German population sample. In addition, we examined the associations between DED, health-related quality of life (HRQoL), and level of fatigue. Finally, we further validated the German version of the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and present norm data of the German population. A random sample of German residents aged 16 years and older was recruited between October and December 2021. All participants completed the SPEED, Short Form 36, and Multidimensional Fatigue Inventory 20 questionnaires. Of the 2495 participants who completed the survey, 450 (21.6%; 95% confidence intervals 20.0-23.1) reported a SPEED total score of ≥4, indicating a positive screening for DED. DED was significantly more common in women and older age. Participants who screened positive for DED reported significantly higher levels of fatigue and lower values in all domains of HRQoL. A receiver operating characteristic curve of the SPEED was generated using an ophthalmologist's diagnosis. The area under the curve was estimated to be 0.886 (95% confidence intervals 0.858-0.913). A cutoff score ≥4 seemed to be appropriate as an indicator of DED. Cronbach's α was excellent (0.95). DED is common in the German population. We confirmed associations with sex, age, HRQoL, and fatigue level, indicating a high burden of DED. The German version of the SPEED is a valid instrument for the assessment of DED symptoms.

Public Attitudes, Inequities, and Polarization in the Launch of the 988 Lifeline.

To address the considerable burden of mental health need in the United States, Congress passed the National Suicide Hotline Designation Act in 2020. The Act rebranded the national suicide prevention lifeline as 988 - a 3-digit number akin to 911 for individuals to call in the case of a mental health emergency. Surprisingly little is known about American attitudes towards this new lifeline. We rely on a demographically representative sample of 5,482 US adults conducted from June 24-28, 2022. We examine the influence of mental health status, partisan identification, and demographic characteristics on public awareness, public support, and intended use of the new 988 lifeline. We find that while only a quarter of Americans are aware of the lifeline, support for the 988 lifeline is widespread, with over 75% of Americans indicating they would be likely to use the new number if needed. We identify key disparities in awareness, support, and intended use, with Republicans, individuals with low socio-economic status, and Blacks less supportive and in some cases less likely to use the 988 lifeline. Our results point to the need for additional interventions that increase public awareness of 988 and reduce disparities in program knowledge, support, and intended use.

Novel polymorphisms in the octopamine receptor gene of amitraz resistant population of Rhipicephalus sanguineus sensu lato, in south India

The brown dog tick or Rhipicephalus sanguineus sensu lato is an ixodid tick, responsible for the dissemination of pathogens that cause canine infectious diseases besides inflicting the direct effects of tick bite. The hot humid climate of Kerala, a south Indian state, is favorable for propagation of tick vectors and acaricides are the main stay of tick control. Though the resistance against synthetic pyrethroids is reported among these species, the status of amitraz resistance in R. sanguineus s. l. in the country is uncertain due to the lack of molecular characterization data and scarce literature reports. Hence the present study was focused on the phenotypic detection and preliminary genotypic characterisation of amitraz resistance in the R. sanguineus s. l. A modified larval packet test (LPT) on a susceptible isolate was performed to determine the discriminating dose (DD). Further LPT-DD on 35 tick isolates was carried out to detect amitraz resistance robustly, along with that full dose response bioassays on the resistant isolates were performed. The results indicated that amitraz resistance is prevalent with 49 per cent of the samples being resistant. Amplification of exon 3 of octopamine receptor gene from both the susceptible and resistant larval isolates was carried out. Amplicons of ten pooled amitraz susceptible and ten pooled amitraz resistant representative samples were sequenced and analysed, unveiling a total of three novel non-synonymous mutations in the partial coding region at positions V32A, N41D and V58I in phenotypically resistant larval DNA samples. In silico analysis by homology modelling and molecular docking of the mutated and unmutated receptors showed that these mutations had reduced the binding affinity to amitraz. However, lack of mutations in the octopamine receptor gene in three of the pooled low order resistant R. sanguineus s. l. larval samples could be suggestive of other mechanisms associated with amitraz resistance in the region. Hence, further association studies should be carried out to confirm the association of these mutations with target insensitivity in R. sanguineus s. l. ticks, along with exploring the status of metabolic resistance and other mechanisms of resistance.

STATISTICAL STUDY OF SOME INDICATORS IN THE LIVESTOCK SECTOR

In this paper, some indicators covering milk production, weight gain and feeding efficiency are studied, such as the duration of lactation, total amount of milk, daily amount of milk, percentage of fat, protein, lactose in milk, for a representative sample taken from S.C.D.A Simnic. In the first part, a descriptive statistical analysis is made of the indicators in the zootechnical field presented, followed by econometric methods regarding confidence intervals for the average of the entire population, at a threshold of 5%. Also, the correlation matrix between the indicators is analyzed and three validated linear regression models are presented with the interpretation of the results. These results help to optimize management in the zootechnical field by making decisions based on quantitative analyses.

Requirements of the experiment

The purpose of the experiment is to derive inferences about the causal effects of a subset of the characteristics of the units of a target population (explanatory characteristics - treatment factors) on characteristics that express the performance of these units (response characteristics). To achieve this objective, the effects of the treatment factors in the sample must manifest themselves as in the target population. This attempt requires the construction of a valid and representative sample of the target population. It is achieved if the experiment plan and its execution satisfy the experiment requirements. These requirements are considered in this article.

The influence of bullying victimization on acculturation and life satisfaction among children from multicultural families in South Korea

ABSTRACT This study investigates the relationship between bullying victimization and both acculturation and life satisfaction among children from multicultural families, while differentiating between the effects of transitions into and out of bullying victimization. This study used data from the Multicultural Adolescent Panel Survey, a nationally representative sample of children from multicultural families in South Korea. A novel asymmetric fixed effects model was employed to estimate the effects of transitions into and out of bullying victimization. Conventional symmetric fixed effects models found no significant association between bullying victimization and acculturation. However, asymmetric fixed effects models revealed that transitions into bullying victimization was linked to a decrease in affective acculturation (b = −0.118, p < 0.001), while transitions out of bullying victimization had no significant association with acculturation. On the other hand, both transitions into and out of bullying victimization were associated with life satisfaction (b = −0.223 and b = 0.179, p < 0.001, respectively), with no significant difference in the magnitude of the coefficients. Our findings regarding the asymmetric effects of bullying victimization offer valuable insights for policymakers seeking to effectively promote the acculturative well-being of children from multicultural families.

Bioarchaeology aids the cultural understanding of six characters in search of their agency (Tarquinia, ninth–seventh century BC, central Italy)

Etruria contained one of the great early urban civilisations in the Italian peninsula during the first millennium BC, much studied from a cultural, humanities-based, perspective, but relatively little with scientific data, and rarely in combination. We have addressed the unusual location of twenty inhumations found in the sacred heart of the Etruscan city of Tarquinia, focusing on six of these as illustrative, contrasting with the typical contemporary cremations found in cemeteries on the edge of the city. The cultural evidence suggests that the six skeletons were also distinctive in their ritualization and memorialisation. Focusing on the six, as a representative sample, the scientific evidence of osteoarchaeology, isotopic compositions, and ancient DNA has established that these appear to show mobility, diversity and violence through an integrated bioarchaeological approach. The combination of multiple lines of evidence makes major strides towards a deeper understanding of the role of these extraordinary individuals in the life of the early city of Etruria.

Black Americans' Diminished Health Returns of Professional Occupations: A Thirty-Year Follow-Up Study of Middle-Aged and Older Adults.

Occupational classes exert substantial effects on both subjective and objective health outcomes. However, it remains unclear whether the health impact of similar occupational classes varies across racial groups among middle-aged and older adults in the United States. Grounded in the theory of Minorities' Diminished Returns (MDRs), which posits that health benefits from resources such as employment are systematically weaker for racial minority populations, particularly Non-Latino Black individuals, this study tested Black-White disparities in the effects of similar occupational classes on health outcomes in middle-aged and older adults. Utilizing data from the Health and Retirement Study (HRS), we employed a 30-year longitudinal design with a nationally representative sample of middle-aged and older adults in the United States. Six occupational classes-operator, managerial, professional specialty, sales, clerical/admin, and service-served as the key predictor variables (independent variables), with race as the moderator. Various health outcomes, including self-rated health, chronic disease, body mass index (BMI), activities of daily living (ADL), and cognitive function, were measured longitudinally from wave 1 to wave 15 (from baseline to 30 years later). Statistical analyses, incorporating logistic regression models, were conducted to assess associations between occupational class and health outcomes overall and based on race. Our analysis included 7538 Non-Latino White or Non-Latino Black participants followed for up to 30 years. Initial findings revealed positive health effects of professional occupations on cognitive function and self-rated health over 30 years of follow-uWe also identified significant interactions between race and professional occupational class on all health outcomes, indicating notable racial differences in the effects of professional occupations on health outcomes across domains. The effects of professional occupational class were weaker for Non-Latino Black individuals than for Non-Latino White individuals. Consistent with the Minorities' Diminished Returns theory, our findings indicated less pronounced positive effects of professional occupations on a wide range of health outcomes for Non-Latino Black individuals compared to Non-Latino Whites. These disparities emphasize the critical need to address structural factors that contribute to the diminished returns of prestigious occupations for Non-Latino Black populations.

Global Overview of the Application of the Braun-Blanquet Approach in Research

Environmental classifications are of paramount importance for assessing the impacts of land-use changes, for prioritizing conservation efforts, and for developing effective management strategies to mitigate the negative impacts of human activities. The aim of our research was to provide as complete an analysis as possible of the studies that have been carried out using the Braun-Blanquet approach. The global review of studies based on the Braun-Blanquet approach includes 1168 papers and was conducted using the PRISMA 2009 methodological recommendations, strict criteria for the selection/quality of papers, and modern methods of data analysis and visualization using VOSviewer software developed by Nees Jan van Eck and Ludo Waltman (Centre for Science and Technology Studies (CWTS) of Leiden University in the Netherlands) (version 1.6.18), which ensures a representative sample, minimization of subjective judgements, and reliability of conclusions. It was noted that the number of publications on Braun-Blanquet is growing exponentially. This is an indication of the scientific interest in this methodology and its continuous further development. Based on a detailed analysis of the keywords, the main research directions and challenges are identified. These include improving the conceptual and methodological foundations of the Braun-Blanquet approach; improvement in regional vegetation classifications, synthesizing them and producing a comprehensive classification for large areas as a basis for biodiversity conservation and sustainable land use; expansion of the geography; compilation and updating of databases of phytosociological data; management of dynamics and vegetation; discussion of the important problem of continuity and discreteness of vegetation in the context of ecological classifications; and vegetation mapping. The top 20 journals publishing the most cited articles were identified, as well as the top 20 most cited journals whose high citation rate is due to the large number of high-quality articles. The analysis of the bibliographic network of papers in dynamics has shown that the structure of relationships is not constant and has changed significantly. The analysis of the authors’ publication activity showed that the vast majority of researchers have a low publication activity and have published only one to three papers. A peculiarity also emerges: if all the most cited authors are concentrated in Eurasia, then most of the most actively published authors are outside Eurasia. The importance of the Braun-Blanquet approach for the study and classification of forest vegetation should be emphasized. In this case, the Braun-Blanquet approach is integrated into forest typologies, increasing their ecological validity and environmental relevance.

Knowledge, attitude and practices of energy utilisation behaviours: a study of residential building occupants

PurposeThis study aims to assess residential energy consumption knowledge, attitudes, and practices in Abuja Municipality, providing insights for effective conservation strategies, reducing costs and mitigating environmental impact.Design/methodology/approachData for this study was collected through a cross-sectional survey conducted among a representative sample of the Nigerian population between February and April 2021. A total of 462 questionnaire responses were collected and subsequently analysed using SPSS. Descriptive statistics, including frequency count, percentages, mean, and standard deviation, were calculated. Additionally, inferential statistics were performed using Chi-Square analysis, with significant level set at p = 0.05 to draw meaningful conclusions from the data.FindingsThe study results indicate that out of the total respondents, 244 individuals (67.4%) demonstrated a profound knowledge of and good practice in energy utilisation. In comparison, 118 individuals (32.6%) exhibited poor knowledge and practice in energy saving. Moreover, the findings reveal a significant association between the sociodemographic factors of the respondents, building type, and their overall practice in energy utilisation. Statistical analysis shows significant? 2 values for each case: 8.563 (p = 0.003), 66.736 (p = 0.000), 60.866 (p = 0.000), 23.487 (p = 0.000), 37.877 (p = 0.000), and 92.334 (p = 0.000), respectively, where p &lt; 0.05. These results highlight the importance of considering sociodemographic profiles and building characteristics when assessing general energy utilisation practices.Originality/valueThe research offers valuable insights into Nigerian energy usage behaviours and attitudes towards energy saving in residential buildings, contributing significantly to the knowledge base.

The role of trust and distrust in technology usage: An in-depth investigation of traffic information apps usage for mandatory and non-mandatory trips

Following the rapid pace of technological advancement and the continuous introduction of new technologies, the study of user acceptance has gained considerable attention. While previous studies have highlighted the role of trust in technology acceptance and adoption, the significance of distrust has received little attention and is often treated as the other end of the trust scale. This study aims to examine the separate roles of both trust and distrust in technology adoption by investigating the relationship between the usage of traffic information apps (TIAs) and the trust and distrust associated with them. To achieve this, a revealed preference questionnaire is designed, and data from a representative sample of 1028 Sydney residents is collected. The validity of treating trust and distrust as two separate constructs is empirically examined by contrasting a single-construct model versus a double-construct model. Both models are integrated choice and latent variable models with structural and choice components. The findings demonstrate that the model with trust and distrust as two distinct latent constructs outperforms the model with one latent construct. The results of the double latent construct model indicate that trust has a significant positive effect on using TIAs for both work and leisure trips, while distrust has a significant negative effect only for work trips. These findings underscore the importance of effectively managing distrust in technology, particularly in situations related to health and safety where individuals’ usage of the technology in these circumstances can save lives.

Colliding harms of gambling and gaming: A four-wave longitudinal population study of at-risk gambling and gaming in Finland

Aims: Both gambling and digital gaming are growing in popularity and there is ongoing discussion about their convergence. This population-based longitudinal survey study investigated how gambling and digital gaming types contribute to at-risk gambling and gaming. Methods: The study was based on a representative sample of 18–75-year-olds from mainland Finland. Survey data were collected at 6 -month intervals in 2021–2022, starting in April 2021. Of original T1 respondents, 58.95% took part in all four time points. In total, 3,608 observations from 902 individuals were analysed. Outcome measures were at-risk gambling and gaming based on the Problem Gambling Severity Index and the Internet Gaming Disorder Test. Various types of gambling and gaming were investigated. Results: Population-averaged models showed that different forms of gambling were associated with a higher risk of at-risk gaming. Online casino games were associated with the highest likelihood of at-risk gambling and gaming. Prevalence of digital gaming problems was low. Hybrid models were used to investigate the longitudinal within-person and between-person effects of gambling and gaming activities. Online casino games and offline slot machines increased at-risk gambling. Microtransactions within digital games increased at-risk gambling and gaming over time, but the amount of money spent on digital gaming was small compared to gambling. Conclusions: Our results underline the risks of EGMs and online gambling for the participants. Although gambling and gaming are converging, harm is mostly based on gambling.

Adherence to the Mediterranean Diet and its association with sustainable dietary behaviors, sociodemographic factors, and lifestyle: a cross-sectional study in US University students

BackgroundPromoting healthy and sustainable diets is increasingly important and the Mediterranean Diet (MD) has been recognized as an appropriate example that can be adapted to different countries. Considering that the college years are the time when US young adults are most likely to adopt unhealthy eating habits, the present study assessed adherence to the MD and the sustainability of dietary behaviors in a nationally representative sample of US university students, aiming to identify crucial levers for improving their eating behaviors.MethodsMD adherence and the adoption of healthy and sustainable dietary patterns were assessed through the KIDMED and the Sustainable-HEalthy-Diet (SHED Index questionnaires, respectively, administered through an online survey that also included sociodemographic and behavioral questions. Non-parametric and logistic regression analyses were performed.ResultsA sample of 1485 participants (median (IQR) age 21.0 (19.0–22.0); 59% women) correctly completed the survey. A medium adherence to the MD was the most prevalent (47%). According to multivariate logistic regression analysis, the likelihood of being more compliant with the MD increased when meeting physical activity recommendations, having a high SHED Index score, having the willingness to purchase and eat healthy and sustainable dishes, eating ultra-processed plant-based meat alternatives foods daily, and regularly attending the university canteen.ConclusionsEncouraging dietary patterns rich in plant-based foods and with a moderate intake of animal products is crucial to increasing the adoption of healthy and sustainable diets, and university dining services represent a suitable setting to build a supportive environment that educates students on human and planetary health.

Body mass index and astigmatism: A nationwide study.

Existing research on the relationship between body mass index (BMI) and astigmatism yields inconsistent results. This study analyses this association in a nationally representative sample of adolescents. This retrospective, cross-sectional study included Israeli adolescents who underwent medical assessments before mandatory military service between 2011 and 2022. BMI was categorised based on the US age- and sex-matched percentiles. Astigmatism was categorised by magnitude [low-moderate: 0.75 to <3.00 diopters (D), high: ≥3.00 D], and axis orientation [with-the-rule (WTR), against-the-rule (ATR), or oblique (OBL)]. Sex-stratified regression models adjusted for sociodemographic variables were used. Of 935 989 adolescents evaluated, 887 325 were included [511 465 (57.6%) males, mean age 17.2 years]. Astigmatism was diagnosed in 123 675 (13.9%) adolescents, of whom 117 081 (13.2%) had low-moderate and 6594 (0.7%) had high astigmatism. WTR astigmatism was the most prevalent (8.2%), followed by ATR (4.1%) and OBL (1.6%) types. Compared with low-normal BMI (5th to 50th percentile), the adjusted ORs for total astigmatism increased with increasing BMI, peaking at 1.65 (1.57-1.74) in males and 1.74 (1.64-1.86) in females with severe obesity. ORs were accentuated for high astigmatism, reaching 3.51 (3.01-4.09) in males, and 3.45 (2.83-4.22) in females with severe obesity. WTR astigmatism demonstrated the strongest association with BMI, with ORs reaching 2.26 (2.13-2.40) in males and 2.04 (1.90-2.20) in females with severe obesity. The results persisted in a series of subgroup analyses. Obesity is associated with higher odds of astigmatism in adolescence. Further investigation into the role of weight management in astigmatism development is warranted.

Experiences of birthing people during the COVID-19 pandemic: Analysis of comments from the 2020 Wisconsin Pregnancy Risk Assessment Monitoring System (PRAMS).

The COVID-19 pandemic has taken a significant toll on the US population, with birthing people having special clinical needs. The Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based surveillance system for monitoring birthing people's experiences. Comment data from the PRAMS survey can provide further insight into birthing people's experiences. This study aims to use PRAMS data to describe pandemic-related experiences in a representative sample of birthing people in Wisconsin to help inform future emergency preparedness planning. This study analyzed 2020 Wisconsin PRAMS data for births in March or later. Content analysis of pandemic-related comment data was conducted, and quantitative data on demographic characteristics and pandemic-related experiences were examined. Findings from 1406 respondents indicated that many birthing people were affected by the pandemic, including changes in healthcare visits and employment. One hundred respondents commented on pandemic-related experiences; four interrelated themes emerged from content analysis: changed nature and quality of healthcare, limited social support, increased anxiety, stress, or fear, and employment or financial burden. Most comments discussed negative impacts; some expressed positive aspects. Findings suggest opportunities for improving support for birthing people during public health emergencies, for example, through developing healthcare policies and public health guidelines that prioritize the protective mechanisms of social support for birthing people, identifying additional and immediately accessible policy protections to support birthing and postpartum people (e.g., insurance and paid leave) during public health emergencies, and implementing additional screening and support to help address increased mental health needs during public health emergencies.

Urban Tourism Appeal: The Effectiveness of Communication Channels and Multimedia Formats in Creating Tourists’ Expectations

Tourists’ expectations related to urban tourist destinations, which often derive from wider concept of destinations’ images, encompass a wide range of needs, desires and anticipations that tourists develop prior to visiting a particular destination. They are formed under the influence of different factors, one of which is traditional and digital communication channels. The objective of this research is to determine whether different communication channels and multimedia formats, used by tourists in the pre-travelling phase, could shape their expectations related to tangible and intangible characteristics of urban tourist destinations. The data gathering was conducted by applying Computer-Aided Web Interviewing (CAWI) on a representative sample of 312 adult citizens residing in Belgrade, the capital of the Republic of Serbia. The findings indicate that both traditional and digital communication channels, alongside personal recommendations used prior to the trip, significantly contribute to shaping respondents’ expectations concerning tangible characteristics of urban tourist destinations. Digital communication channels and personal recommendations appeared to be more important in shaping expectations related to the intangible characteristics of urban tourist destinations. Also, different formats of online media content exhibited positive associations with expectations concerning the tangible and intangible characteristics of urban tourist destinations. The obtained results provide recommendations for tourist organizations and local government entities, valuable for developing effective communication strategies for targeting potential tourists.

How well do participants in clinical trials represent the U.S. population with chronic neck or back pain?

Randomized clinical trials (RCTs) are the gold standard for assessing treatment effectiveness; however, they have been criticized for generalizability issues such as how well trial participants represent those who receive the treatments in clinical practice. We assessed the representativeness of participants from eight RCTs for chronic spine pain in the U.S., which were used for an individual participant data meta-analysis on the cost-effectiveness of spinal manipulation for spine pain. In these clinical trials, spinal manipulation was performed by chiropractors. We conducted a retrospective secondary analysis of RCT data to compare trial participants' socio-demographic characteristics, clinical features, and health outcomes to a representative sample of (a) U.S. adults with chronic spine pain and (b) U.S. adults with chronic spine pain receiving chiropractic care, using secondary data from the National Health Interview Survey (NHIS) and Medical Expenditure Panel Survey (MEPS). We assessed differences between trial and U.S. spine populations using independent t-tests for means and z-tests for proportions, accounting for the complex multi-stage survey design of the NHIS and MEPS. We found the clinical trials had an under-representation of individuals from health disparity populations with lower percentages of racial and ethnic minority groups (Black/African American 7% lower, Hispanic 8% lower), less educated (No high school degree 19% lower, high school degree 11% lower), and unemployed adults (25% lower) with worse health outcomes (physical health scores 2.5 lower and mental health scores 5.3 lower using the SF-12/36) relative to the U.S. population with spine pain. While the odds of chiropractic use in the U.S. are lower for individuals from health disparity populations, the trials also under-represented these populations relative to U.S. adults with chronic spine pain who visit a chiropractor. Health disparity populations are not well represented in spine pain clinical trials. Embracing key community-based approaches, which have shown promise for increasing participation of underserved communities, is needed.

Patient behavioural strategies to improve access to primary care appointments

ABSTRACT We conducted a field experiment to measure whether patients’ use of different phrases can improve access to primary care appointments and whether patient gender, race, and ethnicity moderate these effects. Simulated patients were randomly assigned to three scripts in seeking an appointment: (1) a control script, (2) an additional prompt to seek an alternate provider, and (3) an additional prompt complimenting the practice for its reputation. Simulated patients were randomly assigned to primary care physicians drawn from a nationally representative sample (N = 1,328). Our results show that the reputation script was not associated with any aggregate differences in access outcomes while the alternate provider script was associated with a 20-percentage point increase [95% CI: 0.11, 0.28; p < 0.01] in appointment offers from alternate providers. However, Black patients realized no access benefits and faced longer wait times. Hispanic patients experienced higher levels of access to alternate providers, but at a cost of lower levels of access with their requested physicians. White patients were the only group to experience more access to alternate providers without facing longer wait times or substitution away from their requested physicians. These equity-decreasing results highlight limitations in individualized efforts of minoritized patients to effectively advocate for improved access.

Examining the Effect of Depicting a Patient Affected by a Negative Reimbursement Decision in Healthcare on Public Disagreement with the Decision.

The availability of increasingly advanced and expensive new health technologies puts considerable pressure on publicly financed healthcare systems. Decisions to not-or no longer-reimburse a health technology from public funding may become inevitable. Nonetheless, policymakers are often pressured to amend or revoke negative reimbursement decisions due to the public disagreement that typically follows such decisions. Public disagreement may be reinforced by the publication of pictures of individual patients in the media. Our aim was to assess the effect of depicting a patient affected by a negative reimbursement decision on public disagreement with the decision. We conducted a discrete choice experiment in a representative sample of the public (n = 1008) in the Netherlands and assessed the likelihood of respondents' disagreement with policymakers' decision to not reimburse a new pharmaceutical for one of two patient groups. We presented a picture of one of the patients affected by the decision for one patient group and "no picture available" for the other group. The groups were described on the basis of patients' age, health-related quality of life (HRQOL) and life expectancy (LE) before treatment, and HRQOL and LE gains from treatment. We applied random-intercept logit regression models to analyze the data. Our results indicate that respondents were more likely to disagree with the negative reimbursement decision when a picture of an affected patient was presented. Consistent with findings from other empirical studies, respondents were also more likely to disagree with the decision when patients were relatively young, had high levels of HRQOL and LE before treatment, and large LE gains from treatment. This study provides evidence for the effect of depicting individual, affected patients on public disagreement with negative reimbursement decisions in healthcare. Policymakers would do well to be aware of this effect so that they can anticipate it and implement policies to mitigate associated risks.

The sense of coherence scale: psychometric properties in a representative sample of the Czech adult population

BackgroundSense of coherence (SOC) is a personal resource that reflects the extent to which one perceives the world as comprehensible, manageable, and meaningful. Decades of empirical research consistently show that SOC is an important protective resource for health and well-being. Despite the extensive use of the 13-item measure of SOC, there remains uncertainty regarding its factorial structure. Additionally, a valid and reliable Czech version of the scale is lacking. Therefore, the present study aims to examine the psychometric properties of the SOC-13 scale in a representative sample of Czech adults.MethodsAn online survey was completed by 498 Czech adults (18–86 years old) between November 2021 and December 2021. We used confirmatory factor analysis to examine the factorial structure of the scale. Further, we examined the variations in SOC based on age and gender, and we tested the criterion validity of the scale using the short form of the Mental Health Continuum (MHC) scale and the Generalized Anxiety Disorder (GAD) scale as mental health outcomes.ResultsSOC-13 showed an acceptable one- and three-factor fit only with specified residual covariance between items 2 and 3. We tested alternative short versions by systematically removing poorly performing items. The fit significantly improved for all shorter versions with SOC-9 having the best psychometric properties with a clear one-factorialstructure. We found that SOC increases with age and males score higher than females. SOC showed a moderately strong positive correlation with MHC, and a moderately strong negative correlation with GAD. These findings were similar for all tested versions supporting the criterion validity of the SOC scale.ConclusionOur findings suggest that shortened versions of the SOC-13 scale have better psychometric properties than the original 13-item version in the Czech adult population. Particularly, SOC-9 emerges as a viable alternative, showing comparable reliability and validity as the 13-item version and a clear one-factorial structure in our sample.