Screening Items Research Articles

Utility of pre-injury risk factors and the concussion clinical profiles screening (CP screen) tool for identifying concussion profiles in adolescents

This study determined the combined utility of pre-injury risk factors and Concussion Clinical Profile Screen (CP Screen) items to identify clinician-adjudicated concussion profiles in adolescents. This was a retrospective study of 236 adolescents aged 12–18 who presented to a concussion specialty clinic between 2019 and 2020 within 30 days of injury. Participants completed the CP Screen at their initial evaluation, and clinicians provided blindly adjudicated clinical profiles for each participant. Stepwise logistic regressions and receiver operating characteristic (ROC) curves were conducted. Participants (n = 236; 60.2% male) had a mean age of 14.79 ± 1.62 years, and most injuries were sport-related (n = 185, 78.4%). Combined pre-injury risk factor and CP Screen item predictors of anxiety/mood (AUC = 0.903) demonstrated outstanding utility; vestibular (AUC = 0.802) demonstrated excellent utility; and ocular (AUC = 0.766), PTM (AUC = 0.729), and cognitive (AUC = 0.723) demonstrated acceptable utility. Select pre-injury risk factors and CP Screen items provided acceptable to outstanding predictive utility for all clinical profiles in adolescents following concussion, highlighting their clinical utility for identifying concussion clinical profiles and subsequent targeted interventions. However, certain pre-injury risk factors and CP Screen items represented multiple profiles, highlighting the potential overlap and the need for clinicians to consider a multidomain evaluation to inform the best treatment approach.

Real-time CNN-based object detection of prohibited items for X-ray security screening

Real-time CNN-based object detection of prohibited items for X-ray security screening

Attitudes, experiences, and implications of asking about suicide during the perinatal period: A qualitative study with maternity healthcare practitioners.

Suicide is a leading cause of maternal death. Maternity healthcare practitioners (HCPs) are uniquely positioned to identify perinatal mental health (PMH) problems and/or suicidality. Research exploring HCPs attitudes towards suicide-related screening items and their experiences of asking about perinatal suicidality is limited. (i) to explore HCPs attitudes towards 16 suicide-related screening items; and (ii) to explore HCPs broader views, experiences and implications of discussing suicide with perinatal women in maternity care settings. Fifteen semi-structured interviews were conducted with maternity HCPs. The sample included midwives, health visitors, general practitioners, and specialist PMH practitioners working in the United Kingdom (UK). Inductive thematic analysis was used to explore the data and identify themes. Most HCPs felt uncomfortable with, disliked, or found half of the suicide-related items unhelpful. Reasons included use of ambiguous or emotive terms. HCPs preferred not to use the word 'suicide' with pregnant or postnatal women. In the thematic analysis, four themes were identified: (i) Approaches for discussing and identifying PMH problems and suicidality; (ii) Competing demands and continuity of carer; (iii) PMH and suicidality training and support; and (iv) Availability of PMH services and referral pathways. These factors affected HCPs capacity, willingness, and confidence to ask women suicide-related questions. HCPs need targeted PMH and suicidality training and support in maternity care contexts to enable them to feel more equipped, comfortable, and available to have conversations with women about PMH and suicide. Timely detection and intervention may help to improve care for women experiencing perinatal suicidality.

Development and validation of the BRief Eating Disorder Screener (BREDS) for US veterans in healthcare and community settings.

Development and validation of the BRief Eating Disorder Screener (BREDS) for US veterans in healthcare and community settings.

Testing items to screen for religious or spiritual distress in adult outpatient cancer care.

The experience of cancer diagnosis and treatment is associated with significant stress. While religion and spirituality (R/S) can provide crucial support, many patients also experience R/S distress. Screening for distress has gained recognition, with tools evolving to address spiritual needs; however, existing screening measures have limitations. This study aims to validate screening items for R/S distress among cancer patients undergoing treatment, using a standardized chaplain assessment as a reference standard. The study involved adult cancer patients undergoing outpatient treatment at Rush Cancer Center. Procedures included researcher-administered screening questions and the ONC-5 spiritual assessment interview with a board-certified chaplain. Data included demographics, illness variables, and R/S measures. Eight single-item and two multi-item screening measures were evaluated against the ONC-5. Analysis entailed descriptive statistics and sensitivity/specificity determination. Study participants (N = 71) were predominantly female (53.5%) with common cancers (breast, colon/rectum, and lung). R/S distress was evident in 19.7%. Single-item screeners exhibited sensitivities from 14 to 71% and specificities from 72 to 98%. The King 2-question combination showed 71% sensitivity and 63% specificity. The Rush protocol demonstrated 36% sensitivity and 88% specificity. Post hoc analyses of two-item combinations did not enhance sensitivity. This study evaluated R/S distress screening items among outpatient cancer patients. The single-item screener asking whether participants' R/S provided all the strength and comfort needed now performed best with a sensitivity and specificity of 71% and 83%, respectively. Despite limitations, our findings underscore the importance of refining R/S distress screening tools in oncology care.

Assessment of Geriatric Problems and Risk Factors for Delirium in Surgical Medicine: Protocol for Multidisciplinary Prospective Clinical Study.

An aging population in combination with more gentle and less stressful surgical procedures leads to an increased number of operations on older patients. This collectively raises novel challenges due to higher age heavily impacting treatment. A major problem, emerging in up to 50% of cases, is perioperative delirium. It is thus vital to understand whether and which existing geriatric assessments are capable of reliably identifying risk factors, how high the incidence of delirium is, and whether the resulting management of these risk factors might lead to a reduced incidence of delirium. This study aimed to determine the frequency and severity of geriatric medical problems in elective patients of the Clinics of Oral and Maxillofacial Surgery, Vascular Surgery, and Orthopedics, General Surgery, and Trauma Surgery, revealing associations with the incidence of perioperative delirium regarding potential risk factors, and recording the long-term effects of geriatric problems and any perioperative delirium that might have developed later the patient's life. We performed both pre- and postoperative assessments in patients of 4 different surgical departments who are older than 70 years. Patient-validated screening instruments will be used to identify risk factors. A geriatric assessment with the content of basal and instrumental activities of daily living (basal activities of daily living [Katz index], instrumental activities of daily living [Lawton and Brody score], cognition [6-item screener and clock drawing test], mobility [de Morton Mobility Index and Sit-to-Stand test], sleep [Pittsburgh Sleep Quality Index and Insomnia Severity Index/STOP-BANG], drug therapy [polypharmacy and quality of medication, Fit For The Aged classification, and anticholinergic burden score], and pain assessment and delirium risk (Delirium Risk Assessment Tool) will be performed. Any medical problems detected will be treated according to current standards, and no intervention is planned as part of the study. In addition, a telephone follow-up will be performed 3, 6, and 12 months after discharge. Recruitment started in August 2022, with 421 patients already recruited at the time of submission. Initial analyses of the data are to be published at the end of 2024 or the beginning of 2025. In the current study, we investigate whether the risk factors addressed in the assessment are associated with an increase in the delirium rate. The aim is then to reduce this comprehensive assessment to the central aspects to be able to conduct targeted and efficient risk screening. German Clinical Trials Registry DRKS00028614; https://www.drks.de/search/de/trial/DRKS00028614. DERR1-10.2196/59203.

Development of a brief screening measure of unmet supportive care needs (SCNS-P&C-6) in caregivers of people with high-grade glioma

PurposeInformal caregivers of people with high grade glioma (HGG) often have high levels of unmet support needs. Routine screening for unmet needs can facilitate appropriate and timely access to supportive care. We aimed to develop a brief screening tool for HGG caregiver unmet needs, based on the Supportive Care Needs Survey—Partners & Caregivers (SCNS-P&C).MethodsSecondary analysis was performed on responses to the SCNS-P&C from 188 HGG caregivers, who participated in the Care-IS trial. SCNS-P&C items were assessed against four criteria: factor loadings; prevalence; variation in domain score; diagnostic accuracy. Supplementary analysis was conducted at two timepoints (T1 & T2) on the final selected items to identify caregivers indicating no needs on the screening items but reported a need on the original SCNS-P&C, suggesting they would be “missed” by the screening items.ResultsSix items performed best against psychometric criteria, capturing two domains: Cancer impact needs and Information and communication needs. Supplementary analysis showed screening items failed to identify only 7.4% (14/188) of caregivers with other unmet needs at T1 and 11.4% (18/158) at T2. Of those missed at T1, only four were missed again at T2.ConclusionsWe identified six-items for inclusion in a brief screening tool, the SCNS-P&C-6, demonstrating good sensitivity in detecting unmet needs of caregivers of people with HGG. Use of this tool in clinical practice has the potential to improve access to care and the cancer experience for both the caregiver and person with brain tumor.

Guidance and Considerations When Performing Data-Validity Checks.

This response to a Commentary by Delgado-Ron, Jeyabalan, Watt, and Salway (2024) on Cimpian, Timmer, and Kim's (2023) paper discusses and clarifies some key issues in applying the new data-validity sensitivity analysis proposed by Cimpian etal. (2023). The differences in the applications of the method by Delgado-Ron etal. (2024) and Cimpian etal. (2023) present an opportunity to recognize the possibilities of this method, while also noting some challenges and limitations. This response-commentary focuses on five key areas: (1) surmising a set of likely motivations of the survey respondents, (2) selecting the screener items, (3) considering the outcomes examined, (4) reflecting on null results in a sensitivity analysis, and (5) recognizing the advantages and disadvantages of the ease of this new method.

Patients' sense of medical gain on family doctor contracting services in China: scale development and preliminary validation

Background and aimThe system of family doctor contract services is a crucial component of China's primary healthcare system. Patients enrolled in family doctor contract services typically receive more comprehensive health services. However, it remains uncertain whether the family doctor contract services can fully meet the healthcare needs of patients. Despite extensive research on family doctor contract services, there has been relatively little investigation from the perspective of patients' sense of gain, and there are no specific tools available to measure patients' sense of gain in healthcare. Therefore, this study aims to develop a scale to measure patients' sense of gain in family doctor contract services.MethodsThis study enrolled 600 patients under family doctor contracts. It utilized a review of literature and Delphi expert consultation to form the concept of patients' sense of medical gain in the context of family doctor services, establish an item pool, screen items, and evaluate the scale's reliability and validity. Factor analysis assessed the scale's structural validity, while Cronbach's alpha coefficient evaluated its internal consistency. Test–retest reliability and split-half reliability were used to assess the scale's reliability.ResultsThe Patients' Sense of Medical Gain in the context of Family Doctor services(PSMG-FD) scale for assessing sense of medical gain among family doctor contract patients comprises 19 items, categorized into five factors: Medical convenience, continuity, reliability, humanistic care, and experience. Confirmatory factor analysis results indicated satisfactory fit indices: χ2/df = 2.781, RMSEA = 0.077, RMR = 0.031, GFI = 0.875, NFI = 0.918, IFI = 0.946, TLI = 0.934, CFI = 0.945, and RFI = 0.901. The AVE values for different dimensions were 0.544, 0.739, 0.741, 0.755, and 0.654, all surpassing the threshold of 0.5. The CR values for each dimension were 0.820, 0.919, 0.919, 0.925, and 0.850, all exceeding 0.7, indicating satisfactory convergent validity. The interdimensional correlation coefficients were lower than the square roots of the corresponding AVEs, suggesting correlation among latent variables while maintaining sufficient discriminant validity. The PSMG-FD scale demonstrated good reliability and validity, with a Cronbach’s α coefficient of 0.947, test–retest reliability of 0.955, and split-half reliability of 0.895.ConclusionThe scale exhibits good reliability and validity, making it a suitable instrument for evaluating sense of medical gain among family doctor contract patients in China.

Screening for frequent hospitalization risk among community-dwelling older adult between 2016 and 2023: machine learning-driven item selection, scoring system development, and prospective validation.

Screening for frequent hospitalizations in the community can help prevent super-utilizers from growing in the inpatient population. However, the determinants of frequent hospitalizations have not been systematically examined, their operational definitions have been inconsistent, and screening among community members lacks tools. Nor do we know if what determined frequent hospitalizations before COVID-19 continued to be the determinant of frequent hospitalizations at the height of the pandemic. Hence, the current study aims to identify determinants of frequent hospitalization and their screening items developed from the Comprehensive Geriatric Assessment (CGA), as our 273-item CGA is too lengthy to administer in full in community or primary care settings. The stability of the identified determinants will be examined in terms of the prospective validity of pre-COVID-selected items administered at the height of the pandemic. Comprehensive Geriatric Assessments (CGAs) were administered between 2016 and 2018 in the homes of 1,611 older adults aged 65+ years. Learning models were deployed to select CGA items to maximize the classification of different operational definitions of frequent hospitalizations, ranging from the most inclusive definition, wherein two or more hospitalizations over 2 years, to the most exclusive, wherein two or more hospitalizations must appear during year two, reflecting different care needs. In addition, the CGA items selected by the best-performing learning model were then developed into a random-forest-based scoring system for assessing frequent hospitalization risk, the validity of which was tested during 2018 and again prospectively between 2022 and 2023 in a sample of 329 older adults recruited from a district adjacent to where the CGAs were initially performed. Seventeen items were selected from the CGA by our best-performing algorithm (DeepBoost), achieving 0.90 AUC in classifying operational definitions of frequent hospitalizations differing in temporal distributions and care needs. The number of medications prescribed and the need for assistance with emptying the bowel, housekeeping, transportation, and laundry were selected using the DeepBoost algorithm under the supervision of all operational definitions of frequent hospitalizations. On the other hand, reliance on walking aids, ability to balance on one's own, history of chronic obstructive pulmonary disease (COPD), and usage of social services were selected in the top 10 by all but the operational definitions that reflect the greatest care needs. The prospective validation of the original risk-scoring system using a sample recruited from a different district during the COVID-19 pandemic achieved an AUC of 0.82 in differentiating those rehospitalized twice or more over 2 years from those who were not. A small subset of CGA items representing one's independence in aspects of (instrumental) activities of daily living, mobility, history of COPD, and social service utilization are sufficient for community members at risk of frequent hospitalization. The determinants of frequent hospitalization represented by the subset of CGA items remain relevant over the course of COVID-19 pandemic and across sociogeography.

Using the PROMOTE Screener to Identify Psychosocial Risk Factors for Prenatal Substance Use.

There is an urgent need to improve the identification of psychosocial vulnerabilities in clinical practice (eg, stress, unstable living conditions) and examine their contribution to prenatal substance use, especially for legal substances such as alcohol, tobacco, and recently, cannabis. We conducted a retrospective chart review of 1842 patients who completed the PROMOTE screening instrument during their first prenatal visit to outpatient clinics of a New York State health system in 6/2019-11/2020. The PROMOTE includes 18 core items to assess psychosocial vulnerabilities including the NIDA Quick Screen assessing past year substance use. Outcomes were tobacco, cannabis, and alcohol use during pregnancy based on electronic medical record abstraction including clinical notes, self-report, or urine toxicology. A total of 188 (10.2%) patients used at least 1 substance prenatally, including 132 (7.2%) tobacco, 50 (2.7%) cannabis, and 45 (2.4%) alcohol. Two of the NIDA Quick Screen items (past year tobacco use and past year illegal drug use) were associated in the bivariate analysis with greater use risk of all 3 substances. Additional risk factors uniquely associated with specific prenatal substance use variables include low education predicting tobacco use (adjusted odds ratio [AOR] = 2.74, 95% confidence interval [CI] = 1.43-5.23), being unpartnered predicting cannabis use (AOR = 3.37, 95% CI = 1.21-9.39), and major life events predicting alcohol use (AOR = 3.25, 95% CI = 1.439-7.38). Utilizing brief psychosocial self-screening instruments such as the PROMOTE can help identify and refer at-risk patients to appropriate care. Particular attention should be paid to life context including partner support, emotional health, stress, and past year substance use.

Investigating the implementation of a novel approach to alcohol screening and brief intervention in Mexico: a mixed-methods study using pseudo-patients.

Low- and middle-income countries bear disproportionate burdens from excessive alcohol consumption, yet have fewer resources to identify and intervene with risky drinkers. Low-cost screening and brief intervention (SBI) models offer a tool for addressing this health problem and reducing disparities. In this mixed-methods study, trained pseudo-patients visited health clinics in Zacatecas, Mexico, where a novel SBI model was used with trained nonmedical health educators (HEs) conducting SBI in waiting areas. Pseudo-patients, who provided responses to the AUDIT-C screening items designed to trigger a brief intervention (BI), waited for HEs to engage them in an SBI encounter. Data on HEs' behaviors, SBI components provided, and contextual characteristics were coded from audio recordings of the encounters using an SBI checklist and from pseudo-patient interviews. Quantitative analyses examined the consistency in pseudo-patients' targeted AUDIT-C scores and those documented by HEs as well as the frequency of delivery of SBI components. Across 71 interactions, kappas between HEs' scores and the targeted AUDIT-C scores ranged from 0.33 to 0.45 across AUDIT-C items; it was 0.16 for the total AUDIT-C. In 41% of interactions, the HEs recorded total AUDIT-C scores that accurately reflected the targeted scores, 45% were below, and 14% exceeded them. Analyses of checklist items and transcripts showed that HEs demonstrated desired interpersonal skills (attentive, empathetic, professional) and provided general information regarding risks and recommendations about reducing consumption. In contrast, personalized BI components (exploring pseudo-patients' personal challenges and concerns about reducing drinking; making a plan) occurred much less frequently. Pseudo-patient interviews revealed contextual factors (noise, lack of privacy) that may have negatively affected SBI interactions. Using trained nonmedical persons to administer SBI holds promise to increase its reach. However, ongoing training and monitoring, prioritizing comprehensive BIs, eliminating contextual barriers, and electronic delivery of screening may help ensure high quality delivery.

Revisiting the 8-syndrome of the Child Behavior Checklist (CBCL) in 67257 Chinese school students

ABSTRACT The 8-Syndrome structure of the Child Behavior Checklist (CBCL) has been well supported globally, but its validity in the Chinese sample remains untested. A total of 67,257 school students aged 6–16 were included. The Chinese version of the CBCL consists of 118 specific behavioral and emotional items, with two open-ended screening items. Confirmatory factor analysis (CFA), cluster analysis, and network analysis were employed to test the 8-Syndrome structure in the Chinese CBCL. The Chinese CBCL showed a comparative fit index (CFI) of 0.734, indicating poor fit in the Chinese sample. Cluster and network analyses suggested that Anxious/Depressed (AD), Withdrawn/Depressed (WD), and Thought Problems (TP) might form internalizing factors (representing emotional or thought problems), whereas Aggressive Behavior (AB), Rule-Breaking Behavior (RBB), and Attention Problems (AP) might comprise externalizing factors (representing behavioral problems). Age emerged as a significant factor influencing emotional and behavioral problems in the Chinese sample (p < 0.05). The 8-Syndrome structure of the Chinese CBCL did not fit well, prompting the need for further exploration and possible restructuring across different samples. Definitions of Internalizing and Externalizing factors may require refinement and age considerations should be integrated into future revisions of the CBCL structure.

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

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

Development of Metaverse Assessment Items for Early Screening of Developmental Disabilities

Development of Metaverse Assessment Items for Early Screening of Developmental Disabilities

Development and Preliminary Validation of a Screener for Digital Health Readiness

While telehealth use has grown, patient uptake is variable, which has the potential to increase health disparities. Identifying and understanding individuals' barriers to digital health readiness can help health systems efficiently deploy resources to provide personalized patient-centered support. To develop and validate an instrument to evaluate digital health readiness to identify and quantify barriers to digital readiness. In this qualitative mixed-methods study conducted from April 26, 2022, to June 8, 2023, the instrument was created in 4 phases. Patients and health care professionals were interviewed to explore barriers to telehealth use, scale items were developed for the screener, cognitive interviews were conducted to refine scale items, and psychometric properties of the screener were evaluated. The study was conducted in an urban, multisite academic health system and the surrounding community. Participants were older than 18 years, English-speaking, and able to provide informed consent. Professionals worked within the Jefferson Health system and were involved in telehealth services. Participants completed a semistructured interview (duration: 6-19 minutes), a cognitive interview (duration: 13-137 minutes), or the draft screener survey (duration: 5-10 minutes). Development and validation of a screener for digital health readiness. Of 519 patients approached, 19 were ineligible, 122 declined, and 11 were excluded from analysis, resulting in inclusion of 367 participants (32 patient interviews, 16 professional interviews, 15 cognitive interviews, 304 psychometric survey testing). All 16 professionals who were approached participated. Most patient participants were Black (46.7%) or White (37.9%), male (56.4%), and had a high school degree or some college (49.6%); mean (SD) age was 45 (23) years for participants in cognitive interviews, 53 (18) years for survey respondents, and 57 (14) years for patient interviews. The structured interviews uncovered 21 concepts, leading to 48 items that were refined through cognitive interviews. Psychometric analyses of the 29 items that emerged from the cognitive interviews resulted in a final screener with 24 items across 2 factors: technical readiness (18 items; factor loading range, 0.488-0.968) and quality-of-care concerns (6 items; factor loading range, 0.619-0.942). In this qualitative study of digital health readiness, the findings suggest that the screener items may be valid to assess the complexity of factors influencing digital health uptake and highlight several areas for potential intervention.

Pilot study of parental alienation items in the adverse childhood experiences scale

Pilot study of parental alienation items in the adverse childhood experiences scale

Predominant approaches to measuring pregnancy-related anxiety in Sub-saharan Africa: a scoping review

BackgroundPregnancy-related anxiety significantly impacts maternal and fetal health in low- and middle-income countries (LMICs), including those within Sub-Saharan Africa (SSA). Most studies conducted to evaluate pregnancy-related anxiety in LMICs have utilized scales developed in high-income countries, despite significant variations in pregnancy-related anxiety due to socioeconomic and cultural contexts. This review surveyed existing literature in order to identify which scales have been used to measure pregnancy-related anxiety in SSA.MethodsA systematic search was conducted in PubMed, Health and Psychosocial Instruments, and APA PsycNet for relevant studies published in the English language up to March 22, 2023. Eligible studies focused on anxiety in pregnant populations within SSA, using validated scales or tools. Screening followed PRIMSA guidelines, with blinded review at the abstract/title level and subsequent full-text review. Data was extracted and analyzed to identify trends and characteristics of the screening tools used.ResultsFrom 271 articles, 37 met inclusion criteria, identifying 24 different tools used to measure anxiety in pregnant women in SSA. The most common tools were the Generalized Anxiety Disorder 7-item scale (seven uses), State-Trait Anxiety Inventory (five uses), and the Self-Reporting Questionnaire 20 (five uses). Seven tools were pregnancy-specific, with only two designed specifically for SSA: the Risk Factor Assessment (RFA), and the 4-Item Screening Tool. Studies were most frequently conducted in South Africa, followed by Tanzania, Ethiopia, Nigeria, and Ghana.ConclusionsThis scoping review illustrates that only two tools (the RFA and 4-item Screening Tool) were created to assess pregnancy-related anxiety specifically in SSA. This highlights the need for more culturally sensitive tools tailored to the specific contexts of pregnant populations in SSA.

Within-session chasing of losses and wins in an online eCasino

Chasing refers to the escalation of betting behaviour. It is conventionally seen when losing but can also be seen after wins. Diagnostic and screening items for gambling problems describe chasing as returning ‘another day’ to gamble. However, gamblers may also chase within sessions, and this is particularly relevant in online gambling. This study focused on two expressions of within-session chasing: (1) increasing the bet amount, or (2) a reduced probability of quitting the session, as a function of prior losses or wins. These expressions were examined across five online gambling products: slot machines, probability games, blackjack, video poker, and roulette. Our results showed that gamblers bet more and played longer sessions after immediate losses, but they bet less and played shorter sessions when losing cumulatively. The reversed pattern in the cumulative model may be due to financial constraints. For wins, gamblers bet more after both immediate and cumulative wins, but they also played shorter sessions. Chasing patterns were qualitatively similar by game type—with limited evidence for our hypothesis that chasing would be greatest for slot machines as an established high-risk category. Overall, chasing is multi-faceted, varying across the behavioural expressions, by the immediate or cumulative timeframe of prior outcomes, and by game type.

A Retrospective Analysis of Four STI Pathogens in Obstetrics and Gynecological Patients in Hangzhou, China.

Among sexually transmitted infection (STI) pathogens, UU, CT, NG, and MG are very commonly detected. A retrospective study was conducted to analyze the clinical situations and laboratory data of patients in-fected with the four pathogens in Hangzhou city, Zhejiang Province, China. For this study, 4,716 female outpatients and inpatients of the Department of Obstetrics and Gynecology of Hangzhou Third People´s Hospital were randomly selected from January 2019 to December 2023. Multiple types of specimens were collected and four STI pathogens were detected. Data collection was taken from the hospital's electronic medical records and statistical analysis was processed with SPSS 25.0 software. In the past five years, year by year, the positive rate presented an increasing trend. Out of 4,716 patients, 2,931 were positive, and the positive rate was 62.15%. The positive rate of single infection was significantly higher than of co-infection (p < 0.05). The highest positive rate of all STI patients was found in the  20 age group, and the rate was significantly different between each age group (p < 0.05). Single infection with UU occurred significantly more often than with the other three pathogens (p < 0.05), and co-infection with UU and CT and UU, CT, and MG were significantly dominating (p < 0.05). Only three patients had an infection with all four pathogens, and it was extremely rare. The 21 - 30 and 31 - 40 age groups had high incidences of infection, with a significant difference compared with other age groups (p < 0.05). The positive rate shows an increasing trend in Hangzhou in the past five years. More single infection than co-infection and more younger patients were detected. Single infection with UU was dominant in all positive patients. The publicity and more screening testing items of STI for younger people should be strengthened in Hangzhou, and the people of Hangzhou should be made more aware that information technology is helpful in aiding the control of STI diseases.