Self-reported Indicators Research Articles

Sociodemographic predictors of the association between self-reported sleep duration and depression

Abstract Background This cross-sectional study is apart from one of the first and largest population-based prospective cohort studies in the UAE called the United Arab Emirates Healthy Future Study (UAEHFS). The aim of this study is to investigate the association between self-perceived sleep duration and self-perceived depression after adjustment for sociodemographic factors. Baseline line data from UAEHFS cohort participants were included in this cross-sectional study. Univariable and multivariable logistic regression models were fitted, with the binarized self-reported sleep hours as an outcome. The predictors were the self-reported PHQ-8, sociodemographic factors, and body mass index (BMI). Odds ratios with 95% confidence intervals (CI) were reported. Results Of 11,455 participants, 4,295 (37.5%) were included in the complete case analysis after omitting missing values. We applied a complete case analysis following omitting missing values. Participants’ median age was 32.0 years (Interquartile-Range: 24.0, 39.0). In total, 63.6% of the participants reported sleep duration of more than 7 hours. Statistically significant negative association was observed between the total PHQ-8 score and binarized self-reported sleep, OR = 0.961 (95% CI: 0.948, 0.974). For one unit increase in age and BMI, the odds ratio of reporting shorter sleep with OR of 0.979 (95% CI: 0.969, 0.990) and 0.987 (95% CI: 0.977, 0.998) respectively. Conclusions The study findings indicate a correlation between higher total PHQ-8 scores and an increased probability of individuals reporting shorter self-perceived sleep durations when considering some sociodemographic factors such as age, marital status and employment status. However, there was no difference between females and males in reporting self-perceived sleep duration among depressed individuals. Key messages • There is a correlation between higher total PHQ-8 scores and an increased probability of individuals reporting shorter self-perceived sleep durations. • Our results can help contribute to the knowledge based on current and potential population mental health in the UAE and Gulf Region.

Gestational organophosphate esters (OPEs) and executive function in adolescence: The HOME Study

BackgroundEvidence from toxicological studies indicate organophosphate esters (OPEs) are neurotoxic, but few epidemiological studies investigated associations between gestational OPEs and executive function. ObjectiveTo examine the associations between gestational concentrations of OPE urinary metabolites and executive function at 12 years MethodsWe used data from 223 mother-adolescent dyads from the Health Outcomes of Measures of the Environment (HOME) Study. Women provided spot urine samples at 16 weeks gestation, 26 weeks gestation, and at delivery for quantification of bis(1,3-dichloro-2-propyl) phosphate, bis-2-chloroethyl phosphate (BCEP), diphenyl phosphate (DPHP), and di-n-butyl phosphate (DNBP). Executive function was assessed at age 12 years using the parent- and self-report Behavior Rating Inventory of Executive Function (BRIEF2). Covariate-adjusted associations between specific gravity-corrected OPEs and BRIEF2 scores were estimated using multiple informant models. Bayesian Kernel Machine Regression (BKMR) was used to assess the impact of all OPEs simultaneously. ResultsParent- and self-report BRIEF2 indices and composite scores were weakly to moderately correlated (rs=0.32-0.41). A natural-log unit increase in BCEP at 26 weeks was associated with approximately a 1-point increase on the self-report Cognitive Regulation Index [CRI] (95% CI 0.4, 2.3), the Emotion Regulation Index [ERI] (95% CI 0.3, 2.2), and the Global Executive Composite [GEC] (95% CI 0.4, 2.2), indicating poorer performance. Higher DPHP at 16 weeks was associated with lower parent-report GEC score (β=-1.1, 95% CI -2.3, -0.003). BKMR identified BCEP and DNBP at 26 weeks as important contributors to CRI and ERI, respectively. ConclusionOPE metabolites during gestational development, particularly BCEP, may influence adolescent executive function. However, since the FDR p-values failed to reach statistical significance, additional studies would benefit from using larger cohorts.

Why do patients with chronic musculoskeletal pain reporting a clinically relevant change on disability not achieve such change in walking ability after interdisciplinary multimodal pain treatment?

Purpose Interdisciplinary multimodal pain treatment (IMPT) offers long-term benefits for patients with chronic musculoskeletal pain (CMP). Many patients, despite reporting a clinically relevant decrease of the self-reported Pain Disability Index (PDI), do not achieve such change for the 6-minutes walking test (6MWT). The objective is to identify factors that are associated with no clinically meaningful improvement on the 6MWT in patients with CMP who reported a clinically important improvement on disability (PDI) after 10-weeks of IMPT. Materials and methods Nine hundred and eighty-three patients reporting a clinically important change on the PDI (primary outcome) after IMPT were included. Logistic regression analysis was used to identify baseline and change scores of physiological and psychologic factors independently associated with a clinically important improvement on the 6MWT. Results Three hundred (32%) patients achieved a clinically important change on the 6MWT. A higher increase of the heart rate (HR) during the 6MWT at post-treatment compared to the HR increase at pre-treatment increases the probability of achieving a clinically relevant change on the 6MWT. Higher self-reported working capacity and anxiety at baseline resulted in a lower probability of achieving a clinically relevant increase of the metres walked. Conclusions None of the other factors targeted by IMPT contributed significantly to the final model. These results question the feasibility of the 6MWT as a secondary outcome measure as it merely seems to measure patient’s behaviour (performance) and not capacity.

Investigating the links between objective social media use, attentional control, and psychological distress

Social media use (SMU) has been associated with negative mental health outcomes and has been implicated in inhibitory attentional control deficits. However, findings have been inconsistent, in part due to methodological limitations in past studies (e.g., over-reliance on self-report SMU and attentional control measures). Therefore, the aim of the present study was to examine the associations between SMU, psychological distress (including depression, anxiety, and stress), and inhibitory attentional control, using objective measures of SMU and inhibitory attentional control. Participants (N = 425) completed the DASS-21 and an antisaccade task, and SMU data was accessed via mobile phones, as minutes/week spent using TikTok, Instagram, Snapchat, Facebook, and Twitter/X. Bivariate correlations were examined, and a moderation analysis was conducted to determine whether attentional control moderated the association between SMU and psychological distress. Our findings revealed that SMU was positively associated with attentional control and anxiety, while TikTok use was positively associated with attentional control, and Facebook use with psychological distress. However, the observed associations were very small, suggesting that the links between SMU and both psychological distress and attentional control may be over-stated, particularly in studies that have utilised self-report SMU measures. No moderating effect of attentional control on the relationship between SMU and psychological distress was observed. These findings highlight the importance of utilising objective SMU and cognitive measures when examining the links between SMU, mental health, and cognitive processes (like attentional control), and to corroborate findings based on associations with self-report SMU indicators.

Promoting Patient Care Ownership in Medical Students through Standardized Simulations

Background:Professional identity formation (PIF) has been demonstrated to play an important role in medical students' transition from a peripheral role into becoming a physician that bears primary responsibility for the care of their patients1,2. Multiple factors influence this development, including clinical experiences as well as sociocultural, familial, academic, moral, religious, and gender-based roles, values, beliefs, and obligations. Many of these factors can be emulated in simulations to encourage this merging of identities; the most critical of which is patient care ownership (PCO)6. This study was conducted on the 4th year medical students at the Medical College of Georgia (MCG) and compares a self-reported PCO index score amongst the various subsets. These include main vs regional campus assignment for clinical years, gender identity, ethnicity, and prior healthcare experience before medical school. Methods:For this study, we distributed a questionnaire developed by Avey et al. (2009) and adapted by Wyatt et al.11 (2023) to evaluate the feelings and opinions of medical students regarding their level of patient care ownership11,16,17. To evaluate the effects of the longitudinal simulation curriculum on PCO as measured with the survey instrument index scores, independent sample t-tests and ANOVA between different groups with a Tukey HSD multiple-comparison post-hoc were done. Groups analyzed for differences included campus, gender identity, race, ethnicity, and prior experience in the healthcare field. Results: A total of 201 students were invited to participate in this study. There was no statistically significant difference between students from main and regional campuses in PCO index scores. When comparing between gender identities of male, female, and nonbinary, there was no significant difference (p = 0.248). Comparing ethnicities did not show any significant differences (p = 0.936). Finally, there was no significant difference in PCO index scores between students in regard to their prior healthcare experiences (p = 0.155). Conclusion:This study highlights the importance of a comprehensive and intentionally-designed simulation curriculum to prompt PCO in order to facilitate PIF prior to residency, for the purpose of producing more confident and competent intern physicians2. Conflict of interest: none Treatment of human and animal subjects: not applicable

Investigation of the mental health and cognitive correlates of psychological decentering in adolescence

ABSTRACT The ability to notice and reflect on distressing internal experiences from an objective perspective, often called psychological decentering, has been posited to be protective against mental health difficulties. However, little is known about how this skill relates to age across adolescence, its relationship with mental health, and how it may impact key domains such as affective executive control and social cognition. This study analysed a pre-existing dataset including mental health measures and cognitive tasks, administered to adolescents in Greater London and Cambridge (mean age (SD) = 14.4 (1.77) years, N = 553). A self-report index of decentering based on available questionnaire items in the dataset was developed. Multiple linear regression was used to examine associations between decentering and mental health, affective executive control (measured using an affective Stroop Task, affective Working Memory Task, and affective Sustained Attention to Response Task) and social cognition. Higher decentering was significantly associated with lower depression and anxiety scores and higher psychological wellbeing. Results did not indicate significant relationships between decentering, affective executive control and social cognition. Further research is needed to discover cognitive mechanisms associated with this process, which could allow for optimisation of existing psychological therapy and reveal new avenues of intervention.

The intergenerational metabolic-cardiovascular life course: maternal body mass index (BMI), offspring BMI, and blood pressure of adolescents born extremely preterm.

The aim of this study was to evaluate associations between pre-pregnancy maternal obesity and adolescent blood pressures (BPs) among children born extremely preterm. This longitudinal observational cohort study included participants in the multicenter Extremely Low Gestational Age Newborn (ELGAN) study, born before 28weeks of gestation, recruited at birth between 2002 and 2004, and followed prospectively through late adolescence. Between 2015 and 2022, three oscillometric BPs were obtained from participants (mean age 17.8years). We used linear regression modeling to evaluate the association between maternal self-reported pre-pregnancy body mass index (BMI) and offspring adolescent systolic BP (SBP). In secondary analyses, we evaluated the association between maternal pre-pregnancy and offspring preadolescent (10-year-old) BMI and between offspring preadolescent BMI and adolescent SBP. The 100 (24%) participants born to a mother with a history of pre-pregnancy obesity (BMI ≥ 30) had a greater mean SBP of 120.5 (± 14.3) mmHg compared to the 324 (76%) of adolescents born to mothers without pre-pregnancy obesity (SBP 115.6 (± 12.0) mmHg). Pre-pregnancy obesity was associated with higher offspring BMI (aβ 10.8, 95% CI 2.3, 19.2), and higher offspring BMI was associated with higher adolescent SBP (aβ 0.12, 95% CI 0.09,0.16). For ELGANs, higher maternal pre-pregnancy BMI was associated with higher adolescent SBP. Findings from secondary analyses suggest potential mediation through preadolescent BMI. Future research directions include multi-level interventions to reduce maternal pre-pregnancy obesity, followed by offspring obesity prevention interventions as a way of reducing intergenerational cardiovascular disease in high-risk infants born extremely preterm.

Understanding Depression in Autism: The Role of Subjective Perception and Anterior Cingulate Cortex Volume.

The prevalence of depression is elevated in individuals with autism spectrum disorder (ASD) compared to the general population, yet the reasons for this disparity remain unclear. While social deficits central to ASD may contribute to depression, it is uncertain whether social interaction behavior themselves or individuals' introspection about their social behaviors are more impactful. Although the anterior cingulate cortex (ACC) and amygdala are frequently implicated in ASD, depression, and social functioning, it is unknown if these regions explain differences between ASD adults with and without co-occurring depression. The present study contrasted observed vs. subjective perception of autism symptoms and social performances assessed with both standardized measures and a lab task, in 65 sex-balanced (52.24% male) autistic young adults. We also quantified ACC and amygdala volume with 7-Tesla structural neuroimaging to examine correlations with depression and social functioning. We found that ASD individuals with depression exhibited differences in subjective evaluations including heightened self-awareness of ASD symptoms, lower subjective satisfaction with social relations, and less perceived affiliation during the social interaction task, yet no differences in corresponding observed measures, compared to those without depression. Larger ACC volume was related to depression, greater self-awareness of ASD symptoms, and worse subjective satisfaction with social interactions. In contrast, amygdala volume, despite its association with clinician-rated ASD symptoms, was not related to depression. Due to the cross-sectional nature of our study, we cannot determine the directionality of the observed relationships. Additionally, we included only individuals with an IQ over 60 to ensure participants could complete the social task, which excluded many on the autism spectrum. We also utilized self-reported depression indices instead of clinically diagnosed depression, which may limit the comprehensiveness of the findings. Our approach highlights the unique role of subjective perception of autism symptoms and social interactions, beyond the observable manifestation of social interaction in ASD, in contributing to depression, with the ACC playing a crucial role. These findings imply possible heterogeneity of ASD concerning co-occurring depression. Using neuroimaging, we were able to demarcate depressive phenotypes co-occurring alongside autistic phenotypes.

The role of focused attention in learning from early childhood to late adolescence: Implications of neonatal brainstem compromise following preterm birth.

This comprehensive longitudinal study explored for the first time the interrelations between neonatal brainstem abnormalities, focused attention (FA), and learning-following a preterm cohort (N = 175; 46.3% female; predominantly White) from birth (2003-2006) to 17 years. The findings indicated that FA during early childhood was associated with language outcomes in toddlerhood (n = 131) and academic and attention self-report indices in late adolescence (n = 44). Pilot assessments indicated that FA at 17 years (n = 25) was also associated with concurrent academic and attention functioning. Structural equation modeling analyses revealed that neonatal brainstem functioning, manifested in auditory brainstem response patterns, was associated with early-life FA competence, which affected learning development. Implications underscore the essential role of early brainstem function and FA in shaping childhood learning trajectories.

초기 성인기의 완벽주의와 삶의 만족 관계: 향유신념과 정서인식명확성의 이중매개효과

Objectives The purpose of this study was to verify the double mediating effects of the savoring belief and the emotional perception clarity in the relationship among the perfectionism and the life satisfaction in young adults. Methods For the research objective, the self-reported questionnaire indicator targeting totally 529 early adults between the ages of 20 to 39 nationwide. The collected materials were proved the mediating effects by using SPSS, PROCESS MACRO. Results The results of this study are as follows. First, adaptive perfectionism, maladaptive perfectionism, savoring belief, emotional perception, life satisfaction had meaningful correlations. Second, the savoring belief was confirmed to have a perfect mediation effect after sequentially going through the emotional recognition clarity in the relationship between the adaptive perfectionism and the life satisfaction. Third, the maladaptive perfectionism was assured to have a double mediation effect through the emotional recognition clarity in regular succession. Conclusions The implications and limitations of this study were discussed.

Testing a Reward-Processing Model of Negative Urgency in Women With and Without Binge Eating

Negative urgency (i.e., the tendency to act impulsively when experiencing negative affect) is robustly associated with psychopathology, but the mechanisms underlying negative urgency and its relation to mental health are not well understood. In addition to interfering with cognitive control, negative emotions may lead to impulsive behavior by enhancing reward processing of desired stimuli. In this study, we tested an emotion-enhanced reward-processing model of negative urgency in 153 women who spanned the spectrum of binge-eating severity. Participants completed two experimental tasks under both stressful- and relaxed-mood conditions while physiological, behavioral, and self-report indices of reward processing of palatable food were assessed. Contrary to hypotheses, reward processing of food was not heightened when stressed versus relaxed either in the full sample or in participants with greater negative urgency or binge-eating frequency/severity. Findings are discussed considering study limitations and previous mechanistic work on negative urgency.

Prehospital treatment-seeking for acute coronary syndrome in culturally and linguistically diverse immigrant populations: a scoping review.

Studies consistently report longer prehospital delays in culturally and linguistically diverse (CALD) patients experiencing acute coronary syndrome (ACS). A scoping review was conducted to describe terms and methods used to define and identify CALD populations and summarise available evidence on factors related to prehospital delays in ACS studies involving CALD populations. We searched six electronic databases for published studies and Google Scholar for grey literature to identify studies on prehospital treatment-seeking in CALD immigrants experiencing ACS. We followed the Joanna Briggs Institute methodological framework for scoping review. Twenty-three studies met our eligibility criteria (quantitative n=17; qualitative n=6; mixed n=1). Terms like ethnicity, migrant or expatriate defined CALD populations. Most studies used a single indicator (e.g., country of birth) to identify CALD cohorts, and only two studies used a theoretical model related to treatment-seeking delays to guide data collection. Most factors affecting prehospital delays in CALD populations were similar to those reported in general populations. A unique finding was a difference in the language used to describe symptoms, which, when translated, changes their meaning and resulted in misinterpretation by healthcare providers (e.g., asfixiarse [translates as asphyxiate/suffocate] used for dyspnoea/shortness of breath in Hispanics). Terms and methods used for defining and identifying CALD populations are inconsistent. Studies on factors affecting prehospital treatment-seeking in CALD ACS patients are limited. Future studies should use theoretical models related to treatment-seeking delays to comprehensively explore factors affecting prehospital delays. Additionally, researchers should consider self-reported or multiple indicators to determine CALD status.

In the Realm of Uncertainty: Quantum Thinking Promotes Tolerance for Ambiguity.

According to the principles of quantum mechanics, individuals are unable to accurately predict the precise outcome of a measurement or observation. Despite the significant impact of quantum thinking on science, there is a lack of understanding regarding the psychological consequences associated with adopting such a mindset. This research investigates how engaging in quantum thinking, which accepts the universe's inherent complexities and uncertainties, influences one's tolerance for ambiguity. To test our hypothesis, we conducted three complementary studies involving diverse populations (students and community adults), multiple measures of tolerance of ambiguity (self-report data and behavioral indicators), and different priming procedures (text reading and sentence scrambling tasks). Study 1 demonstrated that university students exposed to quantum thinking principles exhibited greater tolerance for ambiguity within an English as a Foreign Language (EFL) setting. Moving beyond the educational setting, Study 2 corroborated these observations by evaluating an individual's ease with uncertainty and unpredictability across different everyday scenarios. Addressing potential self-report biases, Study 3 incorporated a behavioral measure to objectively validate the observed effect. Together, these findings suggest that the thinking mindset prevalent in physics significantly impacts individuals' cognitive flexibility and behavior, highlighting the broad relevance of quantum thinking beyond its scientific origins.

The email conservation task: Testing the validity of an online measure of direct pro-environmental behavior

There is a need for valid measures of pro-environmental behavior, in particular ones measuring actual behavior. In response, a number of such measures have been introduced recently, however each faces limitations such as high costs, practical use and/or only measure indirect environmental behavior, limiting their scope, accessibility and inclusivity. In response, this study introduces the easily administered and low-cost Email Conservation Task (ECT), which measures direct pro-environmental behaviour (in this case, email use). Here, participants chose between personal costs (time spent on trivial tasks) or environmental costs (receiving unnecessary emails leading to CO2 emissions) across multiple trials. In a pre-registered study testing the validity of the ECT, it was found (as hypothesized) that participants scored higher on the ECT (incurred more personal costs rather than receiving unnecessary emails) when personal costs to them were lower, and scored higher when the environmental costs of receiving unnecessary emails were higher. Finally, total scores on the ECT significantly correlated with scores on three self-reported indicators of pro-environmentalism. Overall, the results of this study support all three hypotheses, indicating that the ECT is a valid measure of pro-environmental behavior that can be implemented across a diverse range of research areas.

Continuous tracking of effort and confidence while listening to speech-in-noise in young and older adults

Reporting discomfort when noise affects listening experience suggests that listeners may be aware, at least to some extent, of adverse environmental conditions and their impact on listening experience. This involves monitoring internal states (effort and confidence). Here we quantified continuous self-report indices that track one’s own internal states and investigated age-related differences in this ability. We instructed two groups of young and older adults to continuously report their confidence and effort while listening to stories in fluctuating noise. Using cross-correlation analyses between the time series of fluctuating noise and those of perceived effort or confidence, we showed that (1) participants modified their assessment of effort and confidence based on variations in the noise, with a 4 s lag; (2) there were no differences between the groups. These findings imply extending this method to other areas, expanding the definition of metacognition, and highlighting the value of this ability for older adults.

Cannabis Users' and Non-Users' Differential Responses to Two Anti-Cannabis Campaigns.

Even though multiple states have approved legal recreational use of cannabis, the expansion of recreational cannabis legalization has led to public health concerns in the United States. Young adults (18-25 years old) have the highest percentage of cannabis use disorder compared to all other age groups. The purpose of this study is to compare cognitive and emotional responses of young adults who use cannabis and non-users to two anti-cannabis media campaigns that employed different message strategies. In total, 50 people (25 people who use cannabis and 25 non-users) participated in the study-a 2 (cannabis use status: people who currently use cannabis/non-users) × 2 (Public Service Advertising [PSA] campaign: Don't be a Lab Rat-Informational/Stoner Sloth-Narrative) × 3 (message replication) experiment. Participants viewed six messages based on the combinations of each of the three message replications within two campaigns. Participants' facial emotional responses were recorded during message exposure. Self-report questions were asked after viewing each message. Self-report indices showed no differences between the two campaigns for participants who use cannabis and non-users. However, after controlling for individual differences, participants who use cannabis displayed more negative emotional responses to the Don't be a Lab Rat messages than to the Stoner Sloth messages. Conversely, cannabis users experienced more positive emotional responses to the Stoner Sloth messages than to the Don't be a Lab Rat messages. The study provides insights for message design in public health campaigns addressing cannabis use, suggesting that psychophysiological measures can be helpful in providing insights into responses not detected by traditional self-report measures.

'My words would have more weight': exploring weight stigma in UK dietetic practice and dietitian's lived experiences of weight stigma.

Weight stigma is pervasive within healthcare and negatively impacts both access to care and the patient-practitioner relationship. There is limited evidence on weight stigma among registered dietitians, particularly in the United Kingdom, though data show weight-related prejudice towards people living with obesity. The aim of this study was to examine both explicit and implicit weight stigma in practicing dietitians in the United Kingdom, as well as the lived experience of weight stigma among dietitians, both towards themselves and towards others. An online cross-sectional survey was disseminated between February and May 2022 using snowball sampling. Inclusion criteria were that participants were UK registered dietitians aged 20-70 years. Four hundred and two dietitians responded to the survey (female [94.1%], mean age 40.2 years [standard deviation (SD) 10.7]; White ethnicity [90%]; median 12 years [interquartile range (IQR) 6, 22] within dietetic practice). Mean self-reported body mass index was 25.1 kg/m² (SD 8.7). Most dietitians reported experiencing weight stigma prior to (51%) and postregistration (59.7%), whereas nearly a quarter (21.1%) felt that weight influenced their ability as a dietitian. Weight stigma was experienced across the weight spectrum. Overall participants reported explicit weight bias attitudes, moderate beliefs that obesity is controllable and implicit antifat bias. Within open-ended responses, dietitians reported three key themes related to their personal experiences of weight stigma: (1) experiences of stigma in dietetic practice, (2) impact of weight stigma and (3) perception of weight, appearance and job. This study shows that UK dietitians exhibit both explicit and implicit weight bias towards people living with obesity. Dietitians reported experiencing weight stigma, which impacted their career-related decisions and their perception of their own ability to perform as dietitians. The study highlights the need to address weight stigma and its implications within the dietetic profession.

Subjective body-related experiences, and perception of the interventions and empathy of the healthcare team in adolescents with overweight.

Introduction. Overweight adolescents are confronted daily with stereotypes that condition their body image, self-esteem, and mood. Objectives. To describe, in adolescents with overweight, the subjective experiences related to the body in daily life and their perceptions regarding the interventions and empathy of the health team. Population and methods. Descriptive study with qualitative approach. Semi-structured interviews were conducted with adolescents aged 11 to 18 years with selfreported mass index (BMI) ≥ 26 and referring to medical or nutritional follow-up for overweight, attended at the Adolescence Service of a hospital in the Autonomous City of Buenos Aires, between October 1, 2021, and May 31, 2022. Results. Twenty adolescents were evaluated, with a median age of 13.5 years, most of them from female sex (16/20). All reported body dissatisfaction from an early age (median age: 10 years old). They mention difficulty dressing due to the lack of different sizes; they even limit sports practice. They suffered weight- related body humiliation at school, in the family, or public (15/20). They perceived weight control in a dual way: weight loss was the primary stimulus for treatment, but its centrality in the consultations generated discomfort. The leading causes of therapeutic abandonment were the impossibility of temporarily sustaining the recommendations and the lack of weight loss. The treating team was willing to listen to the patients but needed to understand their daily experiences, physical, material, esthetic, social conditioning, beliefs, and perceptions. Conclusion. The adolescents included in this study perceived specific interventions of the healthcare team as beneficial, with empathic deficiencies.

A longitudinal study investigating the effects of noise exposure on behavioural, electrophysiological and self-report measures of hearing in musicians with normal audiometric thresholds

Musicians are at risk of hearing loss and tinnitus due to regular exposure to high levels of noise. This level of risk may have been underestimated previously since damage to the auditory system, such as cochlear synaptopathy, may not be easily detectable using standard clinical measures. Most previous research investigating hearing loss in musicians has involved cross-sectional study designs that may capture only a snapshot of hearing health in relation to noise exposure. The aim of this study was to investigate the effects of cumulative noise exposure on behavioural, electrophysiological, and self-report indices of hearing damage in early-career musicians and non-musicians with normal hearing over a 2-year period. Participants completed an annual test battery consisting of pure tone audiometry, extended high-frequency hearing thresholds, distortion product otoacoustic emissions (DPOAEs), speech perception in noise, auditory brainstem responses, and self-report measures of tinnitus, hyperacusis, and hearing in background noise. Participants also completed the Noise Exposure Structured Interview to estimate cumulative noise exposure across the study period. Linear mixed models assessed changes over time. The longitudinal analysis comprised 64 early-career musicians (female n = 34; age range at T0 = 18–26 years) and 30 non-musicians (female n = 20; age range at T0 = 18–27 years). There were few longitudinal changes as a result of musicianship. Small improvements over time in some measures may be attributable to a practice/test-retest effect. Some measures (e.g., DPOAE indices of outer hair cell function) were associated with noise exposure at each time point, but did not show a significant change over time. A small proportion of participants reported a worsening of their tinnitus symptoms, which participants attributed to noise exposure, or not using hearing protection. Future longitudinal studies should attempt to capture the effects of noise exposure over a longer period, taken at several time points, for a precise measure of how hearing changes over time. Hearing conservation programmes for “at risk” individuals should closely monitor DPOAEs to detect early signs of noise-induced hearing loss when audiometric thresholds are clinically normal.

Music therapy with adults in the subacute phase after stroke: A study protocol

Stroke is a highly disabling condition, for which music therapy is regularly used in rehabilitation. One possible mechanism for the effects of music therapy is the motivational aspect of music, for example regarding treatment adherence based on improved mood. In this study, changes in motivation related to Neurologic Music Therapy (NMT) techniques during rehabilitation in the subacute phase after stroke will be investigated. Using a randomised within-subjects cross-over design, the effects of two NMT techniques and related motivational indices will be investigated. Data will be collected at three timepoints: baseline (TP1), after being randomised into groups and receiving NMT or standard care (TP2), and then at a third time point after the cross-over and having received both conditions (TP3). This design allows to counteract order effects, time effects due to spontaneous and/or nonlinear recovery, as well as single-subject comparisons in a relatively heterogeneous sample. Twenty adult participants who have experienced a supratentorial ischaemic or haemorrhagic stroke and are experiencing upper-limb impairments and/or cognitive deficits will be included. Behavioural measures of motor function, cognition, and quality of life will be collected, along with self-reported indices of overall motivation. The study outcomes will have implications for the understanding of the underlying mechanisms of music therapy in stroke recovery, more specifically regarding the relevance of motivational states in neurorehabilitation.