Single-item Scale Research Articles

Comparison of Cannabis-Based Medicinal Product Formulations for Fibromyalgia: A Cohort Study

This cohort study aims to assess the outcomes of fibromyalgia patients enrolled in the UK Medical Cannabis Registry prescribed a homogenous selection of cannabis-based medicinal products (CBMPs). A cohort study of fibromyalgia patients treated with oils (Adven®, Curaleaf International, UK), dried flower (Adven®, Curaleaf International, UK) or both CBMPs was performed. Primary outcomes were changes from baseline at 1, 3, 6 and 12 months in validated patient-reported outcome measures. Secondary outcomes included descriptive analysis of adverse events. One hundred and forty-eight participants were treated with oils (n = 77; 52.03%), dried flower (n = 14; 9.46%) or both (n = 57; 38.51%). Improvements in the generalized anxiety disorder-7 questionnaire, single-item sleep quality scale, fibromyalgia symptom severity score and EQ-5D-5L Index values were observed at each follow up period compared to baseline (p < 0.050). Thirty-six (24.32%) patients experienced 648 adverse events. Improvements were observed across all primary outcomes with no differences observed across different formulations of CBMPs. Adverse events were reported by one-quarter of participants and were more likely to reported by cannabis naïve patients. This present work through focusing on a homogeneous group of CBMPs can help inform randomized controlled trials after observing signals of improvement associated with a specific cultivar of CBMPs.

Noise sensitivity: from systematic review to improving its measurement

Noise sensitivity is known to be the most influential non-acoustic factor affecting noise annoyance. While there is general consensus within the international research community as to how noise annoyance should be measured, it is not true for noise sensitivity. Either single-item rating scales are used or full-fledged questionnaires. Few of these instruments have been validated across different languages, and some of them have never been psychometrically evaluated. Even though noise sensitivity has been studied for many decades, there is no systematic review of what noise sensitivity is. The present research program started out by conducting a systematic review of the instruments available to measure noise sensitivity. Next, an online survey will be carried out to evaluate and compare existing noise-sensitivity questionnaires on a large sample while considering versions in different languages. Finally, on the basis of both the systematic review and the questionnaire evaluation, a resulting measure of noise sensitivity will be assessed in the laboratory by relating it to both noise annoyance and physiological measurements. The relevance of the proposed work is thus to designate a reliable, yet economic method to measure noise sensitivity in future surveys. [Research funded by Fondation pour l'Audition (grant FPA RD-2022-6)]

Single-Item Assessment of Quality of Life: Associations with Well-Being, Mood, Health Correlates, and Lifestyle.

Background: Quality of life (QoL) is traditionally assessed using multiple-item questionnaires. These can be either general, global assessments of QoL or disease-specific questionnaires. However, the use of single-item QoL scales is becoming increasingly popular, as these are more time- and cost-effective, with a readily available and easy-to-interpret outcome. In particular, these are often preferred for quick assessments (e.g., 'at home' testing and mobile phone assessments), and other cases when time constraints are common (e.g., clinical trials and clinical practice). Previous research revealed that multiple-item questionnaires and single-item assessments of QoL have the same validity and reliability. Here we further evaluate the relationship of QoL, assessed with a single-item QoL scale, with well-being, mood, health correlates (e.g., immune fitness, and having underlying diseases), and lifestyle (e.g., sleep, nutrition). Methods: Data from two online surveys are presented. In Study 1, 100 students participated. The single-item QoL score was compared with the World Health Organization Well-Being Index (WHO-5), a single-item score of sleep quality, the Regensburg Insomnia Scale (RIS) score, and the Healthy Diet Scale (HDS). Study 2 comprised a survey among 1415 Dutch adults. Single-item QoL was evaluated and compared with assessments of mood, health correlates (immune fitness and disease status), and lifestyle factors (e.g., sleep, nutrition, stress). Results: The first study revealed significant correlations between QoL and well-being, sleep quality, insomnia ratings, and attaining a healthy diet. The second study revealed significant correlations between QoL and mood, health status, and lifestyle factors (e.g., the ability to cope with stress). Conclusions: The results presented here demonstrate that the single-item QoL scale is an effective and easy-to-implement assessment tool that can be used in both clinical practice and research.

Scrolling through adolescence: unveiling the relationship of the use of social networks and its addictive behavior with psychosocial health

BackgroundUnderstanding the relationship of social network use and addictive behaviors with adolescent psychosocial health is crucial in today’s digital age.AimTo verify the associations between social network use, messaging applications, and the addictive behaviors to social network with psychosocial health in Spanish adolescents.MethodsA cross-sectional study was developed with 632 adolescents, aged 12 to 17 years from the Region of Murcia, Spain. The assessment of social network use (Facebook, Twitter, Instagram, Snapchat, and TikTok) involved evaluating the frequency of use of each social network individually using a single-item scale with five response options. WhatsApp use (i.e., a messaging application) was evaluated in the same manner. The Short Social Networks Addiction Scale-6 Symptoms was employed to assess potential addictive behaviors to social network use. The psychosocial health was assessed using the Strengths and Difficulties Questionnaire. Generalized linear regression models were conducted, and predictive probabilities of having psychosocial health problems were calculated.ResultsThe predicted probability of presenting psychosocial health problems in the medium users and high users of social networks was 19.3% (95% confidence interval [CI] 13.0 to 27.7), and 16.2% (95% CI 10.2 to 24.6) higher compared to low users, respectively. High usage of Instagram, TikTok, Snapchat, and Facebook was associated with increased probabilities of psychosocial health problems, with Facebook showing the highest probabilities, at 31.3% (95% CI 14.8 to 54.2) for medium users and 51.9% (95% CI 26.5 to 76.3) for high users. Additionally, adolescents with addictive behaviors to social network use had from 19.0 to 25.2% probabilities of experiencing psychosocial health problems. Finally, the highest probabilities of having psychosocial health problems were identified in adolescents with high addictive behaviors when using social networks (28.9%; 95% CI 19.3 to 40.8%) and the lowest in those with low addictive behaviors (6.8%; 95% CI 3.3 to 13.6%).ConclusionAdolescents who use social networks more frequently and exhibit more addictive behaviors related to their use are more likely to experience psychosocial health problems compared to those who do not. Facebook showed the strongest association, followed by Snapchat, Instagram, and TikTok. Our data also revealed that adolescents exhibit various signs of addictive behaviors to social network use.

Surgeon Preference for Maximizing Medical Care Is Associated with Recommending More Extensive Surgery for Low-Risk Thyroid Cancer.

Background: While patient-level determinants of total thyroidectomy use have been well described, surgeon-level drivers of more extensive surgery are present and less well described. This survey sought to examine the associations between surgeons' operative recommendations, their beliefs about cancer, and their attitudes about medical maximizing-minimizing. Methods: A mixed-mode, cross-sectional survey was administered in September 2020 via mail and email to 222 thyroid surgeons identified in the Centers for Medicare & Medicaid Services Provider Utilization and Payment Physician and Other Practitioners dataset. Participants were asked their treatment recommendation for a healthy 45-year-old woman with a solitary 2.0-cm papillary thyroid cancer. Surgeons were assessed with the Brief Worry Scale and a validated, single-item measure of cancer-related worry. The Clinician Maximizer-Minimizer scale was used to assess the extent of medical care that physicians tend to favor with their patients. Participants were categorized into terciles based on their responses to the Maximizer-Minimizer scale. The highest scoring tercile ("Maximizers") was compared with the two lower terciles by Student's t-tests, chi-square, ANOVA, and logistic regression. Results: Of the 149 surgeons (response rate 67.1%), 34.9% recommended total thyroidectomy with or without central neck dissection (CND), and 65.1% recommended lobectomy. Overall, the medical Maximizer-Minimizer scale had an average score of 24.6 (SD 6.8). There were no differences between surgeons' age, race, annual thyroidectomy volume, or practice setting by their Maximizer-Minimizer classification. Participants who recommended total thyroidectomy with or without CND had significantly higher Maximizer-Minimizer scores than those recommending lobectomy (25.9 ± 7.2 vs. 23.8 ± 6.4, p = 0.03). Those classified as maximizers also had more cancer-related worry on both the single-item and Brief Worry Scales (p = 0.02). On logistic regression controlling for age, sex, race, specialty training, practice setting, and annual thyroidectomy volume, maximizers were still more likely to recommend total thyroidectomy with or without a CND (OR 2.4, [CI 1.01-5.55], p = 0.047). Conclusions: Medical maximizing-minimizing tendencies represent one of potentially many unmeasured surgeon characteristics that may explain persistent patterns of over-diagnosis, over-treatment, and over-screening. Surgeons may benefit from awareness of how their own tendencies influence their surgical recommendations in patients with low-risk thyroid cancer.

Assessing Autonomy, Competence, and Relatedness Briefly

Abstract: The satisfaction of the psychological needs for autonomy, competence, and relatedness have been established as central components of human well-being, predictive of various positive behavioral and psychological outcomes. However, in many contexts, they need to be assessed very briefly, sometimes with just one item. Recent research has shown that well-designed single-item scales of relatively unidimensional constructs can perform surprisingly well. Accordingly, this project aimed to create and validate single-item scales for the three needs. In Study 1 ( n = 353, UK), we generated new items based on careful examination of the construct definitions and tested them alongside established multi-item need satisfaction scales. In Study 2 ( n = 335, US), we replicated these results using a shorter time span (need satisfaction yesterday). Study 3 ( n = 327, UK) compared the performance to a few other brief need satisfaction scales. In all studies, the new single items loaded excellently on respective longer scales and correlated with criterion variables at near identical levels as the longer scales. Given that the performance of the single-item scales was comparable to the established multi-item scales, they are recommended as valid and useful measures of need satisfaction for research context requiring very brief measures.

Capturing patient-reported sleep disturbance in atopic dermatitis clinical trials

BackgroundPatient-focused approaches to capturing day-to-day variability in sleep disturbance are needed to properly evaluate the sleep benefits of new treatments. Such approaches rely on patient-reported outcome (PRO) measures validated in the target patient population.MethodsUsing atopic dermatitis (AD) as an example of a disease in which sleep is commonly disturbed, we developed a strategy for measuring sleep disturbance in AD trials. In developing this strategy, we conducted a targeted literature review and held concept elicitation interviews with adolescents and adults with AD. We subsequently identified potentially suitable PRO measures and cognitively debriefed them. Finally, we evaluated their psychometric properties using data from phase 2b (NCT03100344) and phase 3 (NCT03985943 and NCT03989349) clinical trials.ResultsThe literature review confirmed that sleep disturbance is a key impact of AD but failed to identify validated PRO measures for assessing fluctuations in sleep disturbance. Subsequent concept elicitation interviews confirmed the multidimensional nature of sleep disturbance in AD and supported use of a single-item measure to assess overall sleep disturbance severity, complemented by a diary to capture individual components of sleep disturbance. The single-item sleep disturbance numerical rating scale (SD NRS) and multi-item Subject Sleep Diary (SSD)—an AD-adapted version of the Consensus Sleep Diary—were identified as potentially suitable PRO measures. Cognitive debriefing of the SD NRS and SSD demonstrated their content validity and their understandability to patients. Psychometric analyses based on AD trial data showed that the SD NRS is a well-defined, reliable, and fit-for-purpose measure of sleep disturbance in adults with AD. Furthermore, the SD NRS correlated with many SSD sleep parameters, suggesting that most concepts from the SSD can be covered using the SD NRS.ConclusionsUsing these findings, we developed an approach for measuring sleep disturbance in AD trials. Subject to further research, the same approach could also be applied to future trials of other skin diseases where itch causes sleep disturbance.

Verbal and pictorial single-item scales are as good as their 10-item counterparts for measuring perceived usability

Single-item scales of perceived usability are attractive due to their efficiency and non-verbal scales are attractive because they enable collecting data from individuals irrespective of their language proficiency. We tested experimentally whether single-item verbal and pictorial scales can compete with their 10-item counterparts at reflecting the difference in usability between well-designed and poorly designed systems. N = 1079 (Experiment 1) and N = 1092 (Experiment 2) participants worked with two systems whose usability was experimentally manipulated. Perceived usability was assessed using the 10-item System Usability Scale, the single-item Adjective Rating Scale, the 10-item Pictorial System Usability Scale and the Pictorial Single-Item Usability Scale. The single-item scales reflect the difference in usability as good as their 10-item counterparts. The pictorial scales are nearly as valid as their verbal counterparts. The single-item Adjective Rating Scale and the Pictorial Single-Item Usability Scale are thus efficient and valid alternatives to their 10-item counterparts.

Identifying the risk of depression in a large sample of adolescents: An artificial neural network based on random forest.

This study aims to develop an artificial neural network (ANN) prediction model incorporating random forest (RF) screening ability for predicting the risk of depression in adolescents and identifies key risk factors to provide a new approach for primary care screening of depression among adolescents. The data were from a large cross-sectional study conducted in China from July to September 2021, enrolling 8635 adolescents aged 10-17 with their parents. We used the Patient health questionnaire (PHQ-9) to rate adolescent depression symptoms, using scales and single-item questions to collect demographic information and other variables. Initial model variables screening used the RF importance assessment, followed by building prediction model using the screened variables through the ANN. The rate of depression symptoms in adolescents was 24.6%, and the depression risk prediction model was built based on 70% of the training set and 30% of the test set. Ten variables were included in the final prediction model with a model accuracy of 85.03%, AUC of 0.892, specificity of 89.79%, and sensitivity of 70.81%. The top 10 significant factors of depression risk were adolescent rumination, adolescent self-esteem, adolescent mobile phone addiction, peer victimization, care in parenting styles, overprotection in parenting styles, academic pressure, conflict in parent-child relationship, parental rumination, and relationship between parents. The ANN model based on the RF effectively identifies depression risk in adolescents and provides a methodological reference for large-scale primary screening. Cross-sectional studies and single-item scales limit further improvements in model accuracy.

Social isolation and psychosocial functioning among cancer survivors in the Cancer Prevention Study-3.

e23170 Background: Social isolation is a major public health concern due to its effects on morbidity and mortality in the general population. Emerging evidence suggests greater social isolation among individuals diagnosed with cancer, but there is limited understanding of its relationship with psychosocial functioning in cancer survivors. This study examined associations of social isolation and mental health, sleep quality, and health-related quality of life (HRQoL) among cancer survivors and age-matched controls in the Cancer Prevention Study-3 cohort. Methods: We included 4,137 cancer survivors and 12,411 controls who provided complete data for variables of interest on the 2018 survey. Social isolation was assessed on a 5-point scale by the Social Network Index, and classified as low (0-1), moderate (2), and high (3-4). Raw scores from the PROMIS Global Health Scale for HRQoL (10 items) and global mental health (GMH; 4 items) were converted to T-scores (higher score = better). Sleep quality was assessed by a single-item 4-point scale: 1 (very poor) to 4 (very well). ANCOVA analyses were adjusted for age, sex, BMI, education, smoking status, alcohol consumption, and physical activity (PA), as well as stratified by age, sex, and lifestyle factors. Results: Mean age of the population was 60 (34-77) years, 76% were female and 90% non-Hispanic White. Thirty-two percent of survivors and 30% of controls reported moderate to high levels of social isolation. Mean scores for sleep quality, GMH, and HRQoL were significantly lower among survivors vs. controls (all P ≤0.01). There were no significant cancer (yes/no) x social isolation interactions. Among all study participants, ANCOVAs showed that high (vs. low) social isolation was associated with poorer sleep quality (adjusted mean difference = 4%; effect size, ES = 0.14), worse GMH (adjusted mean difference = 12%; ES = 0.68), and lower HRQoL (adjusted mean difference = 8%; ES = 0.57; all Ptrend &lt; 0.0001). Stratified analyses showed stronger associations between greater social isolation and lower HRQoL among females vs. males, less active ( &lt; 15 MET-hr/wk) vs. more active (≥15 MET-hr/wk) participants, and infrequent (none/less than daily) vs. regular alcohol drinkers (≥1 drinks/day). The higher social isolation-lower GMH association was also stronger in females vs. males and less active vs. more active participants. The social isolation-sleep quality association was stronger among infrequent vs. regular alcohol drinkers. Conclusions: These results indicated that high social isolation is associated with poorer sleep quality, mental health, and health-related quality of life, independent of cancer diagnosis. Women and less active participants may be particularly at risk, suggesting that targeted interventions to reduce social isolation in these populations may be warranted. Support: The ACS funds the creation, maintenance, and updating of the CPS-3 cohort.

Evaluation of Pain Through a Novel Mobile Application: The Visual, Auditory, and Tactile Scale (VATAS).

Developing a validated, standardized, and easily accessible pain assessment tool is the first step toward improving pain management. Since pain measurement is often used as a primary or secondary endpoint in daily clinical practice and clinical trials, accurate and precise pain measurement is of great importance. Therefore, there is a need for a valid, reliable, safe, and low-cost method to measure and assess pain levels more objectively. Traditional measurement tools, still considered the gold standard in clinical pain research, have significant disadvantages, including low sensitivity and higher rates of false responses. Perhaps most importantly, the assumption that general pain is a one-dimensional experience that can be measured with a single-item scale is limiting. Recently, new technologies utilizing smart devices have emerged to improve existing traditional pain outcome measures. The Visual, Auditory, and Tactile Analog Scale (VATAS) was designed to address tactile, auditory, and visual senses. By including multiple senses, it is thought that errors arising from the objectification of pain solely through a single-dimensional scale, such as Visual Analog Scale (VAS), could be eliminated, providing a more standardized and repeatable pain assessment. VATAS has the potential to complement the deficiencies of standard pain measurement methods by appealing to multiple senses. It can provide a more standardized, patient-compliant, and repeatable pain assessment. Furthermore, it can be used for evaluating and recording pain in visually impaired patients and has the potential for data tracking, allowing patients' pain to be monitored even when they are at home.

From Mind to Plate to Pillow: Examining the Interplay of Mental Health, Eating Disorders, and Sleep Quality

In the context of the contemporary accelerated pace of life, emphasizing the importance of sleep quality is essential for enhancing overall well-being and health. Historically underestimated, recent studies highlight sleep’s vital importance for physical, mental, and emotional well-being. Chronic sleep deprivation is connected to numerous health problems such as cardiovascular disease, diabetes, and weakened immune response. Additionally, lack of sleep can worsen stress, depression, and anxiety, impairing daily life and overall quality of life. This study investigates the link between poor sleep quality and key factors affecting wellness, such as mental health and eating disorders. Through a cross-sectional analysis involving 407 participants, utilizing established measures including the Depression Anxiety Stress Scale (DASS-21), the Eating Disorder Examination Questionnaire Short (EDE-QS), and the single-item Sleep Quality Scale (SQS), data were collected and analyzed using SPSS v28 and R-Statistics. The findings reveal a significant correlation (p &lt; 0.05) between DASS-21, EDE-QS, and SQS, indicating that individuals experiencing poor sleep quality exhibit higher levels of depression, anxiety, and stress. Furthermore, multinomial logistic regression analysis highlights low sleep quality as a risk factor for both mental health (OR: 1.071, 95% CI: 1.042, 1.102, p &lt; 0.05, low vs. high sleep quality) and eating disorders (OR: 1.047, 95% CI: 1.004, 1.092, p &lt; 0.05, low vs. high sleep quality). Overall, these results underscore the critical role of sleep quality in mental health and suggest that insomnia is a predictive factor for both poor mental well-being and disordered eating habits. The main contribution of this study is its identification of poor sleep quality as a common risk factor linking mental health issues and eating disorders, which emphasizes the need for integrated treatment strategies focusing on sleep improvement. Further research through randomized controlled trials is warranted to validate the findings of this cross-sectional study.

Sex and age differences in self-reported immune fitness

Studies have reported sex and age differences in self-rated health. On average, women rate their health as being poorer compared to men, and older individuals report poorer health than younger individuals. The current study evaluated sex and age differences for self-reported immune fitness, i.e. the capacity of the body to respond to health challenges (such as infections) by activating an appropriate immune response in order to promote health and prevent and resolve disease. Data from different survey studies (N = 8586) were combined for the current analyses. N = 8064 participants (93.3%) completed the single-item scale to assess momentary immune fitness (mean (Standard deviation, SD) age of 32.4 (16.7) years old, range: 18 to 103, 68.0% women) and N = 4263 participants (49.7%) completed the Immune Status Questionnaire (ISQ) to assess past year's immune fitness (mean (SD) age of 40.9 (17.1) years old, range: 18 to 103, 61.1% women). The analyses revealed that women rated their momentary and past year's immune fitness significantly lower than men (p < 0.001). A small but significant decline in momentary immune fitness when aging was found (r = −0.073, p < 0.001). In contrast, past year's immune fitness steadily improved with progressing age (r = 0.295, p < 0.001), and for each age group the difference from the 18–24 years old group was statistically significant (p < 0.001). When using age as covariate, the sex differences in immune fitness remained significant for both momentary immune fitness (p < 0.001) and past year's immune fitness (p < 0.001). In conclusion, women report a poorer momentary and past year's immune fitness than men. The sex effects in immune fitness are robust and seen across all age groups except the elderly. A relative stable momentary immune fitness was found across the age groups. However, past year's immune fitness (assessments with the ISQ) improved with age. This observation may be related to the fact that the studies comprised convenience samples. Therefore, the observed age effects should be interpreted with caution and require further investigation in nationally representative samples.

Treatment-seeking threshold and accessibility of psychiatric outpatient services in Switzerland: the relationship with stigma and self-esteem.

Perceived stigmatization and low self-esteem are linked to poorer mental health outcomes, but their impact on treatment-seeking thresholds and the importance of outpatient service location remain unclear. The study included 525 outpatients of the University Psychiatric Clinic (UPK) Basel, Switzerland, of whom 346 were treated at inner city services and 179 at services located on the main site of the UPK at the outer city limits. Perceived discrimination and devaluation (PDD), self-esteem (SE), treatment-seeking threshold (TST), and accessibility were measured via a self-reported questionnaire. The PDD consisted of 12 items evaluating beliefs about the level of stigma towards individuals with mental illness in the general population on a 5-point Likert scale. SE, TST and accessibility were assessed through single-item 7-point Likert scales. PDD and SE were positively correlated (p < 0.001), suggesting that lower perceived stigma was linked to higher self-esteem, and were not associated with TST. The relationship between PDD and SE remained consistent after controlling for age, gender, and nationality. Age was negatively correlated with TST (p = 0.022), while gender did not significantly influence any of the variables. There was little variation regarding PDD, with emergencies at the site of the psychiatric clinic and substance use disorder (SUD) patients reporting higher levels of stigmatization. Emergency patients and those with SUD and personality disorder reported the lowest SE ratings. TST showed a broad range and was highest for emergency services and transcultural psychiatry patients. Differences in accessibility were mainly linked to the location, with outpatient service users in the inner city reporting better accessibility (p < 0.001) and higher SE (p = 0.009). In comparison to patients using services with planned contacts only, patients in emergency settings differed by higher TST (p = 0.018) and better ratings of accessibility (p = 0.004). In conclusion, there was a relevant amount of stigmatization, impaired self-esteem, and, for some outpatient services, high thresholds to seek treatment. Future research should explore other factors influencing TST. The findings highlight the need to address stigmatization and accessibility when planning mental health services.

Prevalence and Assessment of Factors Associated With Malnutrition in Children Residing in Slums of Mumbai: A Cross-Sectional Study.

Background Malnutrition in children continues to be a serious public health problem in India. Therefore, this study aims to evaluate the prevalence of malnutrition and assess factors contributing to it in children of the marginalized slum population of India, masked in the metropolitan cities. Methods A retrospective data analysis with a cross-sectional model was conducted by medical volunteers affiliated with the Rotaract Club of Medicrew who had organized a free pediatric health check-up camp in the Dharavi village of Mumbai, India for children under five. Children under five years of age group of either sex residing in the slums of Dharavi and whose parents consented are included in the study. Neonates, children older than five years of age, and children whose parents did not consent for them to be included in the study were excluded. A pretested, pre-validated questionnaire was administered, and statistical analysis was done with p-values <0.05 considered to be statistically significant. Results A total of 126 children were included. Out of these children, 109 of them (86.50%) had a mid-arm circumference of more than 12.5 cm (normal), 11 (8.73%) were between 11.5 cm and 12.5 cm (moderate acute malnutrition), and five (4.77%) were less than 11.5 cm (severe acute malnutrition). Among the 126 kids, 86 kids were above the age of two and their BMI was assessed, 36 (44.19%) were found to be underweight (<5th percentile) while 14 (16.3%) were obese (>95th percentile), and four (4.65%) were overweight (85th-95th percentile). For 106 (84.13%) of these children, the caregivers were mothers while others were fathers (n=4; 3.18%), grandmothers (n=5; 3.97%), sisters (n=5; 3.97%), and aunts (n=6; 4.76%). Out of those who had commenced receiving formal education, only 39 (55.71%) were in an appropriate grade for their age. The mean expenditure on food as a proportion of the total household income was 36.40% (standard deviation (SD) 15.0%). On the single-item sleep quality scale, the sleep of only 36 kids (28.58%) was reported by their caregivers as excellent. A high proportion of other medical problems were reported in the children. Conclusion Our study reports a substantial burden of malnutrition among children residing in the slums of Dharavi. Rigorous strengthening and conceptualization of on-ground nutritional programs targeted towardslum children should be done by Indian healthcare policymakers.

Starting well to stay well - randomised controlled trial of Whitu, an app for improving the well-being of university students

IntroductionUniversity students often face challenges to their well-being and up to a third develop mental health problems. Given high rates of smartphone use among this group, app-based digital mental health interventions may play a role in preventing these problems. Previously demonstrated to improve well-being and mental health outcomes in young people aged 16-25, ‘Whitu: seven ways in seven days’ is a well-being app based on positive psychology, cognitive behaviour therapy (CBT) and psychoeducation principles.ObjectivesThis randomised controlled trial was undertaken to evaluate the efficacy, usability and acceptability of Whitu with first year university students.Methods Ninety first year university students were recruited via a social media advertising campaign to take part in a prospective randomised controlled trial of Whitu against a standard university self-help website, with 45 participants in each arm. Primary outcomes were changes in well-being on the World Health Organisation 5-item well-being index (WHO-5) and short Warwick-Edinburgh mental well-being escale (SWEMWBS). Secondary outcomes were changes in depression on the Centre for Epidemiological Studies Depression Scale (CES-D), anxiety on the Generalised Anxiety Disorder seven item scale (GAD-7), self-compassion on the Self Compassion Scale- Short Form (SCS-SF), stress on the 10-item Perceived Stress Scale (PSS-10), sleep on the single-item Sleep Quality Scale (SQS), and self-reported acceptability of the app. Outcomes were evaluated at baseline, four weeks (primary study endpoint) and three months.Results At 4 weeks, participants in the intervention group experienced significantly higher mental well-being and significantly lower depression compared to controls. Emotional well-being among the Whitu group was greater in the intervention group at 3 months. Other outcomes did not differ between groups. User feedback was positive, with 88% of those who provided feedback saying they would recommend the app to a friend.ConclusionsOur findings provide preliminary evidence that Whitu is an acceptable and more effective, scalable and multi-modal means of improving some aspects of well-being and mental health among university students than direction to a self-help website.Disclosure of InterestNone Declared

Burnout at a tertiary eye care center significantly higher after the start of COVID-19

ObjectiveTo better understand the burnout rates among ophthalmologists before and after the start of COVID-19 in the United States. DesignRetrospective observational study integrating cross-sectional data from annual faculty surveys conducted in 2018, 2021, and 2022, plus a separate, single-item burnout survey administered prospectively in 2022 and repeated six months later to faculty members, trainees, and staff members. SubjectsUniversity of Michigan faculty, trainees, and staff at a tertiary eye care center (Kellogg Eye Center), and Women in Ophthalmology (WIO) members. MethodsA validated, single-item burnout assessment on a 5-point scale was electronically distributed to WIO and Kellogg physicians and staff in late 2022. Links to wellness resources were provided at submission. The survey was redistributed after six months, with an added question on resource utilization. Responses were compared to Kellogg's Annual Faculty Survey in 2018, 2021, and 2022, which included the same single-item burnout measure. All responses to the single-item scale were dichotomized based on presence of burnout. Self-reported wellness resource utilization was also assessed. OutcomesSelf-reported measures of burnout. ResultsA total of 73, 91, and 81 ophthalmologists on faculty completed the Annual Faculty Survey in 2018, 2021 and 2022, representing a response rate of 64 %, 79 %, and 69 %. The response rate for the single-item survey sent to Kellogg among ophthalmologists in 2022 was 43 %. The Kellogg ophthalmologist burnout rate in 2018 was 39.7 % and was significantly higher in 2021 at 70.3 % (p = 0.0001), and in 2022 at 70.4 %. Burnout rates amongst WIO members and Kellogg ophthalmologists were similar. While no respondents to the single-item survey in 2018 reported the most severe burnout score, in 2021, responses shifted to include the most severe answers. Some respondents reported utilizing wellness resources, follow-up results did not demonstrate significantly decreased burnout in any group. ConclusionsIn 2018, ophthalmologists’ burnout rates at this academic eye center were in line with national averages. However, a significant increase in burnout was seen in 2021 onwards, with a shift towards more severe burnout responses. Though numerous factors may account for these changes, COVID-19 may be a significant contributor. Future work may focus on specific contributors to increased rates of burnout amongst ophthalmologists.

Is Less Sometimes More? An Experimental Comparison of Four Measures of Perceived Usability.

In usability studies, the subjective component of usability, perceived usability, is often of interest besides the objective usability components, efficiency and effectiveness. Perceived usability is typically investigated using questionnaires. Our goal was to assess experimentally which of four perceived-usability questionnaires differing in length best reflects the difference in perceived usability between systems. Conventional measurement wisdom strongly favors multi-item questionnaires, as measures based on more items supposedly yield better results. However, this assumption is controversial. Single-item questionnaires also have distinct advantages and it has been shown repeatedly that single-item measures can be viable alternatives to multi-item measures. N = 1089 (Experiment 1) and N = 1095 (Experiment 2) participants rated the perceived usability of a good or a poor web-based mobile phone contract system using the 35-item ISONORM 9241/10 (Experiment 1 only), the 10-item System Usability Scale (SUS), the 4-item Usability Metric for User Experience (UMUX), and the single-item Adjective Rating Scale. The Adjective Rating Scale represented the perceived-usability difference between both systems at least as good as, or significantly better than, the multi-item questionnaires (significantly better than the UMUX and the ISONORM 9241/10 in Experiment 1, significantly better than the SUS in Experiment 2). The single-item Adjective Rating Scale is a viable alternative to multi-item perceived-usability questionnaires. Extremely short instruments can be recommended to measure perceived usability, at least for simple user interfaces that can be considered concrete-singular in the sense that raters understand which entity is being rated and what is being rated is reasonably homogenous.

Uncovering heterogeneity in mental health changes among first-year medical students

ABSTRACT Introduction The initial year of medical school is linked to a decline in mental health. To assess mental health comprehensively, the dual-factor model posits the consideration of both psychopathology (e.g., depression) and positive mental health (e.g., well-being). Previous mental health research among medical students has primarily examined these two factors independently. This study uses the dual-factor approach for a deeper understanding of mental health changes during the first year of medical school. Methods Students from eight German medical schools (N = 450) were surveyed three times (T0 = entering medical school, T1 = end of the first semester, T2 = end of the second semester) regarding depression (PHQ-9), well-being (subscale of FAHW-12), and general life satisfaction (German Single-Item Scale L1). Latent profile analysis was used to identify distinct mental health groups based on their combinations of psychopathology and positive mental health. We then analysed trajectories descriptively by examining the longitudinal stability and dynamics of mental health group membership during the first year of medical school. Results We identified five mental health groups: (1) complete mental health, (2) moderately mentally healthy, (3) symptomatic but content, (4) vulnerable, and (5) troubled. The examination of change trajectories unveiled diverse paths pointing towards both recovery and deterioration. In comparison to the other groups, students belonging to the complete mental health group exhibited greater stability and a higher potential to recover after initial deteriorations in the first semester. Conclusions Our study uncovers distinct mental health trajectories in the first year of medical school, emphasizing the crucial role of initial mental health status. Our findings stress the diverse nature of mental health changes in medical students, underscoring the need for tailored prevention strategies. The implications for research and practice are discussed.

Influence of Clinical and Demographic Variables 0n the Quality of Life in Patients with Cervical Cancer

Background: Cervical cancer remains a significant public health issue, particularly in low- and middle-income countries, where it disproportionately affects women's quality of life (QoL). Understanding the impact of clinical and demographic variables on the QoL of patients with cervical cancer is crucial for improving care and support strategies. Objective: This study aims to assess how clinical and demographic factors influence the QoL of Pakistani women diagnosed with cervical cancer, comparing these findings against established benchmarks for both healthy individuals and those with malignancies. Methods: Conducted at a leading cancer centre in Pakistan from April to September 2022, this cross-sectional study involved 186 women with histopathologically confirmed cervical cancer, identified through a population-based cancer database. QoL was evaluated using the Organization for Research and Treatment of Cancer QLQ-C30 (Version 3.0) questionnaire, encompassing functional scales, symptom scales, single-item scales, and a global health status score. Data analysis was performed using SPSS version 25, applying logistic regression to identify factors significantly associated with QoL outcomes. Results: The median global health status score for enrolled patients was 50.0 [interquartile range (IQR) 33.3 - 66.7], significantly lower than the reference values for healthy females (58.0 [IQR 41.3 - 82.7]) and those with any malignancy (71.0 at age 55). Functional scale scores indicated compromised physical (65.7 [IQR 60.0 - 75.0]) and social (67.7 [IQR 56.0 - 100]) functioning. Symptom scale scores revealed high levels of pain (84.3 [IQR 65.7 - 84.3]) and fatigue (78.8 [IQR 55.7 - 88.7]). Regression analysis highlighted age and education level as significant predictors of physical health outcomes. Conclusion: The study underscores the profound impact of cervical cancer on the QoL of Pakistani women, with age and education level emerging as key determinants. These findings call for tailored interventions to address the specific needs of this patient population, emphasizing the need for early detection and comprehensive support services.