Single Item Research Articles

Network structures of internet gaming disorder and gaming disorder: Symptom operationalization causes variation.

From 2022, the International Classification of Diseases, eleventh edition (ICD-11) includes the first mental disorder based on digital technology, "gaming disorder," which was previously suggested as a condition for further examination in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). In this cross-sectional study, we provide the first large-scale network analysis of various symptom structures for these constructs to understand the complex interconnections between their proposed symptoms. Culturally diverse samples of 2,846 digital game players (M = 25.3 years) and 746 esports players (M = 23.5 years) were recruited. A network approach was applied to explore a multiverse of gaming disorder symptom structures, effects of item operationalization, and possible external moderators. Gaming disorder was measured using the Internet Gaming Disorder Scale 9-Short Form (IGDS9-SF), Gaming Disorder Test, and several items borrowed from Chinese Internet Gaming Disorder Scale, Personal Internet Gaming Disorder Evaluation-9, and Clinical Video game Addiction Test 2.0 scales. Two symptoms (loss of control and continued use despite problems) present in both, the DSM-5 and ICD-11, were systematically central to most of the analyzed networks. Alternative operationalizations of single items systematically caused significant network differences. Networks were invariant across groups of play style, age, gender, gaming time, and most of the psychosocial characteristics. Our results caution practitioners and researchers when studying and interpreting gaming disorder symptoms. The data indicate that even minor operational changes in symptoms can lead to significant network-level changes, thus highlighting the need for careful wording. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Testing expectations and retrieval practice modulate repetition learning of visuospatial arrays.

One of the best-known demonstrations of long-term learning through repetition is the Hebb effect: Immediate recall of a memory list repeated amidst nonrepeated lists improves steadily with repetitions. However, previous studies often failed to observe this effect for visuospatial arrays. Souza and Oberauer (2022) showed that the strongest determinant for producing learning was the difficulty of the test: Learning was consistently observed when participants recalled all items of a visuospatial array (difficult test) but not if only one item was recalled, or recognition procedures were used (less difficult tests). This suggests that long-term learning was promoted by increased testing demands over the short term. Alternatively, it is possible that lower testing demands still lead to learning but prevented the application of what was learned. In four preregistered experiments (N = 981), we ruled out this alternative explanation: Changing the type of memory test midway through the experiment from less demanding (i.e., single item recall or recognition) to a more demanding test (i.e., full item recall) did not reveal hidden learning, and changing it from the more demanding to a less demanding test did not conceal learning. Mixing high and low demanding tests for nonrepeated arrays, however, eventually produced Hebb learning even for the less demanding testing conditions. We propose that testing affects long-term learning in two ways: Expectations of the test difficulty influence how information is encoded into memory, and retrieval consolidates this information in memory. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Translation and Psychometric Testing of the Hägerbäumer Presenteeism Scale in English.

Interest in presenteeism has increased in research. Presenteeism is a behaviour of going to work despite illness. It has been predominantly measured using single items, which introduce limitations to validity. To overcome these limitations, Hägerbäumer developed a German multi-item presenteeism scale. The aim of the study was to provide an English translation and psychometric testing of the scale. This was conducted in two phases with native English-speaking employed adults. Phase 1 includes translation and cognitive debriefing, phase 2 testing construct validity and internal consistency reliability. Cognitive debriefing with 10 employees revealed no problems with understanding or answering the translated items. In total, 487 employed adults participated in the study, of which data from 287 were included in the analysis. For structural validity, the goodness-of-fit indicators all reached their thresholds (TLI = 0.98, CFI = 0.99, RMSEA = 0.07, SRMR = 0.02). The scale does not show differences between sexes and age groups but between sectors (F6,70.95 = 5.53, p < 0.001). The internal consistency reliability was satisfactory with α = 0.89 (CI 95%, 0.87-0.91). The translated multidimensional scale for measuring presenteeism at the behavioural level demonstrated good psychometric properties in an initial validation. Further psychometric testing is required before using this scale in cross-national comparison in research and international companies.

Loneliness, belonging and psychosomatic complaints across late adolescence and young adulthood: a Swedish cohort study

BackgroundLoneliness and belonging refer to social connectedness and are associated with young people’s health; however, the relationship between these constructs and their impact on health is still being discussed. A dual continuum model of belonging and loneliness has been suggested, consisting of four groups depending on the state of loneliness and belonging: socially fulfilled (low loneliness, high belonging), socially indifferent (low loneliness, low belonging), socially searching (high loneliness, high belonging), and socially distressed (high loneliness, low belonging). The aim of this study is to examine loneliness and belonging in a Swedish sample of 17–18-years-olds who were followed over 3 years, and the associations that these aspects share with young people’s psychosomatic complaints during these ages.MethodsSwedish cohort data collected among late adolescents (age 17–18 in 2019) who were followed up in young adulthood (age 20–21 in 2022) (n = 2684) was used to examine the associations between loneliness, belonging, and psychosomatic complaints. Loneliness and belonging were measured by single items and the cross-combinations of these. Three psychosomatic complaints were assessed: stomach ache, headache, and difficulties falling asleep, and a summary index was calculated.ResultsLinear regression analyses showed that loneliness was positively and belonging was negatively cross-sectionally associated with psychosomatic complaints. The socially fulfilled group reported fewer psychosomatic complaints compared to all other groups, while the socially distressed group reported the highest level of psychosomatic complaints. Additional adjustment for sociodemographic characteristics barely affected the estimates. The prospective analysis supported these patterns; however, after adjustment for earlier psychosomatic complaints, the only statistically significant difference in subsequent psychosomatic complaints was found between the socially fulfilled and the socially distressed groups.ConclusionsLoneliness and belonging (separately and the cross-combinations of these) were cross-sectionally associated with psychosomatic complaints in late adolescence and in young adulthood. Prospectively, only the most vulnerable group in the dual continuum model, the socially distressed group, experienced more psychosomatic complaints than the socially fulfilled group, indicating a temporal relationship. Knowledge about the more nuanced links may be useful for developing specific public health recommendations and interventions for youth, targeting the most vulnerable groups.

Research on Vegetable Sales Volume and Pricing Strategy Based on GWO-LSTM Modeling

This paper focuses on an in-depth study of the problem of sales volume and pricing strategy for vegetable categories, aiming at constructing an automatic pricing and replenishment model to maximize revenue. First, by analyzing the sales data of each category and single item of vegetables, the mean value of sales volume is calculated, and the correlation between each category of vegetables is visualized using charts and Pearson correlation coefficient heat maps, and it is found that there is a significant correlation between specific categories. Secondly, this paper adopts the cost-plus pricing method to calculate the markup rate of each individual item and combines it with linear regression analysis to reveal the relationship between markup rate and sales volume, and further predicts the sales volume and price in the coming week through the GWO-LSTM model, which provides data-driven pricing and replenishment strategies for the superstore based on the data. Finally, for the data of a specific time, this paper develops a linear programming model to formulate a replenishment and pricing scheme that meets market demand and maximizes revenue. The methodology and findings of this study have important practical applications for retail formats such as fresh food superstores.

Happy Moments between Children and Their Parents: A Multi-method and Multi-informant Perspective

Research interest in children’s happiness has increasingly grown in recent years. Studies of children’s happiness have shown that happiness promotes greater social and emotional well-being during childhood. The present study explores the different perspectives of children and their parents on happy moments spent together, examining potential discrepancies in points of view. Semi-structured interviews were conducted with 154 children (6–13 years old: Mage=8.72, SD = 2.00; 57% girls), their mothers (Mage=42.30, SD = 4.50), and their fathers (Mage=45.47, SD = 5.42). Children were asked to indicate their level of happiness using a single item and to recount their happy moments spent with their fathers and mothers. Parents were asked to evaluate their children’s happiness and to identify what they thought was the happiest moment their children had experienced with them. The data was analyzed using Thematic Analysis. Six main themes related to children’s happy moments emerged from the transcripts: (1) Activities outside the home; (2) Shared activities between parents and children; (3) Happy moments of play between parents and children; (4) Parent-child moments of affection; (5) Relevance of material gifts; (6) Non-specified happy moments. Emotional interactions characterized the happiest moments reported with mothers, while those with fathers were more frequently playful and fun situations. Results showed that parents and children disagree on children’s happiness levels and tend to identify different episodes as the happiest moments spent together. The study examined parent-child interactions in the context of family happiness, considering the protective role of a child’s happiness against negative psychological symptoms. It aimed to identify components of happier moments as potential indicators of family well-being, given the family’s role in psychological development.

Physician Estimates and Patient-Reported Health Status in Atrial Fibrillation

A primary objective in managing atrial fibrillation (AF) is to optimize patients' health status, which can be done only if physicians accurately quantify the outcomes associated with AF in patients' lives. To explore physicians' estimation of the health status of patients with AF and its association with subsequent care and outcomes. A multicenter, prospective cohort study was conducted in 2 outpatient practices in Tokyo, Japan. Participants included patients with newly diagnosed AF or those referred for initial treatment of AF at outpatient practices and treating physicians from November 8, 2018, to April 1, 2020. Data analysis was performed from December 22, 2022, to July 7, 2023. Participating patients completed the Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire, a 20-item tool covering 4 domains with a 7-point Likert scale; 3 domains (symptoms, daily activities, and treatment concerns) were used in this study. Blinded to patients' responses, treating physicians answered a 3-item questionnaire quantifying each patient's AFEQT domain with a single item. Patients' mean Likert scale responses within each AFEQT domain were subtracted from the physicians' assessments so that higher scores (≥0.5 points) indicate physician underestimation, while lower scores (≤0.5 points) indicate physician overestimation of the health status of patients with AF. The independent association of physician-patient concordance with treatment escalation (alteration or initiation of antiarrhythmic drugs, cardioversion, or catheter ablation) and 1-year adjusted changes in AFEQT scores. Among 330 patients (238 [72.1%] men; mean [SD] age, 67.9 [11.9] years; 163 [49.4%] with paroxysmal AF), physicians correctly estimated health status in 112 patients (33.9%), underestimated it in 42 patients (12.7%), and overestimated it in 176 patients (53.3%). Treatment escalation occurred in 63.6% of patients whose health status was correctly estimated, 47.6% of those whose health status was underestimated, and 66.3% of patients whose health status was overestimated. After multivariable adjustment, underestimation of health status was independently associated with less treatment escalation (adjusted odds ratio, 0.43; 95% CI, 0.20-0.90) and less frequent AFEQT overall summary score improvement at 1 year (underestimated, 2.5 [95% CI, -1.6 to 6.7] vs correctly and overestimated health status, 8.4 [95% CI, 7.0-9.9] points; P = .01). In this cohort study, physician underestimation of the health status of patients with AF was common and associated with less aggressive treatment and less health status improvement at 1 year.

Factors Relating to Kanji Reading Accuracy in Kun‐readings: An Item‐Level Analysis

AbstractThis study sought to obtain comprehensive data on the difficulty level of kun‐reading (native Japanese reading) of Japanese kanji (Chinese characters adapted for Japanese) learned in junior high and high school. Drawing from an item‐based analysis, it explored the word variables related to the difficulty level of kun‐reading. A reading test comprising 645 kun‐readings of common kanji learned in junior high and high school was administered to 123 university students. Tobit regressions were conducted for the total, okurigana (phonetic kana letters suffix written after kanji), and single kanji items, using the word variables as independent variables and the reading accuracy as the dependent variable. Significant positive contributions were observed for imageability and word frequency for all item categories, kun‐reading ratio for the single kanji items, and okurigana ratio for the total items. A significant negative contribution was observed for okurigana neighborhood size for the okurigana items. The results highlighted the need for education focusing on the meanings of kanji characters, and for a language policy for the use of the okurigana.

An Electronic Health Record-integrated Web Application Augments a QI-directed Morbidity & Mortality Conference and Improves Quality of Care

BackgroundIn 2014, we developed a QI-directed Morbidity and Mortality (M&M) Conference, prioritizing discussion of individual and system failures, as well as development of action items to prevent failure recurrence. However, due to a reliance on individual electronic documents to store M&M data, our ability to assess trends in failures and action item implementation was hindered. To address this issue, in 2019, we created a secure electronic health record (EHR)-integrated web application (web app) to store M&M data. Study designIn this study, we assessed the impact of our web app on efficient review and tracking of M&M data, including system failure occurrence and closure of action items. Additionally, in 2021, it was discovered that a backlog of action items existed. To address this issue, we implemented a QI initiative to reduce the backlog, and used the web app to compare action item closure over time. ResultsUse of the web app dramatically improved review of M&M data. During the study period, there was a 67.0% reduction in the occurrence of the most common system failures. Additionally, our QI initiative resulted in a 97.7% reduction in the duration of time to complete a single action item and a 61.1% increase in the on-time closure rate for action items. ConclusionsIntegration of a web app into a QI-directed M&M Conference enhanced our ability to track system level failures and action item closure over time. Using this web app, we demonstrated that our M&M Conference achieved its intended goal of improving the quality of patient care. Level of EvidenceIV.

Limitations and opportunities for the appropriation of the Mediterranean diet in Chilean adults with diagnostic elements of metabolic syndrome

Background: a healthy food intake pattern, specifically the Mediterranean diet (MedDiet), is a factor associated with reduced risk, lower prevalence, and better management of chronic diseases. However, there is limited information regarding how patients integrate proposals for adherence to this food pattern in their daily lives. Objective: to identify factors and conditions that influence adherence to the MedDiet in Chile. Methods: an exploratory qualitative study was applied in 35 to 65-year-old patients of both sexes who presented at least one diagnostic criterion of metabolic syndrome (MetS). Through in-depth interviews and focal groups, knowledge, assessment, attitudes, and practices associated with changes and maintenance of healthy eating habits, with emphasis on the MedDiet, were investigated. Information analysis was carried out under the grounded theory approach using the ATLAS.ti software. Results: participants recognized the value of healthy eating, including the MedDiet, but declared low knowledge (identification of single foods items) together with facilitators (variety of ingredients) and limiting factors (taste, availability/cost of some items, family dynamics) for its routine adoption. In addition, change in eating habits generates a high initial cognitive and emotional load that requires not only individual but also relational effort as it implies modifications of family and collective practices. Conclusions: information obtained on barriers and opportunities to adhere to healthy eating such as the MedDiet is key to design and implement nutritional interventions based on this food pattern and that can be sustainable in time for chronic disease management in Chile.

Large-scale screening of clinical assessments to distinguish between states in the Integrated HD Progression Model (IHDPM).

Understanding the sensitivity and utility of clinical assessments across different HD stages is important for study/trial endpoint selection and clinical assessment development. The Integrated HD Progression Model (IHDPM) characterizes the complex symptom progression of HD and separates the disease into nine ordered disease states. To generate a temporal map of discriminatory clinical measures across the IHDPM states. We applied the IHDPM to all HD individuals in an integrated longitudinal HD dataset derived from four observational studies, obtaining disease state assignment for each study visit. Using large-scale screening, we estimated Cohen's effect sizes to rank the discriminative power of 2,472 clinical measures for separating observations in disease state pairs. Individual trajectories through IHDPM states were examined. Discriminative analyses were limited to individuals with observations in both states of the pairs compared (N = 3,790). Discriminative clinical measures were heterogeneous across the HD life course. UHDRS items were frequently identified as the best state pair discriminators, with UHDRS Motor items - most notably TMS - showing the highest discriminatory power between the early-disease states and early post-transition period states. UHDRS functional items emerged as strong discriminators from the transition period and on. Cognitive assessments showed good discriminative power between all state pairs examined, excepting state 1 vs. 2. Several non-UHDRS assessments were also flagged as excellent state discriminators for specific disease phases (e.g., SF-12). For certain state pairs, single assessment items other than total/summary scores were highlighted as having excellent discriminative power. By providing ranked quantitative scores indicating discriminatory ability of thousands of clinical measures between specific pairs of IHDPM states, our results will aid clinical trial designers select the most effective outcome measures tailored to their study cohort. Our observations may also assist in the development of end points targeting specific phases in the disease life course, through providing specific conceptual foci.

Pressure to provide milk among mothers of very low birth weight infants: an explorative study

BackgroundPump-dependent mothers of very low birth weight (VLBW, < 1500g) infants experience specific challenges achieving sufficient milk supply in the neonatal intensive care unit (NICU) and are therefore less frequently able to achieve (exclusive) breast milk feeding. Stress due to the limitations on participating in the infant’s care may contribute to this problem. Some explorative studies suggest that pressure to provide milk may be an additional stressor in mothers. However, the type of pressure to provide milk perceived by mothers of VLBW infants has rarely been examined.MethodsA retrospective and anonymous questionnaire was conducted with mothers of VLBW infants aged 6 to 24 months at the time of data collection. Quantitative data and written comments were used to examine the mothers’ perceptions. Descriptive and bivariate tests (Spearman´s rho, Pearson’s chi2) were performed to show correlations between pressure to provide breast milk, parental stress (PSS:NICU: role alteration subscale), milk volume, and maternal factors. Pressure to provide milk was measured through two self-developed single items to differentiate between internal and external pressures.ResultsData of n = 533 mothers of VLBW infants was analysed. More than 70% of the mothers agreed that they pressured themselves to provide milk for their infant. In contrast, 34% of the mothers agreed that they felt pressure from outside to provide milk. Higher milk volume 14 days post-partum was significantly correlated with less internal (Spearman´s rho = 0.2017, p = 0.000) and less external pressure to provide milk (Spearman´s rho = 0.2991; p = 0.000). Higher PSS:NICU parental role alteration scores were significantly correlated with more internal (Spearman´s rho = -0.2865, p = 0.000) and more external pressure to provide milk (Spearman´s rho = -0.1478; p = 0.002). Milk volume 14 days post-partum and the PSS:NICU were not significantly correlated (Spearman´s rho = -0.0190; p = 0.701). Qualitative analyses highlighted these results and enhanced the bidirectional relationships between maternal pressure to provide milk and milk volume.ConclusionsEspecially internal pressure to provide milk is perceived by many mothers, being mutually dependent on milk supply and parental stress. Pressure to provide milk may be an important factor to decrease maternal stress in the NICU and, therefore, lead to more positive pumping and breastfeeding experiences. More research and validated instruments are needed to adequately measure pressure to provide milk with its different psychological, social, and environmental dimensions.

Simulation clinic waste audit assessment and recommendations at the University of Washington School of Dentistry.

Dentistry produces waste contributing to climate change and adverse health outcomes, thus reducing waste is essential; however, there has been minimal emphasis on sustainability or climate action in dentistry. Waste audits quantify the type and amount of waste produced and may inform waste reduction strategies. We conducted a waste audit to identify areas of potential waste reduction and recommend interventions to reduce waste. In this cross-sectional study, we conducted a waste audit of garbage produced during a typical 4-hour pre-clinical restorative dentistry simulation exercise. The sample was composed of 72 second-year dental students. This exercise is part of a standard curriculum with a uniform format regarding supplies used and participants. Potentially infectious materials were not used during this exercise. In total, 26.6kg of waste was discarded. Plastic was the largest contributor by mass (57.5%), followed by paper barriers (19.6%), then impression materials (6.5%). We found 894 gloves and 70 masks discarded. Based on these findings, we categorized waste reduction opportunities into policy changes, purchasing sustainable materials, and increasing awareness through education. Specific suggested actions include: relaxing glove and gown requirements during laboratory simulations; replacing single use items with more sustainable options; increasing use of intraoral scanners; and posting informational signage with examples of what can be recycled.

The impact of different data handling strategies in exploratory and confirmatory factor analysis of diary measures: an evaluation using simulated and real-world asthma nighttime symptoms diary data

ABSTRACT Background Daily diaries are an important modality for patient-reported outcome assessment. They typically comprise multiple questions, so understanding their underlying structure is key to appropriate analysis and interpretation. Structural evaluation of such measures poses challenges due to the high volume of repeated measurements. Potential strategies include selecting a single day, averaging item-level observations over time, or using all data while accounting for its multilevel structure. Method The above strategies were evaluated in a simulated dataset via exploratory and confirmatory factor modelling by comparing their impact on various estimates (i.e., inter-item correlations, factor loadings, model fit). Each strategy was additionally explored using real-world data from an observational study (the Asthma Nighttime Symptoms Diary). Results Both single day and item average strategies resulted in biased factor loadings. The former displayed lower overall bias (single day: 0.064; item average: 0.121) and mean square error (single day: 0.007; item average: 0.016) but greater frequency of incorrect factor number identification compared with the latter (single day: 46.4%; item average: 0%). Increased estimated inter-item correlations were apparent in the item-average method. Non-trivial between- and within-person variance highlighted the utility of a multilevel approach. However, convergence issues and Heywood cases were more common under the multilevel approach (90.2% and 100.0%, respectively). Conclusions Our findings suggest that a multilevel approach can enhance our insight when evaluating the structural properties of daily diary data; however, implementation challenges still remain. Our work offers guidance on the impact of data handling decisions in diary assessment.

Reliability and validity of cross‑culturally adapted oral health‑related quality‑of‑Life instruments for Brazilian children and adolescents: a systematic review

Objective This systematic review aimed to review the reliability and validity of oral health-related quality of life (OHRQoL) questionnaires for Brazilian children and adolescents. Also, the cross-cultural adaptation was evaluated.Methods This systematic review is registered in PROSPERO (CRD42022300018) and was performed based on the COSMIN guideline. Electronic searches were performed in the PubMed/MEDLINE, Web of Science, Lilacs, BVS (BIREME), Scielo, and Embase databases until March 2023 by two independent reviewers. There was no restriction on time or language. The following studies were included: validation studies and cross-cultural adaptation of OHRQoL instruments into Brazilian Portuguese; studies that evaluated the measurement properties of OHRQoL questionnaires in children and adolescents and that reported at least one of the measurement properties: reliability, internal consistency, error measurement, content validity, construct validity, criterion validity, discriminant validity, and/or convergent validity. The following were excluded: studies of systematic reviews of OHRQoL measures; studies reporting OHRQoL assessment through instruments; construction (development) and validation of a new instrument; questionnaires that had a single item; and validation for Portuguese from Portugal. The cross-cultural adaptation process and psychometrics of the included studies were verified.Results 6556 articles were identified, and 19 manuscripts were included. All studies were conducted in Brazil, and the age of the participants ranged from 2 to 15.42 years old. Sixteen articles presented the cross-cultural validation steps. Cronbach's alpha of the revised instruments ranged from 0.59 to 0.86.ConclusionsIt can be concluded that most studies provided information and evidence regarding validity, reliability, translation, and cultural adaptation.

Measurement and stratification of nonsuicidal self-injury in adolescents

BackgroundNonsuicidal self-injury (NSSI) is highly prevalent in adolescents. In survey and interview studies assessing NSSI, methods of assessment have been shown to influence prevalence estimates. However, knowledge of which groups of adolescents that are identified with different measurement methods is lacking, and the characteristics of identified groups are yet to be investigated. Further, only a handful of studies have been carried out using exploratory methods to identify subgroups among adolescents with NSSI.MethodsThe performance of two prevalence measures (single-item vs. behavioral checklist) in the same cross-sectional community sample (n = 266, age M = 14.21, 58.3% female) of adolescents was compared regarding prevalence estimates and also characterization of the identified groups with lifetime NSSI prevalence. A cluster analysis was carried out in the same sample. Identified clusters were compared to the two groups defined using the prevalence measures.ResultsA total of 118 (44.4%) participants acknowledged having engaged in NSSI at least once. Of these, a group of 55 (20.7%) adolescents confirmed NSSI on a single item and 63 (23.7%) adolescents confirmed NSSI only on a behavioral checklist, while denying NSSI on the single item. Groups differed significantly, with the single-item group being more severely affected and having higher mean scores on difficulties in emotion regulation, self-criticism, number of methods, higher frequency of NSSI, higher rates of suicidal ideation and suicidal behavior and lower mean score on health-related quality of life. All cases with higher severity were not identified by the single-item question. Cluster analysis identified three clusters, two of which fit well with the groups identified by single-item and behavioral checklist measures.ConclusionsWhen investigating NSSI prevalence in adolescents, findings are influenced by the researchers’ choice of measures. The present study provides some directions toward what kind of influence to expect given the type of measure used, both with regards to the size of the identified group and its composition. Implications for future research as well as clinical and preventive work are discussed.

Pandemic Grief and Suicidal Ideation in Latin American Countries: A Network Analysis.

This study aimed to characterize the network structure of pandemic grief symptoms and suicidal ideation in 2174 people from eight Latin American countries. Pandemic grief and suicidal ideation were measured using the Pandemic Grief Scale and a single item, respectively. Network analysis provides an in-depth characterization of symptom-symptom interactions within mental disorders. The results indicated that, "desire to die," "apathy" and "absence of sense of life" are the most central symptoms in a pandemic grief symptom network; therefore, these symptoms could be focal elements for preventive and treatment efforts. Suicidal ideation, the wish to die, and the absence of meaning in life had the strongest relationship. In general, the network structure did not differ among the participating countries. It identifies specific symptoms within the network that may increase the likelihood of their co-occurrence and is useful at the therapeutic level.

A systematic review of psychosocial protective factors against suicide and suicidality among older adults.

Research on suicide rarely focuses on protective factors. The goal of this systematic review was to assess the evidence of the associations between protective factors and reduced suicidality among older adults. First, a scoping review was conducted to identify pertinent terms that refer to various protective factors against suicidality. A systematic review, following the PRISMA guidelines, was then conducted on a selection of 15 protective factors (e.g., perceived control, well-being and quality of life, life satisfaction, purpose-in-life, resilience, coping, religiosity, hope, self-regulation, sense of belonging, mattering, positive relationship, social support, social connectedness, and social participation), with separate searches performed on each factor in five databases. Empirical studies were eligible if participants were adults aged 60 years and over, and if the studies reported predictive statistical analysis. A total of 70 studies were retained for the review. Suicidal ideation was the main outcome measure (91%). Significant associations were consistently observed between all protective factors and reduced suicidal ideations or behaviors, particularly for purpose-in-life, resilience, and positive relationships, indicating that these are solid components for suicide prevention. Using scales, instead of a single item, to measure protective factors (e.g. life satisfaction) was more efficient to capture the associations. On the other hand, results were similar whether studies used subjective (e.g., sense of belonging) or objective (e.g., social connectedness) measures. Protective factors were inversely associated with suicidal ideation. Improving protective factors is essential for the development of late-life suicide prevention and interventions, instead of merely focusing on risk factors.

Patient-reported outcomes (PRO) in patients (pts) with BRCA1/2-altered metastatic castration-resistant prostate cancer (mCRPC) receiving niraparib (NIRA) with abiraterone acetate and prednisone (AAP): Results from MAGNITUDE study.

105 Background: MAGNITUDE, an international phase 3 randomized double-blind study, demonstrated that mCRPC pts with BRCA1/2 alterations receiving NIRA + AAP had significantly improved radiographic progression-free survival, and clinically relevant prolongations in time to symptomatic progression and time to cytotoxic chemotherapy compared with placebo (PBO) + AAP. Here, we report PRO results (pain, health-related quality of life [HRQoL], and side effect bother) in the BRCA1/2 subset of mCRPC pts in the final analysis of MAGNITUDE. Methods: Pts were screened prospectively for homologous recombination repair (HRR) gene alterations. Eligible pts had ECOG status ≤1 and a Brief Pain Inventory–Short Form (BPI-SF) worst pain score ≤3 (scale of 0-10), and were randomized 1:1 to NIRA + AAP or PBO + AAP orally daily in 28-day cycles. PRO assessments on day 1 of specified cycles included BPI-SF and Functional Assessment of Cancer Therapy–Prostate (FACT-P). Time to deterioration (TTD) in pain (BPI-SF worst, average, and pain interference, and FACT-P pain-related scale [PRS]) were compared between treatment arms using proportional hazards regression models. Changes from baseline in HRQoL (FACT-P total, scale of 0-156) were compared using repeated measures analysis, and side-effect bother was assessed in both arms as a single item from FACT-P (GP5). Results: PRO compliance for FACT-P and BPI-SF was &gt;85% in 225 pts with BRCA1/2-altered mCRPC. At baseline, mean BPI-SF pain scores was 1.09 (SD, 1.57) in NIRA + AAP and 1.35 (SD, 1.98) in PBO + AAP. Mean FACT-P Total in NIRA + AAP and PBO + AAP was 116.33 (SD, 18.42) and 114.8 (SD, 18.9), respectively. Median TTD in BPI-SF worst pain, pain interference, average pain, and FACT-P PRS were numerically longer for NIRA + AAP vs. PBO + AAP (Table). Repeated measures results showed HRQoL was maintained on treatment for the BRCA subgroup with no clinically meaningful differences in the FACT-P total score over time or between treatment arms. Analysis of FACT-P item GP5 in the BRCA subset showed side effect bother was rated “not at all” or “a little bit” by 87% of NIRA + AAP and 92% of PBO + AAP subjects across treatment cycles. Conclusions: In pts with BRCA1/2-altered mCRPC, NIRA + AAP maintained HRQoL. Pts experienced minimal bother from side effects associated with treatment. These data further support the benefit-risk profile of NIRA + AAP for the treatment of mCRPC pts with BRCA1/2 alterations. Clinical trial information: NCT03748641 . [Table: see text]

Pycnogenol® improves cognitive function in post-stroke patients: a 6 month-study.

This pilot study in post-stroke patients evaluated the effects of supplementation with Pycnogenol® on alterations in cognitive functions (COFU) over a period of 6 months, starting 4 weeks after the stroke. The effects of supplementation - possibly acting on residual brain edema, on global cognitive function, attention and on mental performance - were studied. A control group used standard management (SM) and the other group added Pycnogenol®, 150 mg daily to SM. 38 post-stroke patients completed the 6-month-study, 20 in the Pycnogenol® group and 18 in the control group. No side effects were observed with the supplement. The tolerability was very good. The patients included into the two groups were comparable for age, sex and clinical distribution. There were 2 dropouts in the control group, due to non-medical problems. Main COFU parameters (assessed by a cognitive questionnaire) were significantly improved (all single items) with the supplement compared to controls (P<0.05). Additional observations indicate that Pycnogenol® patients experienced significantly less mini-accidents (including falls) than controls (P<0.05). The incidences of (minor) psychotic episodes or conflicts and distress and other problems including rare occurrence of minor hallucinations, were lower with the supplementation than in controls (P<0.05). Single observations concerning daily tasks indicated a better effect of Pycnogenol® compared to controls (P<0.05). Plasma free radicals also decreased significantly with the supplement in comparison to controls (P<0.05). Globally, supplemented subjects had a better recovery than controls. In post-stroke subjects, Pycnogenol® supplementation resulted in better recovery outcome and faster COFU 'normalization' after the stroke in comparison with SM; it can be considered a safe, manageable post-stroke, adjuvant management possibly reducing local brain edema. Nevertheless, more patients and a longer period of evaluation are needed to confirm these results.