Single Question Research Articles

Mental health literacy in patients with acute myocardial infarction: a cross-sectional registry-based study

IntroductionThis study aimed to explore mental health literacy (MHL) and its related factors in a cross-sectional, registry-based sample of patients after acute myocardial infarction (AMI).MethodsAll survivors of AMI between 2017 and 2019 from the Myocardial Infarction Registry Augsburg (n=1.712) received a postal questionnaire on MHL (Mental Health Literacy Scale (MHLS-GER)) and single questions on experiences with and information on mental disorders in 2023. The response rate was 49.9%. Logistic and linear regression models were used to investigate the associations between these variables and sociodemographic factors.ResultsIn the sample of 855 patients (77.5% male, mean age 71.4 ± 10.9 years), 30.0% had experienced mental problems about 5 years after AMI. Among these, 17.4% received psychotherapy and 26.1% psychotropic drugs. Information about possible mental problems after their AMI was obtained from a physician by 30.8% of the patients and in a rehabilitation setting by 46.4%, respectively. Of the patients, 26.2% wished to receive more information on mental problems after AMI. MHLS-GER subscale scores ranged between and 54 (“Social distance”) and 76 (“Information seeking”) (best score 100). Age was the most important factor that was significantly associated with the report of mental health problems, a perceived lack of information, help seeking behavior and treatment, and MHL.DiscussionElderly and poorly educated patients were at risk of poor MHL. Further studies are required to specify the role of MHL in post-AMI life and health care.

Optimal cutoff score of the circular tandem walk test for determining the risk of falls in older community-dwelling individuals with type 2 diabetes

Patients with chronic diabetes may have a physical performance decline, which significantly increases the risk of falling. The study aimed to assess the validity of the Circular Tandem Walk Test (CTWT) in determining fall risk among older community-dwelling Thais with type 2 diabetes mellitus (T2DM). This is a cross-sectional diagnostic study of 71 older participants with T2DM from various communities. The participants were divided into “faller” (who had experienced one or more fall events) and “non-faller” groups based on 6-month fall history data. They were then interviewed about their fear of falling (FOF) using a single question and the Falls Efficacy Scale International (FES-I), followed by the CTWT. Thirty-five participants reported having fallen in the past six months. Significant differences were in the fallers and non-fallers CTWT, FOF, and FES-I scores (p < 0.001). CTWT results were significantly correlated with FOF (rpb = 0.605, p < 0.001), FES-I (rho = 0.837, p < 0.001), and number of falls (rho = 0.736, p < 0.001). The study suggested that the cutoff score for CTWT is 15.2 s, with a sensitivity = 80.00, specificity = 86.11, and AUC = 0.915. This study demonstrated the validity of the CTWT for determining the risk of falls in older community-dwelling individuals with T2DM. Implementing this tool in a community setting would be helpful in the initial screening and referral of data by concerned healthcare professionals. However, further studies may be needed to explore the reliability of CTWT and ensure the appropriate clinical use of CTWT by healthcare professionals.

Teacher Bullying—Does It Have an Impact on Peer Bullying Victimization?

AbstractPeer bullying in schools is well-documented through international research. There is, however, limited knowledge about teachers who bully students and how this is related to peer bullying. In the school hierarchy, the teachers have a strong position of formal power. When this power is exercised positively, through authoritative classroom leadership, this will both prevent bullying and support and protect victims of bullying. However, we cannot neglect the possibility that teachers can use their formal power negatively, and in the worst cases bully students. This study aimed to explore how teacher bullying was associated with being bullied by peers. Data from the Norwegian Annual Pupil Survey (2018) was used. The sample consisted of 173,742 students (48.93% female). The participation rate was approximately 90%. A Likert scale was used to estimate the extent to which students were being bullied by peers and teachers. The main results showed that teacher bullying was positively associated with peer offline and online bullying victimization while statistically controlling for gender and grades. With a rather small effect size, the association of teacher bullying with offline bullying victimization was stronger than with online bullying victimization. Bullying was measured using self-reporting with a single question. In future research, it is recommended that several questions be used to capture the complexity of bullying. The results from this study show that it is necessary to develop and implement preventive measures not only against bullying among peers but also against teacher bullying.

The prevalence of behavior problems in dogs in the United States

Numerous studies have reported the prevalence of various behavior problems in dogs and cats around the world. The actual number of animals included in each varies but is typically less than 1000. The reported prevalence of the behavior problem also varies considerably. It was thought that data from 43,517 dogs enrolled in the Dog Aging Project (DAP), entered by their owners, might provide a more realistic picture of canine behavior problems in the United States. All behavior questions included in the DAP were taken from the C-BARQ and mini C-BARQ questionnaires and included four multi-question categories (i.e., aggression, separation and attachment behaviors, fear and anxiety behaviors, and housesoiling) and seven behaviors asked as single questions. Except for two yes/no questions, all were rated by the owner between 0 (no problem), 2 (moderate) and 4 (serious). Data was analyzed to determine the number of dogs showing moderate (2) to serious (4) levels of behavior appropriate for the question. Overall, 99.12% of dogs showed at least one problem of moderately serious (3) to serious (4) intensity or at least two problems of moderate to serious (2−4) intensity. Within the four multi-question categories, the prevalence of dogs showing moderate (2) to serious (4) behaviors at least twice with the category was 55.6% for aggression, 85.9% for separation and attachment behaviors, 49.9% for fear and anxiety behaviors, and 4.1% for housesoiling.

Single Question for Screening Suicide Risk in Patients With Cancer in Nursing Routine Work: A Retrospective Cross-Sectional Study.

To examine the efficacy of the Single Suicide Question, a tactful single-item tool, in assessing suicide risk among cancer patients. Suicide risk screening in cancer patients faces challenges such as cultural, the degree of attention given and the complexity and diversity of assessment methods. An efficient and simple suicide screening tool is needed within the nursing and treatment process. A retrospective cross-sectional study. All data utilised in this study were obtained from assessments conducted by researchers at our institution between March 2018 and August 2023. Retrospectively analysed Single Suicide Question scores from 9703 patients (March 2018-August 2023), with 229 undergoing additional using other established tools (the Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Distress Thermometer) alongside the Mini International Neuropsychiatric Interview Suicidal Subscale (MINI Suicidal Subscale). These 229 patients were divided into the cut-off determination dataset (174/229) and the validation dataset (55/229) to analyse, validate and compare the screening efficacy, consistency and optimal cut-off points of the tools relative to the MINI Suicidal subscale (golden standard). K-fold cross-validation was employed to assess the stability of the Single Suicide Question and to revalidate its screening efficacy. In cut-off determination dataset, the Single Suicide Question exhibited good screening efficacy and substantial agreement relative to the MINI Suicidal subscale, as validated in the validation dataset, outperforming other tools. The optimal cut-off points of Single Suicide Question for screening moderate or higher and high suicide risk as 2 and 3 respectively. Its stability in K-fold cross-validation further supported its screening efficacy. The Single Suicide Question shows potential as a preliminary screening tool for suicide risk. Furthermore, it has also demonstrated the potential of a simple, tactful, culturally fitting question in assessing suicide risk, providing insight for the development of relevant tools in different cultural and linguistic backgrounds. Our study demonstrates the potential of the Single Suicide Question as a screening tool for identifying suicide risk among cancer patients, which may facilitate efficient suicide screening. Furthermore, it reveals that tactful, culturally fitting, yet simple tools can achieve good screening efficacy, providing insights for the development of similar tools in different cultural and linguistic contexts. This study investigated the effectiveness of using a culturally contextualised, specific single question to screen for suicide risk in Chinese cancer patients, demonstrating high screening efficacy and stability. With further research, this method may provide a tactful, culturally informed and efficient suicide screening approach to address the critical issue of suicide risk in cancer care, and it also serves as a reference for developing similar tools in diverse cultural and linguistic contexts. The study followed the STROBE checklist guidelines for cross-sectional studies. The data provided by patients were the foundation of this study. Nurses played a central role in conducting the majority of assessments and contributing to the research design in this study.

Exploring adult hearing aid user experiences: meaning extraction methods, content patterns, and associations with demographic and outcome variables

Objective Employing automated language analysis, specifically Meaning Extraction Method (MEM) and Principal Component Analysis (PCA), to identify key factors in open-text responses about hearing aid experiences. Design Exploratory, cross-sectional design, using an online questionnaire. Responses to a single open-ended question were analysed using MEM, PCA, regression, and correlation analyses. Study sample Participants (n = 538) included adult hearing aid users sampled from the Hearing Tracker website community and Lexie Hearing user databases in the United States. Results The MEM-derived items revealed six factors related to hearing aid experiences: (1) life change, (2) social situation, (3) quality of life, (4) impact and speech understanding, (5) communication and interaction, and (6) music and environmental sounds. IOI-HA item 3 had the most statistically significant correlations with PCA factors. Quantile regression revealed that factors one and two significantly predicted the IOI-HA total score. Positive correlations were observed between self-reported hearing difficulty and factors one, four, and five, as well as between factor one and general health and factor two and physical activity. Conclusion Natural language analysis of open-ended textual responses can offer valuable insights into hearing aid users’ experiences. Future studies should aim to refine this methodology to enhance clinical relevance and generalisability.

Reducing Racial Asymmetries in the Survey Overestimation of Voter Turnout

Abstract Research has consistently demonstrated that Black respondents are more likely than their White counterparts to overstate their plans or previous decisions to vote. We propose that by using a single question regarding turnout intention and candidate preference (rather than the typical approach of using two separate questions), survey researchers can reduce these racial asymmetries. The reason, we suggest, is that doing so encourages Black respondents to consider the turnout question through the lens of candidates and parties, rather than as a civic responsibility they have toward other Black Americans, which therefore mitigates the social desirability bias that leads to overestimation. We evaluate this argument using a survey experiment that randomly asks a control group of survey respondents to answer two voting questions—one about turnout and one about vote choice—and asks the other half of the sample, the treatment group, a single question that combines the two. Using original data from a nationally representative survey, we find that using the single turnout/preference question reduces the racial asymmetry in turnout overestimation substantially. We further observe that the decrease is concentrated among respondents with relatively high levels of campaign indifference and especially racial civic consciousness, a condition that is much more common among Black respondents than among White respondents. We believe these findings are particularly relevant to election scholars and campaign professionals, given their focus on understanding the thought processes of survey respondents and prospective voters, as well as improving the validity of self-reports in survey research.

Development of a German version of a single-question restless legs syndrome screening questionnaire

Abstract Background The “Single Question for the Rapid Screening of Restless Legs Syndrome (RLS Single Question) ©” is a questionnaire specifically designed to screen for restless legs syndrome (RLS). This research article describes the process of development and cultural adaptation of the German version of the questionnaire. Objective The primary objective of this study was to create a culturally appropriate and linguistically precise tool for evaluating RLS symptoms within German-speaking populations. Materials and methods The translation process involved meticulous forward and backward translations coupled with cognitive interviews conducted with patients to ensure the linguistic accuracy and cultural relevance of the instrument. Results The resultant final version of the questionnaire demonstrated an optimal level of comprehension and is anticipated to serve as an asset for the early detection and effective management of RLS among individuals who speak German. Conclusion The study highlights the successful development of the RLS questionnaire for the German-speaking context. Patient involvement in cognitive interviews proves pivotal in resolving minor comprehension issues. Its successful adaptation underscores the significance of comprehensive translation in diverse linguistic and cultural contexts, ultimately enhancing patient care. Future research will explore the validation of the test in larger populations and its integration into holistic diagnostic strategies.

Arthroscopic treatment for femoroacetabular impingement yields favourable patient-reported outcomes and method survivorship at 10-year follow-up.

To compare the outcomes of hip arthroscopy for femoroacetabular impingement syndrome (FAIS) preoperatively and at minimum 10-year follow-up using patient-reported outcome measures (PROMs). A total of 128 patients with FAIS were prospectively included. The patients underwent arthroscopic surgery for FAIS between 2011 and 2013 and had a minimum of 10-year follow-up. The International Hip Outcome Tool short version (iHOT-12) was the primary outcome. Secondary outcomes were the Copenhagen Hip and Groin Outcome Score (HAGOS), the European Quality of Life-5 Dimensions Questionnaire (EQ-5D), the European Quality visual analogue scale (EQ VAS), the Hip Sports Activity Scale (HSAS) for physical activity level, the Visual Analogue Scale (VAS) for overall hip function and a single question regarding overall satisfaction with the surgery. The Wilcoxon signed rank test was used to compare pre- and postoperative PROMs. There was a significant improvement (p < 0.001) of iHOT-12, HAGOS subscales, EQ-5D, EQ VAS and VAS for overall hip function. A total of 83% of the patients were satisfied with their surgery. The survivorship of hip arthroscopy, defined as nonconversion to total hip arthroplasty (THA), at the end of the follow-up period was 77%. Patients undergoing arthroscopic treatment for FAIS reported statistically significant and clinically relevant improved outcomes at 10-year follow-up. Case series, level IV.

Use of long-acting triple therapy for chronic obstructive pulmonary disease (COPD) in practice: The ELETHON physicians' survey

Gaps in optimal COPD management have been identified in clinical practice, with discrepancies between guideline recommendations and routine care. The reasons for such discrepancies are incompletely understood. The ELETHON survey aimed to identify physicians' attitudes towards general concepts of COPD management and, in particular, initiation of inhaled triple therapies. ELETHON was a nationwide cross-sectional survey with general practitioners (GP) and pulmonary specialists (PS) working in the ambulatory outpatient setting in Germany, using a structured 17-item questionnaire (single or multiple choice questions) addressing the topics of secondary prevention, exacerbation detection, strategies for therapy escalation, choice of inhaled triple therapies and evaluation of treatment benefits. Questionnaires filled by n=2028 GPs and n=371 PS were analyzed. In both groups, secondary prevention was deemed important in COPD care (GP/PS 76.4%/90.6%), with inhalation technique, vaccination status, and appropriate inhaled pharmacotherapy as key components. Activity/rehabilitation was rarely mentioned by GPs (48.3% vs. 84.5%). Exacerbations and symptomatic worsening were the main triggers for therapy escalation, but were not recorded in a structured way. "Hospitalization" and "≥2 ambulatory exacerbations" were mentioned most frequently as thresholds. Neither GPs nor PS measured eosinophils in the majority of patients. Fixed triple combinations were preferred, with availability of different treatment steps in the same device as important decision aid. Treatment success was evaluated by exacerbations, quality of life, symptoms, lung function and rescue medication use, while COPD Assessment Test (CAT) score was rarely used by GPs and PS. The ELETHON survey identified gaps in COPD management in Germany. While secondary prevention is deemed important, escalation of inhaled therapy is undertaken rather late, the reported importance of vaccinations does not match current quota in German COPD patients, and non-pharmacological measures are often unused. Exacerbation and symptom documentation is rather subjective, validated questionnaires and blood eosinophils are of minor relevance. These results provide evidence of barriers and hidden potentials towards optimization of routine ambulatory care for COPD patients in Germany.

Can a single question replace patient-reported outcomes in the follow-up of elbow arthroplasty? A validation study

BackgroundTo assess the results after elbow arthroplasty it is essential to gather patient-reported outcome measures (PROMs). However, the acquisition of PROMs poses a challenge because of potential low literacy, lengthiness and diversity of questionnaires, and questionnaire fatigue. Instead of a questionnaire, patient-reported outcomes can be collected using a single assessment numeric evaluation (SANE), the subjective elbow value (SEV). The aim of this pilot study is to assess the correlation between the SEV and conventionally used patient reported outcome measures (PROMs) after elbow arthroplasty.Materials and methodsThe SEV was added to our follow-up system in 2021, consisting of a scale from 0 to 10 in which the patients are asked to rate the overall functionality of their elbow, 0 corresponds to very poor functionality and 10 to a perfectly functional or healthy elbow. All patients who underwent elbow arthroplasty (total or radial head) and responded to the SEV question were retrospectively identified and included. The correlation between the SEV at the final follow-up and the Oxford Elbow Score (OES), and between the SEV and the Quick Disbailities of the Arm, Shoulder, and Hand (quickDASH) score was assessed using Pearson’s r.ResultsIn total, 82 patients responded to the SEV question and were included in the study, with a median follow-up of 5 years [interquartile range (IQR) 3–7]. Of these patients, 17 (21%) underwent radial head arthroplasty and 65 (79%) total elbow arthroplasty. The Pearson’s r for the correlation between SEV and OES was 0.502 (p < 0.001) and between the SEV and the QuickDASH −0.537 (p < 0.001), which correspond to a moderate correlation.ConclusionsThe SEV shows a moderate correlation with conventional PROMs, demonstrating its potential in simplifying the follow-up of elbow arthroplasty, possibly decreasing time, costs, and patients’ questionnaire fatigue compared with conventional PROM questionnaires.Evidence level: III.

Enhancing Faculty Grading Productivity Using Robotic Process Automation (RPA): The Development of a Structured Query Language (SQL) Automated Grading Tool

ABSTRACT Using the design science methodology, we develop an automated grading bot using robotic process automation (RPA) software. This grader demonstrates RPA’s capability to enhance the efficiency and accuracy of grading structured query language (SQL) queries. Validation of the RPA grader demonstrates that it can grade assignments and/or exams in 30 to 60 minutes, a task that would take a human grader approximately 50 hours. In contrast to human graders, who misgraded 5 to 8 percent of queries, the RPA grader graded all queries correctly. Notably, it correctly evaluated 188 distinct correct solutions submitted by students to a single question. To facilitate broad adoption, we provide instructions and the necessary code for implementing the RPA grader. We validate that professors and teaching assistants can successfully implement the RPA grader even with no previous bot building experience.

Quality assessment of oral health promotion contents regarding caries, periodontal disease, and oral cancer through websites using discern instruments: a cross-sectional study

ABSTRACTIntroduction: One way to improve public oral health is through conducting health promotion activities. As technology develops, the internet has been used as a medium for health promotion by presenting health content through websites. However, the use of these websites has the potential to provide inaccurate health information due to the flexibility of users in uploading health content without a prior regulatory process and review of the contents. This study aims to describe oral health promotion content quality through regarding caries, periodontal disease, and oral cancer websites using Discern Instruments. Methods: This study used the descriptive method with a cross-sectional approach. Samples were taken using the purposive sampling technique, with a total of 46 samples. The instrument consisted of 16 questions divided into three sections. The first section, comprising seven questions, focused on the reliability and accuracy of the presented health information. The second section, with eight questions, focused on the quality of information regarding treatment options. The final section, consisting of a single question, assessed the overall assessment based on the previous questions. The quality of the websites was assessed by two reviewers. The inter-rater reliability between the two reviewers was calculated using the Cohen’s Kappa test. Data presentation included frequency distribution, mean, and standard deviation. Results: In this study, 33.3% of caries websites had low quality and 66.6% had moderate quality. In periodontal disease, 33.3% of websites were of low quality, 60% were of moderate quality and 6.6% were of high quality. In oral cancer, 26.3% were of low quality and 73.6% were of medium quality. Conclusion: The quality of dental and oral health promotion content on websites, assessed using the Discern Instruments, shows that most websites regarding caries, periodontal disease, and oral cancer have moderate quality, some have low quality, and only one website is of high quality.

The role of health literacy in the association between social support and self-rated health: a Danish population-based study in 10,787 individuals with a long-term condition.

Managing a long-term condition requires higher health literacy. Social networks may play a crucial role for self-management. However, the pathway is not entirely understood. This study aimed to examine whether the association between social support and self-rated health is mediated by health literacy among individuals with a long-term condition. This cross-sectional study used data from the "How are you?" 2021 survey in Central Denmark Region. Social support was assessed using a single question, health literacy with two dimensions from the Health Literacy Questionnaire (HLQ): 'Understanding health information' and 'Engaging with healthcare providers', and self-rated health with a single question from SF-36. Multiple logistic regression analyses were used to examine the associations, and multiple mediation analyses were performed using the Karlson-Holm-Breen method. A total of 10,787 individuals with a long-term condition were included in the study, whereas 6% (n = 595) reported a low level of social support. Both health literacy scales mediated the association between social support and self-rated health, particularly the ability to engage with healthcare providers, accounting for 25% of the variance. After adjustment for sociodemographic factors, individuals with a low level of social support had significantly higher odds of reporting difficulties in understanding health information (OR 2.53 (95% CI: 1.84-3.48)) and engaging with healthcare providers (OR 3.77 (95% CI: 2.96-4.79)). Health literacy, particularly the ability to engage with healthcare providers, was a mediator between social support and self-rated health. Additionally, a low level of social support was associated with higher odds of reporting lower health literacy. These findings suggest that strategies to enhance health literacy, improve health outcomes, and reduce health inequities may benefit from strengthening individuals' social network, particularly focusing on those with limited support.

Do impulse control difficulties moderate the relationship between intermittent fasting and disordered eating?

BackgroundRecent findings suggest positive associations between intermittent fasting (IF, i.e., an eating pattern that consists of alternating between consuming and abstaining calories over specified periods of time) and disordered eating (DE), including binge eating, laxative use, and self-induced vomiting. However, as not all individuals who engage in IF present with DE, the current study aimed to investigate whether 1) IF was associated with elevated DE, and 2) impulse control difficulties differentially predict DE in intermittent fasters compared to non-intermittent fasters. MethodsParticipants included 929 undergraduates (M = 19.8, SD = 2.97) from a university in the United States. IF was assessed with a single item question, “Do you intentionally engage in intermittent fasting in order to lose/maintain your weight or due to health-related motivations?” The Eating Disorder Examination Questionnaire was used to measure DE (i.e., global score, restraint, eating, shape, and weight concerns). One subscale from the Difficulties in Emotional Regulation Scale was used to measure impulse control difficulties. Hierarchal regressions examined whether impulse control difficulties moderated the relationship between IF and DE while controlling for age, gender, race, and ethnicity. ResultsIF was significantly associated with all DE outcomes. Adjusted analyses indicated that impulse control difficulties moderated the relationship between IF and two DE outcomes (i.e., global score (b = 0.038, se = 0.017, t = 2.17, p < 0.05) and restraint (b = 0.042, se = 0.019, t = 2.22, p < 0.05)). DiscussionThese results support previous literature that suggests an association between IF and elevated DE. Further, individuals engaging in IF with impulse control difficulties may experience more feelings of restraint towards eating and increased overall DE though effects were small. Future research delineating who is at highest risk for DE when engaging in IF is needed.

Single simple question in axonal polyneuropathy.

The single simple question (SSQ), "What percentage of normal (0%-100%) do you feel regarding your disease?" has proven feasible and valid in assessing myasthenia gravis and a heterogeneous spectrum of neuropathies. This study explores the utility of the SSQ in axonal polyneuropathies (PNPs), encompassing diabetic neuropathy, and evaluates its responsiveness to scale changes. A retrospective chart review of 150 patients with axonal PNP responding to the SSQ was performed. Patients underwent clinical and electrophysiological evaluations, and were evaluated by clinical and disability scales, including the Medical Research Council sum score, modified Toronto Clinical Neuropathy score (mTCNS), Overall Neuropathy Limitation Scale, and Rasch-built Overall Disability Scale (RODS). The SSQ total scores correlated moderately with both the RODS score (r = .59, p < .001) and the mTCNS symptom score (r = -.43, p < .001), maintaining significance after adjustment for multiple comparisons. Longitudinally, after adjusting for multiple comparisons, the change in mTCNS symptom score retained statistical significance (adjusted p = .048). The SSQ did not show any association with electrophysiological parameters or sensory symptoms, other than a lower score in those with pain (100% with SSQ <40%, 85% with SSQ 40%-70%, and 34% with SSQ >70%). The SSQ is a feasible, valid scale that may be utilized to assess and follow patients with length-dependent axonal PNPs. Given that the SSQ is not strongly associated with clinical and disability scales or electrophysiological findings, additional investigations are required for a comprehensive assessment of PNP.

Comparison of a Single Assessment Numeric Evaluation Method and the Banff Patella Instability Instrument 2.0 for Patients With Patellofemoral Instability.

The concept of Single Assessment Numeric Evaluation (SANE) has been introduced for several clinical entities; however, a validated SANE focusing on patients with patellofemoral instability has not been described. The purpose of this study was to investigate the expressiveness of SANE questions (SQs) for the assessment of patients experiencing patellofemoral instability. It was hypothesized that the complexity of patellofemoral instability cannot be demonstrated by a single question. Cohort study (diagnosis); Level of evidence, 2. Between October 2022 and March 2023, 120 consecutive patients (male/female, 50/70; mean age, 23.9 ± 8.0 years; mean body mass index, 25.3 ± 5.1 kg/m2) with patellofemoral instability were assessed with the Banff Patella Instability Instrument 2.0 (BPII 2.0). Patients were randomized into 3 groups (40 patients each) and asked to answer 1 of 3 SQs: "How do you rate your knee joint if a completely stable kneecap means 100%?" (SQ 1), "How do you rate your knee joint if complete satisfaction means 100%?" (SQ 2), and "How do you rate your knee joint if complete normal function means 100%?" (SQ 3). Means ± standard deviations were compared using 1-way analysis of variance, the correlation between BPII 2.0 and each SQ was assessed by Pearson correlation, and Bland-Altmann analysis was performed to investigate biases of each SQ in comparison with BPII 2.0. The mean BPII 2.0 score was 40.5 ± 16.8 points, and the mean results of SQ 1, SQ 2, and SQ 3 were 44.2% ± 26.0%, 42.6% ± 25.4%, and 44.2% ± 18.9%, respectively, without significant differences between the groups (all P > .05). The correlations between BPII 2.0 and SQ 1, SQ 2, and SQ 3 were high (r = 0.75; 95% CI, 0.58 to 0.86; P < .0001), low (r = 0.35; 95% CI, -0.05 to 0.6; P = .02), and low (r = 0.31; 95% CI, -0.002 to 0.56; P = .051), respectively. Bland-Altman analysis between BPII 2.0 and SQ 1, SQ 2, and SQ 3 revealed biases of -0.12 (SD, 17.1), -1.45 (SD, 24.4), and -8.0 (SD, 19.4), respectively. The SQ "How do you rate your knee joint if a completely stable kneecap means 100%?" demonstrated concurrent validity with the BPII 2.0 and may serve as a helpful tool to quickly assess patients with recurrent patellofemoral instability in a preoperative setting.

Inadequate management of opioid-induced constipation in European cancer pain patients: results of a real-world, multicentre, observational study ("E-StOIC").

The objectives of the study were to determine the prevalence of (uncontrolled) OIC, relevant medications / interventions employed by healthcare professionals, and the additional strategies utilised by patients, amongst European patients with cancer pain. This study was a prospective observational study conducted at 24 research sites in ten European countries. Cancer patients receiving opioid analgesics for at least a week were recruited, and asked to complete a questionnaire including background information, single question (Are you constipated?), Rome IV diagnostic criteria for OIC, Bowel Function Index (BFI), and Patient Assessment of Constipation Quality of Life questionnaire (PAC-QOL). Participants were characterised as having / not having OIC on the basis of the Rome IV diagnostic criteria. 1200 participants completed the study. 59.5% met the Rome IV diagnostic criteria for OIC: only 61.5% that met these criteria self-reported constipation. 72% participants were prescribed a regular conventional laxative / peripherally acting mu-opioid receptor antagonist (PAMORA). However, only 66% took their prescribed laxatives every day. Many participants had utilised other strategies / interventions to manage their OIC. Furthermore, 27% had needed to use suppositories, 26.5% had needed to use an enema, and 8% had had a manual evacuation. The use of PAMORAs, and other novel effective medications, was relatively uncommon. The results of this study suggest that management in Europe is often inadequate, and this undoubtedly relates to a combination of inadequate assessment, inappropriate treatment, and inadequate reassessment.

Co-occurrence of unhealthy lifestyle behaviours in middle-aged adults: findings from the Swedish CArdioPulmonary bioImage Study (SCAPIS)

Middle-aged adults engaging in unhealthy lifestyle behaviors are at higher risk of chronic diseases. However, little is known about the co-occurrence of these behaviors and their determinants. This cohort study examined the co-occurrence of unhealthy lifestyle behaviors (alcohol consumption, diet, physical inactivity, and smoking) in 30,154 middle-aged adults and their associations with sociodemographic factors, social support, and disease history. Alcohol use was measured by the AUDIT, diet by the MiniMeal-Q, and physical inactivity and smoking by single questions. Participants had a mean age of 58 years, with 51% being female. Of them, 14% had no unhealthy behaviors, 38% had one, 36% had two, 10% had three, and 2% had all four. The most common co-occurrence was between physical inactivity and poor diet (38%). Higher education decreased the likelihood of having three or four unhealthy behaviors, while financial difficulties, having no one around who appreciated one’s efforts, and suffering of a lung disease increased it. In conclusion, middle-aged adults exhibit varying levels of unhealthy lifestyle behaviors. Higher education is linked to reduced engagement in multiple unhealthy behaviors, whereas financial strain, lower quality of social support, and lung disease increase the risk.

Hip Arthroscopy for Femoroacetabular Impingement Syndrome in High-Level Athletes: A 10-Year Follow-up.

Arthroscopic treatment for femoroacetabular impingement syndrome (FAIS) has previously been reported to have favorable short-term results in high-level athletes. Less is known about long-term outcomes. To report outcomes 10 years after hip arthroscopy for FAIS in high-level athletes using validated patient-reported outcome measures (PROMs). Case series; Level of evidence, 4. Patients who underwent hip arthroscopy between November 2011 and January 2013 were included in a local hip arthroscopy registry and completed preoperative PROMs. At 10-year follow-up, the same PROMs were completed. Inclusion criteria were age <40 years at time of surgery, no prior hip surgeries, and a pre-symptomatic Hip Sports Activity Scale (HSAS) level of 7 or 8. The exclusion criterion was total hip arthroplasty at follow-up. The PROMs included the international Hip Outcome Tool-12 items (iHOT-12), the Copenhagen Hip and Groin Outcome Score (HAGOS), visual analog scale (VAS) for overall hip function, European Quality of Life-5 Dimensions questionnaire (EQ-5D) and European Quality of Life-visual analog scale (EQ-VAS), HSAS, and a single question on patient satisfaction. The rates of patients achieving minimal important change and reporting Patient Acceptable Symptom State (PASS) were reported for HAGOS and iHOT-12. For iHOT-12, preoperative results were compared with 1, 5, and 10-year follow-ups. A total of 45 patients (34 men, 11 women; 70 hips; mean age 24.4 years at time of surgery) were included, with 77 patients eligible for inclusion. Significant improvements (P < .001) were seen at 10-year follow-up in all HAGOS subscales: Symptoms, Pain, Daily Activity, Sports, Physical Activity, Quality of Life (50.3 vs 78.6, 59.2 vs 86.8, 65.9 vs 88.8, 37.1 vs 81.1, 24.4 vs 81.1, 32.1 vs 79.3), iHOT-12 (40.1 vs 81.6), EQ-5D (0.59 vs 0.89), EQ-VAS (65.6 vs 80.4), and VAS for overall hip function (48 vs 79). For iHOT-12, the largest change was seen between preoperative and 1-year follow-up values, with consistent results over time. There was no statistically significant difference between HSAS levels preoperatively and at 10-year follow-up (HSAS level 4), with 24% of patients reporting a HSAS level 7 or 8 at the follow-up. Of the patients, 93% reported satisfaction with the surgery. PASS was achieved in 82% for iHOT-12, with a range of 76% to 91% for HAGOS subscales. Furthermore, 93% exceeded the minimal important change for iHOT-12, and a range of 67% to 84% for HAGOS. In a high-level athletic population, significant improvements in long-term outcomes are reported after hip arthroscopy for FAIS, with patients reporting a high satisfaction rate. The results also show that the largest improvement occurs within the first postoperative year, with results being maintained for 10 years.