Social Subscale Research Articles

Identifying dementia in Down syndrome with the Severe Impairment Battery, Brief Praxis Test and Dementia Scale for People with Learning Disabilities.

Individuals with Down syndrome (DS) are at high risk for dementia, specifically Alzheimer's disease. However, many measures regularly used for the detection of dementia in the general population are not suitable for individuals with DS due in part to floor effects. Some measures, including the Severe Impairment Battery (SIB), Brief Praxis Test (BPT) and Dementia Scale for People with Learning Disabilities (DLD), have been used in clinical trials and other research with this population. Validity research is limited, particularly regarding the use of such tools for detection of prodromal dementia in the DS population. The current project presents baseline cross-sectional SIB, BPT and DLD performance in order to characterise their predictive utility in discriminating normal cognition, possible dementia and probable dementia in adult DS. Baseline SIB, BPT and DLD performances from 100 individuals (no dementia=68, possible dementia=16 & probable dementia=16) were examined from a longitudinal cohort of aging individuals with DS. Receiver operating characteristic curves investigated the accuracy of these measures in relation to consensus dementia diagnoses, diagnoses which demonstrated high percent agreement with the examining neurologist's independent diagnostic impression. The SIB and BPT exhibited fair discrimination ability for differentiating no/possible versus probable dementia [area under the curve (AUC)=0.61 and 0.66, respectively]. The DLD exhibited good discrimination ability for differentiating no versus possible/probable dementia (AUC=0.75) and further demonstrated better performance of the DLD Cognitive subscale compared with the DLD Social subscale (AUC=0.77 and 0.67, respectively). Results suggest that the SIB, BPT and DLD are able to reasonably discriminate consensus dementia diagnoses in individuals with DS, supporting their continued use in the clinical assessment of dementia in DS. The general performance of these measures suggests that further work in the area of test development is needed to improve on the AUCs for dementia status discrimination in this unique population. At present, however, the current findings suggest that the DLD may be the best option for reliable identification of prodromal dementia in this population, reinforcing the importance of including informant behaviour ratings in assessment of cognition for adults with DS.

Improvements in Diet and Physical Activity-Related Psychosocial Factors Among African Americans Using a Mobile Health Lifestyle Intervention to Promote Cardiovascular Health: The FAITH! (Fostering African American Improvement in Total Health) App Pilot Study.

BackgroundAfrican Americans continue to have suboptimal cardiovascular health (CVH) related to diet and physical activity (PA) behaviors compared with White people. Mobile health (mHealth) interventions are innovative platforms to improve diet and PA and have the potential to mitigate these disparities. However, these are understudied among African Americans.ObjectiveThis study aims to examine whether an mHealth lifestyle intervention is associated with improved diet and PA-related psychosocial factors in African Americans and whether these changes correlate with diet and PA behavioral change.MethodsThis study is a retrospective analysis evaluating changes in diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors (daily fruit and vegetable intake and moderate-intensity PA [MPA] per week) in 45 African American adults (mean age 48.7 years, SD 12.9 years; 33/45, 73% women) enrolled in the FAITH! (Fostering African American Improvement in Total Health) app pilot study. The intervention is a 10-week, behavioral theory–informed, community-based mHealth lifestyle intervention delivered through a mobile app platform. Participants engaged with 3 core FAITH! app features: multimedia education modules focused on CVH with self-assessments of CVH knowledge, self-monitoring of daily fruit and vegetable intake and PA, and a sharing board for social networking. Changes in self-reported diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors were assessed by electronic surveys collected at baseline and 28 weeks postintervention. Changes in diet and PA-related psychosocial factors from pre- to postintervention were assessed using paired 2-tailed t tests. The association of changes in diet and PA-related psychosocial variables with daily fruit and vegetable intake and MPA per week was assessed using Spearman correlation. Associations between baseline and 28-week postintervention changes in diet and PA-related psychosocial measures and CVH behaviors with covariates were assessed by multivariable linear regression.ResultsParticipants reported improvements in 2 subscales of diet self-regulation (decrease fat and calorie intake, P=.01 and nutrition tracking, P<.001), one subscale of social support for healthy diet (friend discouragement, P=.001), perceived barriers to healthy diet (P<.001), and daily fruit and vegetable intake (P<.001). Improvements in diet self-regulation (increase fruit, vegetable, and grain intake, and nutrition tracking) and social support for healthy diet (friend encouragement) had moderate positive correlations with daily fruit and vegetable intake (r=0.46, r=0.34, and r=0.43, respectively). A moderate negative correlation was observed between perceived barriers to healthy diet and daily fruit and vegetable intake (r=−0.25). Participants reported increases in PA self-regulation (P<.001). Increase in social support subscales for PA (family and friend participation) had a moderate positive correlation with MPA per week (r=0.51 and r=0.61, respectively).ConclusionsOur findings highlight key diet and PA-related psychosocial factors to target in future mHealth lifestyle interventions aimed at promoting CVH in African Americans.

Effects of Laser Acupuncture Therapy for Patients With Inadequate Recovery From Bell's Palsy: Preliminary Results From Randomized, Double-Blind, Sham-Controlled Study.

Introduction: Inadequate recovery from Bell's palsy exists in a third of patients and results in physical and social impairments. The controversial nature of existing medical treatment options means that novel, alternative approaches are needed. In basic and clinical studies, low-level laser therapy (LLLT) has proven successful in regenerating peripheral nerves. Laser acupuncture therapy (LAT) is a rapidly growing treatment modality; however, its effectiveness for treating chronic Bell's palsy is unknown. The feasibility of this innovative approach is the focus of this pilot study. Methods: A two-armed, parallel, randomized, investigator-subject-assessor-blinded, sham-controlled pilot study was conducted, and 17 eligible subjects were randomly allocated to either LAT (n=8) or sham LAT (n=9). The LAT group received three treatments each week for six weeks (18 sessions), while the sham LAT group received the same procedure but with a sham laser device. The change from baseline to week 6 in the social subscale of the Facial Disability Index (FDI) was the primary outcome. Secondary outcomes were changes in the House-Brackmann facial paralysis scale (HB), the Sunnybrook facial grading system (SB) and a stiffness scale at weeks 3 and 6. Results: A significant difference was shown in the HB score (P=0.0438) between baseline and week 3 and borderline significance was observed in both SB and stiffness scores from baseline to week 6 (P=0.0598 and P=0.0980 respectively). There was no significant difference in the FDI score between baseline and week 6. Conclusion: To the best of our knowledge, this clinical trial is the first such investigation on this topic. Our findings suggest that using LAT may have clinical effects on long-term complications of Bell's palsy and justify further large-scale studies.

Predicting veteran health-related quality of life following mild traumatic brain injury.

To examine health-related quality of life (HR-QOL) in Veterans with and without a history of mild traumatic brain injury (mTBI) and investigate correlates and predictors of HR-QOL within the mTBI sample. Research Method/Design: Participants (N = 144) included 81 Veterans with a history of mTBI and 63 Veteran controls (VCs) without a history of mTBI. Primary outcomes of interest were the 8 subscales of the 36-Item Short Form Survey (SF-36). Participants also completed questionnaires measuring combat exposure, depressive and posttraumatic stress disorder (PTSD) symptoms, and neurobehavioral symptoms. ANCOVAs adjusting for age found that, relative to VCs, the mTBI group demonstrated poorer HR-QOL across all SF-36 subscales (p's = ≤.001-.006; ηp² = .05-.21). After adjusting for age, combat exposure, and depressive and PTSD symptoms, the mTBI group endorsed poorer HR-QOL on the Physical Role Functioning, General Health, and Social Functioning subscales (p's = .011-.032; ηp² = .03-.05). Within the mTBI sample, employment status, lifetime number of mTBIs, depression, PTSD, and neurobehavioral symptoms collectively predicted all 8 SF-36 subscales (p's < .001), accounting for 29-65% of the total variance. Although depression and neurobehavioral symptoms tended to be the strongest predictors of HR-QOL, lifetime number of mTBIs and employment status were also important predictors of specific HR-QOL domains. Results suggest that, above and beyond depression, PTSD, and combat exposure, history of remote mTBI contributes to aspects of HR-QOL-particularly in perceptions of physical health and social functioning. Furthermore, different combinations of predictor variables are associated with different HR-QOL domains, highlighting the need for multimodal treatments within this vulnerable population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Assessment of Post-COVID-19 Quality of Life Using the Quality of Life Index.

BackgroundCOVID-19 has impacted many aspects of peoples’ quality of life (QOL).AimTo assess the QOL of post-COVID-19 cases and determine their associated sociodemographic attributes.MethodsA cross-sectional community-based study targeted recovered COVID-19 cases using an online questionnaire. An Arabic version of the Quality of Life Index (QLI) was evaluated for reliability and validity using Cronbach’s alpha and Spearman’s product moment tests, respectively. Descriptive analysis, Mann–Whitney U, Kruskal–Wallis H, and Spearman correlation tests were used to investigate the relationships between QOL and study independent variables, including sociodemographic characteristics, time since infection, intention for vaccination, perception of the influence of COVID-19 on general health, history of hospitalization, and history of chronic illness. Subgroups were compared using a Student’s t-test for normally distributed data and the Wilcoxon rank-sum test or the Kruskal–Wallis test for non-normally distributed data.ResultsIn a sample of 449 respondents, the total QLI score was 22.64 ± 4.36; for subscales, it ranged from 20.86 ± 5.04 to 24.99 ± 4.74. Males had significantly higher health and functioning subscale (HFSUB) scores compared to females (p = 0.033). Employed cases had significantly higher social and economic subscale (SOCSUB) scores than unemployed cases (p = 0.000). Married people reported significantly higher family subscale (FAMSUB) scores (p = 0.000) than unmarried people. People who believe that their general health was affected by COVID-19 had significantly lower HFSUB and psychological and spiritual subscale (PSPSUB) scores (p = 0.000 and p = 0.021, respectively). Individuals with a history of hospital admissions scored lower on PSPSUB (p = 0.000). Age was significantly associated with both SOCSUB (p = 0.006) and FAMSUB (p = 0.040).ConclusionSociodemographic attributes of people with a history of COVID-19 revealed significant differences in some QOL domains, as measured by the Arabic version of the generic QLI. History of hospitalization and beliefs about COVID-19’s impact on general health negatively influenced individual’s HFSUB and PSPSUB.

Prenatal Psychosocial Profile: Validity and Reliability Study to Its Use in Turkey

Objective: This study was planned to test the statistical properties of the prenatal psychosocial profile assessment tool in Turkish sample and to examine its validity and reliability on healthy pregnant women.&#x0D; Methods: This reliability and validity study was conducted in the gynecology and obstetrics outpatient clinic of a training and research hospital with 440 healthy pregnant women between March and June 2017.&#x0D; Results: In the analysis performed for internal consistency in the Prenatal Psychosocial Profile (PPP) reliability study, Cronbach’s alpha reliability coefficient was found to be μ=.75 for the stress subscale, μ = .94 for the social support-partner subscale, μ = .96 for the social support-other people subscale, and μ= .80 for the self-esteem subscale. In the construct validity of the PPP-stress subscale, loads of all items except one item were found to be sufficient, and in the social support-partner, social support-other people, and self-esteem subscales, loads of all items were found to be sufficient.&#x0D; Conclusion: The Prenatal Psychosocial Profile-Turkish Version is a valid and reliable assessment tool that can be used to determine the psychosocial profile of women during pregnancy.

Intranasal Oxytocin in Children and Adolescents with Autism Spectrum Disorder

BackgroundExperimental studies and small clinical trials have suggested that treatment with intranasal oxytocin may reduce social impairment in persons with autism spectrum disorder. Oxytocin has been administered in clinical practice to many children with autism spectrum disorder.MethodsWe conducted a 24-week, placebo-controlled phase 2 trial of intranasal oxytocin therapy in children and adolescents 3 to 17 years of age with autism spectrum disorder. Participants were randomly assigned in a 1:1 ratio, with stratification according to age and verbal fluency, to receive oxytocin or placebo, administered intranasally, with a total target dose of 48 international units daily. The primary outcome was the least-squares mean change from baseline on the Aberrant Behavior Checklist modified Social Withdrawal subscale (ABC-mSW), which includes 13 items (scores range from 0 to 39, with higher scores indicating less social interaction). Secondary outcomes included two additional measures of social function and an abbreviated measure of IQ.ResultsOf the 355 children and adolescents who underwent screening, 290 were enrolled. A total of 146 participants were assigned to the oxytocin group and 144 to the placebo group; 139 and 138 participants, respectively, completed both the baseline and at least one postbaseline ABC-mSW assessments and were included in the modified intention-to-treat analyses. The least-squares mean change from baseline in the ABC-mSW score (primary outcome) was −3.7 in the oxytocin group and −3.5 in the placebo group (least-squares mean difference, −0.2; 95% confidence interval, −1.5 to 1.0; P=0.61). Secondary outcomes generally did not differ between the trial groups. The incidence and severity of adverse events were similar in the two groups.ConclusionsThis placebo-controlled trial of intranasal oxytocin therapy in children and adolescents with autism spectrum disorder showed no significant between-group differences in the least-squares mean change from baseline on measures of social or cognitive functioning over a period of 24 weeks. (Funded by the National Institute of Child Health and Human Development; SOARS-B ClinicalTrials.gov number, NCT01944046.)

Validation of the Arabic Severe Respiratory Insufficiency Questionnaire

Background/objectivesAssessment of Health-Related Quality of Life (HRQL) in patients with chronic respiratory insufficiency requiring Home Mechanical Ventilation (HMV) requires a valid measurement tool. The Severe Respiratory Insufficiency (SRI) questionnaire, originally developed in German, has been translated into different languages and tested in different contexts, but has so far not been in use in Arabic-speaking populations. The objective of this study is to validate the Arabic version of the SRI questionnaire in a sample of Arabic-speaking patients from Lebanon.MethodsFollowing forward/backward translations, the finalized Arabic version was administered to 149 patients (53 males–96 females, age 69.80 ± 10 years) receiving HMV. Patients were recruited from outpatient clinics and visited at home. The Arabic SRI and the 36-Item Short-Form Health Survey (SF-36) were administered, in addition to questions on sociodemographics and medical history. Exploratory Factor Analysis (EFA) was used to explore dimensionality; internal consistency reliability of the unidimensional scale and its subscales was assessed using Cronbach’s alpha. External nomological validity was examined by assessing the correlation between the SRI and SF-36 scores.ResultsThe 49-item Arabic SRI scale showed a high internal consistency reliability (Cronbach alpha for the total scale was 0.897 and ranged between 0.73 and 0.87 for all subscales). Correlations between the SF-36-Mental Health Component MHC and SF-36-Physical Health Component with SRI-Summary Scale were 0.57 and 0.66, respectively, with higher correlations observed between the SF-36 and specific sub-scales such as the Physical Functioning and the Social Functioning subscales [r = 0.81 and r = 0.74 (P < 0.01), respectively].Conclusion and recommendationsThe Arabic SRI is a reliable and valid tool for assessing HRQL in patients with chronic respiratory insufficiency receiving home mechanical ventilation.

Coronaphobia in patients with fibromyalgia.

Objectives This study aims to evaluate the level of coronaphobia caused by the novel coronavirus disease 2019 (COVID-19) pandemic in patients with fibromyalgia syndrome (FMS) and to compare the results in patients without FMS.Patients and methods Between August 2020 and October 2020, a total of 61 patients who were admitted to our outpatient clinic were included. The patients were divided into two groups as Group 1 (n=30; 2 males, 28 females; mean age: 43.2±9.3 years; range, 21 to 61 years) consisting of patients who were newly diagnosed or under follow-up for FMS and Group 2, the control group, (n=31; 4 males, 27 females; mean age: 49±10.7 years; range, 25 to 66 years) consisting patients who presented with any locomotor system complaint and were not diagnosed with FMS. Sociodemographic data of the patients and comorbidities were recorded. All the patients in both groups completed the COVID-19 Phobia Scale (C19P-S).Results The C19P-S total score and psychological, psychosomatic, social, and economic subscale scores were statistically significantly higher in the FMS group than the control group (p<0.05).Conclusion Our study results suggest that FMS patients have more concerns in this extraordinary global pandemic situation. Early detection of coronaphobia and timely psychological support are critical for individuals prone to psychological disorders, such as FMS.

RECONNECT (ZYN2-CL-033): DESIGN OF A PHASE 3 TRIAL OF ZYN002 CANNABIDIOL TRANSDERMAL GEL IN CHILDREN AND ADOLESCENTS WITH FRAGILE X SYNDROME BASED UPON LEARNINGS FROM CONNECT-FX (ZYN2-CL-016)

ZYN002 is a pharmaceutically manufactured transdermal cannabidiol gel in development for the treatment of behavioral symptoms in Fragile X syndrome (FXS). RECONNECT is a pivotal, randomized, double-blind, Phase 3 trial to assess the efficacy and safety of ZYN002 in children/adolescents aged 3 to 17 years with a full FMR1 gene mutation. RECONNECT is designed based on learnings from CONNECT-FX which was completed during the SARS-COV-2 (COVID-19) pandemic in patients with FXS dependent upon caregivers for assessments and support. The results and conduct of CONNECT-FX were reviewed to identify key learnings to design RECONNECT. Lessons learned: 1) treatment response for ZYN002 was greatest in patients with ≥90% methylation of the FMR1 gene; 2) the Aberrant Behavior Checklist–Community FXS Specific (ABC‒CFXS) was determined fit-for-purpose and meaningful within-patient change was determined for the Social Avoidance, Irritability and Socially Unresponsive/Lethargic subscales; 3) the Caregiver Global Impression of Severity/Change (CaGI-S/C) were highly responsive to change, with greatest change on the Social Interactions; 4) a FXS-specific Clinical Global Impression of Severity/Improvement (CGI-S/I) assessment was developed based upon outcomes in response to FDA guidance to use a disease-specific CGI; and 5) virtual visits were successfully incorporated as a result of COVID-19. RECONNECT will randomly assign approximately 200 patients 1:1 to receive 18-weeks of treatment with ZYN002 or placebo. The primary endpoint is change from baseline in the ABC‒CFXS Social Avoidance subscale at week 18 in patients with complete methylation of the FMR1 gene (100% by methylation PCR). Key secondary endpoints include change from baseline in ABC-CFXS Irritability, improvement in CaGI-C Social Interactions and FXS-specific CGI-I, and change from baseline in ABC-CFXS Social Avoidance in the full population (complete and partial methylation). Four of 8 visits will be virtual to reduce family burden. Results from RECONNECT may provide the data needed to support the potential approval of ZYN002 as the first treatment of the behavioral symptoms associated with FXS.

6.26 Lost in Translation: Expressed Emotion and Social Functioning in Youth With Autism Spectrum Disorder

Existing studies substantiate a relationship between high familial expressed emotion (EE) and externalizing behaviors in children with autism spectrum disorder (ASD); however, little is known about the relationship between EE and the severity of core symptoms of ASD, specifically social communication and adaptive functioning. This study assesses the hypothesis that EE demonstrates significant relationships with measures of social cognition, perception of the quality of peer relationships, and adaptive functioning. A preliminary analysis includes 16 adolescents with ASD ages 13 to 17 years old, and 12.5% were female. The Social Responsiveness Scale, Second Edition (SRS-2) was administered to measure social interaction and communication deficits. The Child and Adult versions of the Reading the Mind in the Eyes Tests (RMET-C and RMET-A, respectively) were administered as measures of theory of the mind. The Adaptive Behavior Composite score from the Vineland-3 (VABS-3) assessed adaptive functioning. The NIH Patient-Reported Outcomes Measurement Information System (PROMIS) measure was used to evaluate the perception of quality of peer relationships. EE was determined using the Five-Minute Speech Sample. There was a nonsignificant difference in the hypothesized direction between SRS-2 total score (p = 0.34), Social Communication subscale score (p = 0.34), and Social Communication and Interaction DSM-5–compatible subscale score (p = 0.36) between the high and low EE groups. On the RMET-C and -A, subjects with high caregiver EE had similar error rates as those with low EE (p = 0.18 for RMET-C and p = 0.36 for RMET-A). There was no significant difference between the groups on the VABS-3 (p = 0.86). High EE youth rated the quality of their peer relationships lower by 4.9 points on the PROMIS Peer Relationship scale than individuals with low EE (p = 0.16). Although these preliminary results do not support our hypotheses, the nonsignificant differences were in the hypothesized direction. Our sample size was small (N = 16) and likely lacking the power needed to identify significant differences in the social communication of youth with ASD living with low vs high degrees of caregiver EE. Directions for future study include reexamining these hypotheses with a larger sample size and identifying directionality in the association between EE and core deficits.

Analysis of Health-Related Quality of Life of Patients with Clinically Localized Prostate Cancer After Treatment with Intensity Modulated Radiation Therapy (IMRT) Versus 3D Radiation Therapy

Abstract Background Prostate cancer is the most common malignancy in men. Patients with localized prostate cancer have multiple treatment options including active surveillance, prostatectomy, brachytherapy, and external beam radiation therapy (EBRT). Aim of the Work: to report on the quality of life outcomes in a number of male patients who underwent intensity modulated radiation therapy (IMRT) for clinically localized cancer prostate, compared to patients underwent 3D CRT, using licensed Arabic version of FACT-P questionnaire. Patients and Methods The present study included 103 patients diagnosed by localized prostate cancer. Patients files were collected from International medical center and oncology department at Ain Shams University hospital from June 2018 to December 2018. They were divided into two groups: Group I consisted of 51 patients treated using 3D CRT, all of them are under hormonal treatment. They completed a questionnaire at (Month 0) baseline, then on the followup visit, after 3, 6 months (Month 3, 6). Group II consisted of 52 patients treated by IMRT and hormonal treatment, the same dose range and field as 3D CRT. They participated and completed the questionnaire at the same phases (Month 0, 3, 6) with the same methods as the 1st group. Results stability in HRQoL (social and emotional subscales) in 3DCRT and the IMRT groups, and no significant difference among the two groups was observed throughout the follow-up period, although the radiation doses prescribed differed from one another. And showed a significant improvement in scores of (physical, functional and prostate concerns) subscales. Conclusion The two approaches used in this study showed similar patterns of alterations regarding general and disease specific HRQL with mild superiority for IMRT for the first 6 months after radiation therapy. Comparison of results between the 3DCRT and the IMRT groups revealed no substantial degrees of impairment in rectal toxicity and sexual function despite the dose escalation in the IMRT protocol. Thus, IMRT seems to offer a good treatment delivery approach with favorable HRQL outcomes.

Mindfulness as a mediator in the relationship between social media engagement and depression in young adults

Social media engagement has been inconsistently linked to depression and it is important to determine whether specific motivations for engagement are linked to depression and what the mechanisms may be. This study investigated five factors of mindfulness as potential mediators between behavioral, affective, and cognitive social media engagement and depression. Participants (between 17 and 24 years old) at a university or found through social media (Reddit, Facebook, and Instagram; N = 371) were given the Five Factor Mindfulness Questionnaire (FFMQ), the Social Media Engagement Scale for Adolescents (SMES-A), and the Patient Health Questionnaire (PHQ-8), which measured depression. The awareness facet of mindfulness significantly mediated the relationship between all three social media engagement subscales (behavioral, affective, and cognitive) and depression. Additionally, there was a significant mediation between the affective engagement subscale and depression by the nonjudge, nonreact, and describe facets of mindfulness. Our results suggest that mindfulness is an important mechanism of the relationship between social media engagement and depression. The implementation of mindfulness-based interventions (MBIs) may be useful to help teach how to engage in social media mindfully and positively.

Persistent Symptoms, Quality of Life, and Correlates with Health Self-Efficacy in Adolescent and Young Adult Survivors of Childhood Cancer.

Purpose: The numbers of adolescent and young adult (AYA) survivors of childhood cancer are exponentially growing. To ensure suitable services are available to meet the needs of this growing population, understanding the experience of late effects, quality of life, and potentially modifiable factors, such as self-efficacy, is required. Methods: AYA survivors of childhood cancer recruited through an After Cancer Therapy Service at a Children's Hospital rated their symptoms experience, quality of life, and self-efficacy using the Patient Reported Outcome Common Terminology Criteria for Adverse Events, Functional Assessment of Cancer Therapy-General (FACT-G), and Patient-Reported Outcomes Measurement Information System (PROMIS®), respectively. Descriptive statistics were used to characterize the sample. Quality-of-life scores were compared with population norms. Regression analyses were used to explore the relationships between symptom experience, quality of life, and self-efficacy. Results: Thirty participants (mean age 22 ± 4.4 years) reported an average of nine symptoms as persistently experienced at moderate or higher rated intensity among participants (standard deviation ±8.7; range: 0-32; interquartile range: 2-16); over half (n = 17, 56.7%) had finished treatment 10 or more years ago. Participants scored lower on the FACT-G Physical Well-being and Emotional Well-being, and higher on Social Well-being subscales than the general population. Around two-thirds of participants were confident in their ability to self-manage their health based on their health self-efficacy score. Bivariate linear regression identified a statistically significant increase in the overall quality of life with increased self-efficacy, adjusted for age and sex (0.60, 95% confidence interval [CI] 0.30-0.90, p < 0.01). Higher symptom burden was associated with a lower overall quality of life after adjusting for age and sex (-0.95, 95% CI: -1.35 to -0.54, p < 0.001). Conclusion: Young cancer survivors experience a substantial number of persistent symptoms related to their cancer treatment that may negatively impact aspects of their quality of life. Health self-efficacy is a potential target for future interventions.

Contributors to Dysphagia-Related Burden Among Spousal Caregivers of Stroke Survivors

<h3>Research Objectives</h3> To identify individual- and dyadic-level factors associated with caregiver burden in couples experiencing post-stroke swallowing difficulties (dysphagia). As burden negatively impacts survivor and caregiver well-being, it is important to understand the variables that contribute to post-stroke caregiver burden. <h3>Design</h3> Cross-sectional online survey. <h3>Setting</h3> General community. <h3>Participants</h3> A volunteer sample of 28 adult stroke survivors with dysphagia (mean age 60 years) and their spouses (mean age 57 years). Survivors were >3 months post-stroke (median 12.5 months) and living with their spouse who was providing some degree of caregiving. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Dependent variable: dysphagia-related caregiver burden. Independent variables: swallowing-specific quality of life; stroke impact (Stroke Impact Scale; SIS); dietary restrictiveness (based on consumption of texture modified food and drink); survivor, spouse, and dyadic congruence of appraisal of dysphagia's impact on the social aspect and logistics of mealtimes (e.g., socializing during meals; meal preparation). <h3>Results</h3> Increased burden was significantly associated with greater survivor- and spouse-perceived impact of dysphagia on the logistics of mealtimes (r=.547, p=.002 and r=.758, p < .001, respectively), but was not associated with dyadic congruence of perceived impact (p=.113). Increased burden was also associated with increased dietary restrictiveness (r=-.647, p < .001) and decreased swallowing-specific quality of life (r=-.566, p=.001). Finally, burden was not associated with measures of stroke impact/severity (p=.265, .692, .120, .099 for physical, cognitive, emotional and social SIS subscales). <h3>Conclusions</h3> Factors related to dysphagia-related caregiver burden are multifactorial and include both survivor (dietary restrictiveness, swallowing-specific quality of life, perceived impact of dysphagia on mealtime logistics) and spousal (perceived impact of dysphagia on mealtime logistics) variables. These results support the interrelatedness of stroke survivor and caregiver health and well-being. There is a need for speech-language pathologists and other rehabilitation professionals to focus on the lived experience of both patients and their families in developing treatment plans. Further, incorporating increased dietary education and counseling into dysphagia management may facilitate reduced burden for stroke survivors and their families. <h3>Author(s) Disclosures</h3> Nothing to disclose.

Experience of Loneliness and Social Support during COVID-19 Confinement: A Nation-wide self-Assessment among Undergraduates of Nepal

In the account of the social nature of human beings, the given difficult circumstance due to COVID-19 may call upon social loneliness, emotional loneliness, and moreover, lack of perceived social support. We aim to elucidate by assessing the level of loneliness and the level of social support perceived by college students amidst the COVID-19 lockdown. A web-based cross-sectional survey was conducted among 970 Nepalese undergraduate students. Responses were extracted, cleaned, and analyzed with the help of R-studio (version 1.2.5033). Descriptive statistics such as frequency, percentage, mean and standard deviation described participants’ demographic characteristics. Karl Pearson’s Correlation analysis and significant test of correlation for loneliness, social support, and their various subscales, respectively were significant at 0.1%, 1%, and 5% level of significance. The mean age of respondents was 22.2 years (SD =2.74). Significant correlations were observed among social loneliness, emotional loneliness, overall loneliness (social loneliness and emotional loneliness combined), social family support, social friends support, social significant others support, and total social support (that is to say, all the social support subscales). The study reported that a decrease in social support leads to an increase in loneliness. Likewise, a decrease in social support from family, friends, and from significant others can increase emotional and overall loneliness.

CREATING AFFILIATIONS, LEARNING, AND MINDFULNESS FOR IN VITRO FERTILIZATION PATIENTS (CALM IVF)

Objective: To determine if a psychoeducational group (PG) model can improve quality of life (QoL) in patients undergoing IVF. Materials and Methods: Patients starting their first IVF cycle at our institution between 8/13/2019 - 12/31/2020 were recruited. Exclusions included previous IVF treatment, use of donor gametes/embryos, and non-English speakers. Enrolled participants completed baseline surveys (FertiQoL, PHQ-9, GAD-7, the 2-index Connor-Davidson Resilience scale, and an IVF knowledge survey). Participants were assigned to groups of 5-8 couples by projected oocyte retrieval date. Randomization to control (standard of care (SOC)) or intervention (CALM IVF + SOC) was done at the group level. CALM IVF participants attended 3 one-hour PG sessions prior to oocyte retrieval. 3 days after retrieval, all participants repeated surveys. Participants were followed for 3 months after retrieval to determine outcome and return to care. We estimated needing a sample size of 40 to show a 13.5 point difference in FertiQoL scores with 82.5% power and α=0.05. Analyses were performed using Student’s t-tests or Fischer’s exact tests as appropriate. Intent-to-treat analyses were performed for overall group differences as well as for differences in outcomes for those participating during the COVID-19 pandemic (after IVF clinical operations were paused on 3/16/20). Results: 76 couples enrolled. Due to drop-out, 20 females and 11 males participated in CALM IVF, and 20 females and 13 males in the control group. Those randomized to CALM IVF were more likely to experience a cancelled oocyte retrieval or poor embryo development in comparison to control (26% vs 13%). Males had significantly higher total QoL (6.68 [0.39 – 12.98], p=0.039), treatment QoL (8.26 [0.69 – 15.82], p=0.034), and resilience (1.13 [0.54 – 1.72], p=0.001) change in scores from pre-treatment to post-treatment after participating in CALM IVF versus control. Prior to COVID clinical pause, knowledge scores in the CALM IVF group significantly increased compared with control (13.19 [3.53 – 22.84], p=0.011). CALM IVF groups spanning 3/16/2020 and those recruited after had a significant improvement in the social subscale score (11.67 [-0.54 – 22.79], p=0.042 and 10.42 [1.79 – 19.04], p=0.023, respectively). Rates of ongoing pregnancy and return to care were not significantly different between groups. Conclusions: QoL and resilience are improved in males participating in CALM IVF during their first IVF cycle. Prior to COVID-19 shutdowns, CALM IVF improved IVF knowledge scores in participants. In participants who underwent treatment after COVID-19 shutdowns, CALM IVF improved social QoL scores. Impact Statement: Male partners of the IVF dyad may receive significant fertility related QoL and resilience benefits from a PG intervention. Female partners may experience improved social QoL with PG experiences, especially during a time of additional stressors and isolation.

The relationship between irritability and autism symptoms in children with ASD in COVID-19 home confinement period.

ObjectiveThis study investigated the impact of COVID‐19 home confinement on autism spectrum disorder (ASD) symptoms and irritability in children and adolescents with ASD.MethodThe study participants included 46 drug‐naive children aged 4‐17 years diagnosed with ASD. Parents of the participants completed the Autism Behaviour Checklist (AuBC) and Affective Reactivity Index (ARI) scales for both normal conditions and COVID‐19 home confinement.ResultsAll subscale scores for AuBC (sensory, relating, body and object use, language, and social and self‐help) and ARI scores significantly increased during the COVID‐19 home confinement period (P < .05). The participants’ irritability and ASD symptoms were significantly worse during the COVID‐19 outbreak and home confinement period compared to normal conditions. The variables that predicted irritability were the social and self‐help subscales of AuBC.DiscussionThese results have alerted us of the importance of focusing on the symptoms such as irritability exhibited by extremely vulnerable populations during disease outbreaks and of the necessity of developing new strategies to avoid such adverse outcomes in similar situations.

Perceived Discrimination and Social Isolation Among Postpartum Hispanic Women in the MADRES Pregnancy Cohort Before and After the COVID-19 Pandemic

BACKGROUND AND AIM: Previous research has shown that perceived discrimination and social isolation due to immigration policies have important health implications among US Hispanic populations. Moreover, the early postpartum period is characterized by periods of social isolation which may be exacerbated by the COVID-19 pandemic. The pandemic also coincided with a growing awareness of discrimination and structural racism experienced by marginalized communities. We evaluated differences in perceived discrimination and social isolation between early postpartum Hispanic women in Los Angeles before and during the COVID-19 pandemic. METHODS: Questionnaires were administered at one month postpartum to 176 Hispanic women in the MADRES pregnancy cohort. Perceived discrimination and social isolation are two subscales on the Perceived Immigration Policy Effects (PIPES) questionnaire. Respondents between 9/1/2018–3/1/2020 were classified as “pre-pandemic” (N=129) and between 3/1/2020–9/14/2020 as “during the pandemic” (N=47). Average social isolation and discrimination subscale scores were rounded to the nearest integer. Proportional odds models were used to evaluate COVID-19 pandemic impacts on perceived discrimination and social isolation among postpartum mothers. RESULTS:Participants were on average 28.9 (SD=5.9) years old and approximately half were born in Latin America (51.7%). Average pre-pandemic scores were 1.2 (SD=0.5) for both discrimination and social isolation and 1.4 (SD=0.6) for discrimination and 1.5 (SD=0.7) for social isolation during the pandemic. After adjusting for age, education, nativity, and postpartum distress, participants at one month postpartum during the pandemic had 3.98 times the odds of a higher score on the perceived discrimination scale (p=0.0017) and 5.29 times the odds of a higher score on the social isolation scale (p0.0001) than those responding to the questionnaire at one month postpartum before the pandemic. CONCLUSIONS:Higher perceived discrimination and social isolation at one month postpartum during the COVID-19 pandemic vs. pre-pandemic periods suggest increased social inequities during the pandemic among US Hispanic women. KEYWORDS: COVID-19, Mental health outcomes, Non-chemical stressors

P–478 Quality of life assessment in women undergoing assisted reproduction. A study of FertiQol and HADS

Abstract Study question The present study aims to explore infertility-related psychosocial outcomes, including fertility quality of life (QoL), as well as anxiety and depression levels, in women diagnosed with infertility. Summary answer Differences on fertility-related QoL appeared when comparing treatment types (gamete donation vs own gamete). Furthermore, statistically significant associations were found between QoL and anxious-depressive symptomatology. What is known already Those who wish to have children and do not achieve their objective just like other peers can see their goals and expectations with pessimism, generating concern and a series of negative emotions. Several psychological implications of infertility have been described, such as increased levels of stress, anxiety, depression, decreased self-esteem, mood and hope, or poor relationship adjustment. The emotional impact of infertility in people’s life cycle can be so strong that reducing it only to biological aspects would lead to a dangerous situation of neglect. For this reason, QoL assessment in ART becomes an important need. Study design, size, duration FertiQol stands as the most widely used tool to assess infertility-related QoL, overcoming the limitations of other instruments that only target specific medical conditions. The present is a multi-site cross-sectional study over patients with infertility (n = 104), aiming to explore their fertility-QoL, as well as their anxiety and depression levels, which are symptoms that have been previously associated.Questionnaire administration, and sociodemographic and medical data gathering took place between January 2019 and December 2020. Participants/materials, setting, methods Participants were 104 female patients (M.age= 39.8) undergoing or expecting a fertility treatment. The FertiQol Spanish version was administered through mobile app, and its paper version distributed at medical/psychological appointments. QoL was self-reported through FertiQol, assessing the influence of infertility problems in various areas (e.g. impact on self-esteem, emotions, general health, family, partners, social relationships, work, life projects...). Additionally, HADS (Hospital Anxiety and Depression Scale) was provided as a measurement of anxiety and depression levels. Main results and the role of chance Regarding treatments, 50.6% of participants were currently undergoing gamete donation while 44.3% were undergoing treatments that involved using their own gametes. After comparing QoL between these treatment types, results showed that patients who underwent egg donation, compared to those who used their own eggs, reported statistically significantly lower scores of QoL in the Social Subscale (p = .03), but not in the other psychological outcomes. Also, statistically significant negative correlations were found between HADS and all core FertiQol subscales (p&amp;lt; .05). Results are consistent with previous studies showing similar associations between fertility QoL and anxiety and depression, as well as with increased psychological negative implications of gamete donation. The majority of participants reported non-pathological scores of anxiety and depression when considering the cut off value of 8 for HADS, thus suggesting the presence of a relatively healthy sample. The number of treatments that patients had previously taken and the years of infertility were not associated with any of the psychological variables. Limitations, reasons for caution Some limitations to consider are presence of co-morbid diagnosis, differences in medication, or patient’s cultural backgrounds.Also, conclusions should be interpreted cautiously since the design doesn’t allow causal inferences. Further investigations should consider a continuous assessment to explore changes in psychological well-being at different points of intervention, specially with gamete donation. Wider implications of the findings: The great advantage we’ve seen so far when using FertiQol is the possibility to identify more accurately the true impact on other aspects of patient’s well-being besides the emotional area.ART professionals, including psychologists and counselors,will have more information within a small amount of time about QoL when using this tool. Trial registration number 1503-BCN–019-DG