Subscale Scores Research Articles

The Spectrum of Functional, Structural and Patient-Reported Outcomes in Intermediate Age-Related Macular Degeneration – A MACUSTAR Study Report

Introduction: There is an unmet medical need for therapies in intermediate age-related macular degeneration (iAMD). The prospective European multi-center cohort study MACUSTAR validates structural, functional and patient-reported iAMD endpoints for use in future trials. The multiplicity of assessments allows characterizing iAMD in more dimensions than previously available. We describe the heterogeneity of assessments in the iAMD baseline cohort of the MACUSTAR study. Methods: A wide range of assessments were administered across 20 European study sites in accordance with established guidelines. These assessments encompassed multiple structural evaluations, such as color fundus photography, fundus autofluorescence, and optical coherence tomography. Additionally, functional tests were conducted, including assessments of best-corrected and low-luminance visual acuity (VA), Moorfields acuity, contrast sensitivity, reading speed, mesopic and scotopic microperimetry, and dark adaptometry. Moreover, patient-reported outcome assessments, specifically the Vision Impairment in Low Luminance questionnaire, were also incorporated into the evaluation process. Associations between variables were investigated using Phi coefficients, Pearson correlation coefficients and age-corrected regression models. Results: Five-hundred eighty-five individuals with iAMD (66% women; mean (standard deviation) age: 72±7 years) were included in the MACUSTAR study. Forty-nine percent had pigmentary abnormalities, 27% had reticular pseudodrusen; 10% and 9% had incomplete and complete retinal pigment epithelium and outer retinal atrophy at baseline, respectively. Mean best-corrected VA, low-luminance VA and mesopic average threshold on microperimetry at baseline were 0.03±0.11 logMAR, 0.24±0.16 logMAR and 23.3±3.7 dB. Mean VILL subscale scores at baseline were 2±2 to 2±3 logits. Phi coefficients between structural assessments ranged between 0.17 and 0.22 (median 0.21); correlation coefficients between function tests ranged between 0.07 and 0.69 (median 0.34) and between VILL scores ranged between 0.21 and 0.68 (median 0.23). Conclusion: The findings from this broad and comprehensive spectrum of assessments of structure, function, and patient-reported outcomes in iAMD suggest that the disease spectrum is diverse and heterogeneous and that further efforts are necessary to fully understand and characterize iAMD in all its complexities. A further in-depth characterization will enable novel enrichment strategies for clinical trials in iAMD. Trial registration: ClinicalTrials.gov, NCT03349801. Registered on November 22, 2017

Advancing treatment response prediction in first-episode psychosis: integrating clinical and electroencephalography features.

Prompt diagnosis and intervention are crucial for first-episode psychosis (FEP) outcomes, but predicting the response to antipsychotics remains challenging. We studied whether adding electroencephalography (EEG) characteristics improves clinical prediction models for treatment response and whether EEG-based predictors are influenced by initial treatment. We included 115 antipsychotic-naïve patients with FEP. Positive and Negative Syndrome Scale (PANSS) and sociodemographic items were included as clinical features. Additionally, we analyzed resting-state EEG data (n = 45) for (relative) power, functional connectivity, and network organization. Treatment response, measured as change in PANSS positive subscale scores (∆PANSS+), was predicted using a random forest regression model. We analyzed whether the most predictive EEG characteristics were influenced after treatment. The clinical model explained 12% variance in symptom reduction in the training set and 32% in the validation set. Including EEG variables in the model led to a nonsignificant increase of 2% (total 34%) explained variance in symptom reduction. High hallucination symptom scores and a more hierarchical organization of alpha band networks (tree hierarchy) were associated with ∆PANSS+ reduction. The tree hierarchy in the alpha band decreased after medication. EEG source analysis revealed that this change was driven by alterations in the degree and centrality of frontal and parietal nodes in the functional brain network. Both clinical and EEG characteristics can inform treatment response prediction in patients with FEP, but the combined model may not be beneficial over a clinical model. Nevertheless, adding a more objective marker such as EEG could be valuable in selected cases.

The Effectiveness of a Pap Smear Screening Practical Skills Training Program for Nurse-Midwifery Students

Pap smear screenings effectively reduce the incidence of cervical cancer. However, the effectiveness of practical teaching strategies for this procedure is seldom discussed. This study was designed to evaluate the effectiveness of a Pap smear screening training approach using the two strategies of classroom simulation and practical community screening demonstrations. Convenience sampling was used to recruit undergraduate students enrolled between 2021 and 2023 in the nursing midwifery department of a national university. Data were collected between September 2023 and June 2024 and analyzed using a pre-experimental design with a one-group pretest-posttest design. The learning outcomes considered included self-directed learning ability and practical ability performance in cervical smear procedures. Self-directed learning ability was assessed using a self-reported questionnaire, while practical ability performance was separately evaluated by two instructors using direct observation. Fifty-two students were enrolled as participants. Over time, and with the changes in teaching strategies, significant improvements were observed in self-directed learning ability in terms of mean total and subscale scores. In addition, DOPS scores showed a significant increase in practical ability performance. Integrating clinical hands-on training into classroom-based simulation teaching can enhance autonomous learning, improve skill proficiency, and foster future self-directed learning and practical abilities in students to promote women's health.

Colorectal Cancer Screening Participation and Health Belief Levels of Public Hospital Patients in Türkiye.

Colorectal cancer can be diagnosed early with screening tests; therefore, patients' beliefs regarding colorectal cancer screening are closely related to clinical and pathological disease stages at the time of diagnosis. This study aimed to determine participation in colorectal cancer screening programs and health beliefs related to protection from colorectal cancer among patients aged 40-70years and evaluate factors affecting their participation in such screening programs. This descriptive study was conducted in a state hospital in Türkiye between May 2021 and December 2021 with the participation of 1,016 patients. Study data were collected through face-to-face interviews using a questionnaire consisting of an "Introductory Information Form" and the "Health Belief Model Scale for Prevention of Colorectal Cancer." Signed voluntary consent was obtained from all participants, as well as ethics committee approval and institutional permission from the hospital. The mean age of the participants was 50.12±9.29years, 54% were 40-50years old, 55.5% were female, 87.3% were married, 6.8% had a primary education or below, and 39.3% were employed. The internal consistency was low for the health motivation subscale and relatively high for other subscales of the Health Belief Model Scale for Prevention of Colorectal Cancer.

Abstract TP109: Safety and Feasibility of Paired Upper Extremity Gamified Rehabilitation and Vagus Nerve Stimulation in Patients with Chronic Stroke

Introduction: Upper extremity motor impairment and hemiparesis are prevalent following stroke, and can impact independence, ability to perform activities of daily living and overall quality of life.1 While the majority of motor recovery post stroke occurs within the initial 3 months, gains can continue through chronic stages.2 Evidence has identified vagus nerve stimulation (VNS) paired with intensive rehabilitation as an effective intervention for improving upper extremity (UE) function in persons with chronic stroke.3 Utilization of gaming-based stroke rehabilitation has been shown to increase engagement and improve UE motor function.4–6 This work reports on a cohort of patients with chronic stroke who participated in gamified UE rehabilitation paired with VNS. Methods: Data from 6 patients with UE motor impairment due to chronic stroke (> 1 year) were included. Following surgical vagus nerve stimulator implantation, patients participated in UE therapy sessions 3 times a week for 6 weeks. Intervention included gamified rehabilitation with VNS triggered upon each movement attempt. Between sessions, patients were provided with a magnet to activate VNS while performing an UE home activity program up to 8 times per day. Each self-initiated stimulator activation delivered 30 minutes of VNS. At the conclusion of 6 weeks, patients were encouraged to continue their VNS home program. Safety was assessed using adverse event reporting. Feasibility was assessed using time on task reported by the gamified rehabilitation software. Exploratory clinical outcomes included the Action Research Arm Test (ARAT) and Fugl Meyer Assessment (FMA) at baseline following implantation, upon completion of 6 weeks of therapy, and at 4 months post intervention. Results: Patients participated in 64.1 ± 14.9 mins of gamified rehabilitation per session with 29.9 ±8.6 of those minutes being active time on task. No adverse events were reported. FMA-UE motor subscale and ARAT scores increased from baseline to the end of 6 weeks by an average of 9.3±3.6 and 7±7.4 respectively. Average increases from baseline to 4 month follow up for FMA-UE motor subscale and ARAT score were 14±6.3 and 10±8.2 respectively. Conclusion: These findings suggest that VNS paired with gamified rehabilitation is a safe and feasible intervention for UE motor impairment post stroke. Future work will investigate short- and long-term feasibility and efficacy of the intervention in patients with chronic stroke.

Risk Factors for Incontinence-Associated Dermatitis in Adults: A Systematic Review and Meta-Analysis.

A meta-analysis was conducted to comprehensively identify risk factors of incontinence-associated dermatitis (IAD) in adults and provide evidence-based support for healthcare professionals to formulate IAD preventive interventions and bundled interventions. Systematic review and meta-analysis of pooled findings. Two researchers independently searched databases PubMed, EBSCO, Cochrane Library, Embase, Medline, Web of Science and Scopus and 4 Chinese databases (CNKI, Wanfang Data, VIP and CBM) for relevant studies published from their inception to March 15, 2023. Two researchers independently extracted relevant data and literature characteristics and evaluated the quality of the included studies. Twenty-seven studies that collectively enrolled 4046 participants were included in our systematic review. Five were written in English, 1 was written in Spanish, and the other 21 were written in Chinese. The odds ratios (ORs) and 95% confidence intervals (CIs) of the risk factors for IAD were determined. Fecal incontinence, an etiologic factor (OR=5.79; 95% CI=[1.88-17.87]), stool characteristics (OR=5.28; 95% CI=[2.51-11.07]), and daily frequency of bowel movements (OR=5.76; 95% CI=[4.48-7.42]) were associated with an increased likelihood of IAD. The following risk factors: fever (OR=4.23; 95% CI=[1.89-9.46]), age (OR=1.04; 95% CI=[1.01-1.09]), hypoproteinemia (OR=3.30; 95% CI=[1.90-5.72]), impaired consciousness (OR=2.43; 95% CI=[1.66-3.54]), days of antibiotic use (OR=4.13; 95% CI=[3.11-5.49]), diabetes mellitus (OR=2.90; 95% CI=[1.73-4.86]), and a higher overall Perineal Assessment Tool (PAT) score (OR=2.56; 95% CI=[1.23-5.30]) emerged as independent risk factors for IAD in adult patients. In contrast, a higher serum albumin level (OR=0.88; 95% CI=[0.84-0.93]), a higher Braden Scale for Predicting Pressure Score Risk (Braden Scale) score (OR=0.66; 95% CI=[0.56-0.77]), and a higher Braden Scale mobility subscale score (OR=0.86; 95% CI=[0.74-1.00]) were protective factors that reduced the likelihood of IAD. Identification of risk factors for IAD may be used to identify patients at risk and in need of preventive interventions. Identification of modifiable risk factors may be used to design novel preventive interventions.

The effect of dance and massage applied by spouses during childbirth on labor pain, comfort, and satisfaction.

The aim of this study is to evaluate the effects of endorphin massage and dance applied by spouses during labor on labor pain, satisfaction with childbirth, postpartum comfort, and person-centered maternity care. The sample of this randomized controlled experimental study consists of 105 pregnant women in their second childbirth (35 in the birth dance group,35 in the endorphin massage group, and 35 in the control group). The endorphin massage taught by the researcher to the pregnant women and their spouses was applied for 10min. For the dance group, the birth dance, taught by the researcher to the pregnant women and their spouses, was performed for at least 15min per session. The control group received routine midwifery care. Data were collected using the Descriptive Information Form, Visual Analog Scale, Birth Satisfaction Scale, Postpartum Comfort Scale, and Person Centered Maternity Care Scale. No significant difference was found in the total scores of the Person Centered Maternity Care scale between the groups. However, the communication and autonomy subscale scores of the massage group were significantly higher than those of the dance group. The total Birth Satisfaction Scale score of the dance group was significantly higher than those of the massage and control groups (133,17±9,85; 125,54±11,18; 122,4±11,55, respectively). The VAS-2 scores of participants in the dance and massage groups were significantly lower than those in the control group after the interventions (4,83±0,79; 4,69±0,72, 7,89±0,93, respectively). The study found that dance and massage had a positive effect on postpartum comfort, person-centered maternity care, and childbirth satisfaction, and significantly reduced the average pain scores felt during labor.

The effect of the self-management promotion model on the quality of life of patients with chronic heart failure: A randomized clinical trial

The present study aims to determine the effect of the self-management promotion model on the quality of life of patients with chronic heart failure. A randomized controlled trial was conducted at Kashan University of Medical Sciences in Iran, to investigate the effects of the self-management promotion model on the quality of life among individuals diagnosed with chronic heart failure. Sampling was conducted using a continuous method, followed by random allocation into two groups: control and intervention, through a stratified block method. In the intervention arm, the self-management promotion model was implemented, consisting of six stages. The data collection instrument employed in this study consisted of a two-part questionnaire, encompassing background information inquiries and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). The 60 patients enrolled in this study on heart failure management. The participants were stratified into two groups: intervention and control. A noteworthy contrast emerged in the socioeconomic subscale scores before, immediately post, and one month following the intervention within the intervention group (P=0.039). Conversely, no significant distinctions were observed between the control and intervention groups across the remaining subscales and the overall score during the three temporal intervals before, immediately following, and one month after the intervention (P>0.05). The findings of the current study collectively indicate that the implementation of the self-management promotion model in heart failure patients did not yield statistically significant effects on their quality of life.

Professional Identity and Self-efficacy Among Occupational Therapy Students Engaged in Objective Structured Clinical Examination Utilizing Simulation Learning.

Objective structured clinical examination (OSCE) is widely used in health programs and has been applied in medical education to enhance clinical knowledge and help build clinical competence and confidence. It is carried out in different clinical stations that simulate real clinical situations and scenarios and helps prepare students for clinical training and practical applications. The purpose of this study was to investigate the change in professional identity and self-efficacy of occupational therapy students after applying OSCE utilizing simulated learning. A pre-post study design was used. The participants were 48 occupational therapy university students at 1 university in Saudi Arabia. Total scores and subscale scores for professional identity and self-efficacy were compared before and after OSCE using the Wilcoxon signed- rank test. Spearman's rank correlation coefficient was calculated to examine the relationship between professional identity and self-efficacy. There were significant increases in both professional identity and self-efficacy total scores after OSCE (P < .05). Most items in the professional identity, such as choosing occupational therapy again (P < .01) and improving occupational therapy skills (P < .01) and the self-efficacy, such as doing very well in class (P < .01) and ability to learn the material for class (P < .01) increased significantly. OSCE utilizing simulated-based learning plays a supportive role in forming occupational therapy students' identities as clinicians and can potentially enhance their overall self-efficacy, professional identity and growth. It is a beneficial teaching and learning strategy for occupational therapy educators and considered important steppingstones for students transitioning to real life occupational therapy practice.

Is the Modified Dental Anxiety Scale (MDAS) a Single or Two Construct Measure? A Theoretical and Pragmatic Perspective

Background: The MDAS questionnaire is one of a number of scales available to assess dental anxiety. It is widely used and translated into many world languages; however, it lacks an explicit theoretical backdrop to the content and structure of the measure. This paper draws upon original expositions of dental anxiety: how it develops, is maintained, and how this draws attention to a re-evaluation of the measure. To assist this inspection it was proposed to investigate a two latent construct formulation through a stepwise analysis using data from a representative survey of English respondents on their oral health (the Adult Dental Health Survey). Aim: To present a brief theoretical framework to underpin the measure and, as part of this study’s objectives, to provide some evidence to support the measure’s potential two-construct structure. Method: Narrative review, structural equation modelling, and testing of specific associations to indicate a two latent construct formulation. Data included the MDAS items (where items 1 and 2 comprise the anticipatory subscale, and items 3 to 5 describe the treatment-related subscale). These items were completed by the representative sample of respondents from the most recent Adult Dental Health Survey conducted in 2009. Results: The two latent construct solution for describing dental anxiety was supported. The anticipated and treatment-related subscales could be discriminated, although they were strongly correlated, demonstrating overlap. Comparison of how each construct varied across the three age groups suggests an interesting heterogeneity. In addition, the two constructs behaved differently when acknowledging previous experience of respondents’ last dental visit. Anticipatory dental anxiety was more strongly related to oral health-related quality of life (OHRQoL) than treatment-related dental anxiety as predicted. This partial evidence from empirical data and previous reports in other studies suggests that the separation of the MDAS measure into the two subscales may be warranted. Discussion: Researchers are recommended to report not only the total score of the MDAS in their studies but also consider presenting the two subscale scores, namely, anticipatory and treatment-related dental anxiety. Further work is indicated to determine if clinicians may find the subscales of use when assessing their patients.

Predictors of Antidepressant Use Among People With Multiple Sclerosis.

Anxiety and depression are common among individuals with multiple sclerosis (MS) but are often undertreated. Little is known about factors that influence the odds of antidepressant treatment for MS. The authors aimed to identify predictors of antidepressant use among people with MS. A retrospective chart review was undertaken for a consecutive sample of 315 individuals with MS attending a tertiary neuropsychiatry clinic in Toronto. Predictor variables of antidepressant use included age, sex, MS duration and subtype, disease-modifying therapy use, psychotropic medication use, Expanded Disability Status Scale (EDSS) score (for neurological disability), Hospital Anxiety and Depression Scale subscale score (for anxiety and depression), and the abbreviated five-item Modified Fatigue Impact Scale (MFIS-5) score (for fatigue). Independent predictors of antidepressant use were identified with backward stepwise regression analyses (p<0.05). Participants' mean±SD age was 45.5±11.4 years, 74% were female, the mean EDSS score was 2.8±1.9 out of 10.0, and 70% had a relapsing-remitting subtype of MS. Psychotropic medication use such as antipsychotics and anxiolytics (OR=1.77, p<0.01), increased EDSS scores (OR=1.20, p<0.01), and increased MFIS-5 scores (OR=1.11, p<0.01) independently predicted antidepressant use. Polypharmacy, neurological disability, and fatigue may increase the odds of antidepressant use among people with MS. These findings clarify differences between people with MS who use or do not use antidepressants, shedding light on the factors that may influence antidepressant use among people with MS.

Xanomeline-Trospium for Adults with Schizophrenia Experiencing Acute Psychosis: A Systematic Review and Meta-analysis of Safety and Tolerability Outcomes.

The United States Food and Drug Administration approved the xanomeline-trospium combination in September 2024 for treating schizophrenia, based in part on three double-blind, randomized placebo-controlled trials in adults with schizophrenia experiencing acute psychosis. This random-effects model pairwise meta-analysis of those three trials found that xanomeline-trospium was comparable to placebo in terms of all-cause discontinuation, discontinuation rate due to adverse events, Simpson-Angus Scale score change, Barnes Akathisia Rating Scale score change, body weight change, body mass index change, blood pressure change, serum total cholesterol change, blood glucose change, QTc interval changes, and the incidence of headache, somnolence, insomnia, dizziness, akathisia, agitation, tachycardia, gastroesophageal reflux disease, diarrhea, increased weight, and decreased appetite. However, xanomeline-trospium was associated with a higher incidence of at least one adverse event, dry mouth, hypertension, nausea, vomiting, dyspepsia, and constipation, and increased serum triglyceride compared with placebo. Notably, xanomeline-trospium demonstrated superior efficacy than placebo in improving the Positive and Negative Syndrome Scale (PANSS) total score, PANSS positive subscale score, and PANSS negative subscale score.

Accelerometer-Assisted Physical Activity Outcomes During the First Year of Recovery After Anterior Cruciate Ligament Reconstruction: A Prospective Cohort Pilot Study.

Wearable activity-measurement devices are increasingly popular among the public, but there is little information regarding their use among patients undergoing sports medicine procedures. The purpose of this study was to compare accelerometer-measured data with traditional patient-reported measures and to determine the trajectory of physical activity from before surgery to 1 year after anterior cruciate ligament reconstruction. Adult patients undergoing primary anterior cruciate ligament reconstruction were enrolled in this prospective cohort pilot study. The Tegner activity scale, Marx activity scale, International Physical Activity Questionnaire Short Form (IPAQ-SF), Knee injury and Osteoarthritis Outcome Score (KOOS), and EuroQoL-5D were administered preoperatively and 3, 6, and 12 months postoperatively. At these intervals, each patient was asked to wear an accelerometer for 7 consecutive days. Time spent in moderate-to-vigorous physical activity (MVPA min/wk), metabolic equivalents of physical activity, and average daily steps were calculated from the accelerometer output and correlated with patient-reported measures. Twenty-eight patients were included in this study. Of the 28 patients, 20 remained, and at the 12-month analysis, 18 patients were analyzed. There were significant improvements in Tegner activity scale score, KOOS symptoms, sports/recreation, and quality of life subscales, and IPAQSF MVPA min/wk at final follow-up. All accelerometer-based outcomes had improvements at 3, 6, and 12 months. The accelerometer may be a useful tool for understanding patients' activity levels at different time points during their recovery and for providing tangible targets for patients to achieve at least an average recovery. [Orthopedics. 202x;4x(x):xx-xx.].

Sleep spindles and slow oscillations predict cognition and biomarkers of neurodegeneration in mild to moderate Alzheimer's disease.

Changes in sleep physiology can predate cognitive symptoms by decades in persons with Alzheimer's disease (AD), but it remains unclear which sleep characteristics predict cognitive and neurodegenerative changes after AD onset. Using data from a prospective cohort of mild to moderate AD (n=60), we analyzed non-rapid eye movement sleep spindles and slow oscillations (SOs) at baseline and their associations with baseline amyloid beta (Aβ) and tau and with cognition from baseline to 3-year follow-up. Higher spindle and SO activity predicted significant changes in Aβ and tau at baseline, lower Alzheimer's Disease Assessment Scale Cognitive Subscale (better cognitive performance) score, and higher Mini-Mental State Examination score from baseline to 36 months. Spindles and SOs mediated the effect of phosphorylated tau 181 (pTau181)/Aβ42 on cognition, while pTau181/aβ42 moderated the effect of spindles and SOs on cognition. Our findings demonstrate that spindle and SO activity during sleep constitute predictive and non-invasive biomarkers of neurodegeneration and cognition in AD patients. Sleep spindles predict long-term cognitive performance in AD. Sleep spindle and SOs can be predictive, non-invasive biomarkers for AD. Sleep may be one of the most important modifiable risk factors for AD progression. Sleep microarchitecture is a novel therapeutic target for preserving brain heath. Sleep physiology can provide novel therapeutic targets to slow AD progression.

Low-level auricular vagus nerve stimulation lowers blood pressure and heart rate in paroxysmal atrial fibrillation patients: a self-controlled study

ObjectiveTo investigate the effects of low-level auricular vagus nerve stimulation (LL-aVNS) on blood pressure and heart rate in patients with paroxysmal atrial fibrillation.MethodsA total of 22 patients with paroxysmal atrial fibrillation diagnosed in Fuzhou First General Hospital Affiliated with Fujian Medical University from September 2021 to December 2022 were selected and given LL-aVNS treatment based on the original unchanged drug treatment for 4 weeks. The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate maximum (HRmax), heart rate minimum (HRmin), left ventricular ejection fraction (LVEF), left atrial diameter (LAD), Atrial Fibrillation Severity Scale (AFSS) symptom subscale, and Memorial Symptom Assessment Scale-Heart Failure (MSAS-HF) before and after the treatment were observed and compared. In addition, adverse effects of the LL-aVNS procedure and 6-month follow-up were recorded.ResultsSBP, DBP, and HRmin were lower after the treatment than before the treatment (p &amp;lt; 0.05); AFSS symptom subscale scores and MSAS-HF scores after the treatment were lower before the treatment (p &amp;lt; 0.05); itching of the skin was observed in one case during the course of LL-aVNS; and two patients were hospitalized for acute exacerbation of chronic heart failure between 4 months and 6 months after the treatment.ConclusionLL-aVNS in patients with paroxysmal atrial fibrillation can assist in controlling blood pressure and heart rate, effectively relieving symptoms, and the treatment process is safe and feasible.

Attention Deficit Hyperactivity Disorder and Treatment Adherence in Adolescent Acne Patients: Investigating the Relationship for Better Care Strategies

Introduction: Accompanying comorbidities in acne vulgaris (AV) patients affect treatment adherence. Objectives: The purpose of this study was to investigate the relationship between treatment compliance and attention deficit hyperactivity disorder (ADHD) in adolescents with AV. Methods: This study included 140 patients with AV. At the beginning of the treatment, each patient's acne severity was assessed, and the Conners-Wells' Adolescent Self-Report Scale-Long Form (CASS-L) was administered. The Morisky Medication Adherence Scale (MMAS-8) was used to assess treatment adherence. The treatment response was assessed using a six-point scale. Results: Significant differences were found in the scores on the 10 subscales of the CASS-L among the 3 groups. The Global Acne Grading System (GAGS) scores showed a positive correlation with the scores of the subscales of the CASS-L, with 3 of them at a moderate level and 7 at a weak level. Five MMAS subscales had a weak correlation and 5 had a moderate correlation with the CASS-L subscale scores. The 9 subscales and the treatment response showed a slight negative correlation. Conclusion: ADHD is one of the many psychiatric comorbidities that frequently coexist with acne vulgaris. Its treatment is long-term and achieving a good treatment response relies heavily on patient adherence. Our study, which showed a decrease in acne treatment adherence and response as ADHD symptoms increased, will raise awareness among dermatologists to be more vigilant in their approach to this patient group.

An Investigation of the Psychological Need Satisfaction Levels of Foster Families

Purpose: This study aimed to investigate the psychological need satisfaction levels of foster families. Design/Methodology/Approach: The present study is descriptive and cross-sectional. Data were collected between July 1 and 30, 2020, from 138 volunteer foster parents living in Turkey. Findings: The Need Satisfaction Scale was a significant difference was found by age group in the subscale and overall scale scores of the individuals participating in the study. Significant differences by families’ educational status were only present in the Competence subscale. Significant differences by age at which they became foster families were found in the Autonomy subscale and overall scores, and significant differences by age of fostered child were found in the Competence and overall scores (p

Uniform Differential Item Functioning Across Gender, Grade Level and Racial Groups: A MIMIC Investigation of the Non-clinical Parent Ratings of the Pediatric Symptom Checklist-17

The Pediatric Symptom Checklist-17 (PSC-17) is a screening instrument designed to measure children’s behavioral and emotional problems. This study investigated the factor structure of the PSC-17 and the uniform differential item functioning (DIF) of the PSC-17 item scores as a function of school children’s gender, grade level, and racial/ethnic groups. Parent ratings of 1,305 children from pre-K to Grade 1 were used. Confirmatory factor analysis (CFA) of the scale’s factor structure indicated that parent ratings of PSC-17 were composed of three subscales: Externalizing Problems, Internalizing Problems, and Attention Problems. A multiple indicators multiple causes (MIMIC) analysis results showed that four of the PSC-17 items exhibited statistically uniform DIF as a function of race/ethnicity but not as a function of gender or grade level. Uniform DIF had little impact on latent mean differences of Internalizing, Attention, and Externalizing Problems among gender, race/ethnicity, and grade-level groups. This study’s results implied that teachers or schools should be cautious with comparing racial/ethnic groups at the item level. However, they can compare children’s subscale scores across gender, race/ethnicity, and grade levels with parent ratings of the PSC-17.

The Development and Psychometric Properties of Malay Language Child Oral Health Impact Profile—Short Form 19 (ML COHIP-SF 19)

Background/Objectives: The Child Oral Health Impact Profile—Short Form 19 (COHIP-SF 19) is widely used to measure the oral health-related quality of life (OHRQoL) of children and adolescents. The current study aimed to validate the Malay language version of the COHIP-SF19 (ML COHIP-SF 19) and to assess its psychometric properties among Malaysian children/adolescents. Methods: Children aged from 9 to 16 years attending the Faculty of Dentistry, Universiti Teknologi MARA (UiTM) participated in this study. The original English version of the COHIP-SF 19 was translated using forward- and back-translation. The psychometric properties of the final version were tested for reliability and validity using Cronbach’s alpha, a non-parametric Spearman’s correlation test, and confirmatory factor analysis (CFA). Results: A total of 252 children aged from 9 to 16 years (mean age = 11.33 ± 1.87 years) self-completed the ML-COHIP-SF 19. The total scores of the ML COHIP-SF 19 ranged from 20 to 75 (mean = 55.67 ± 10.45) with an internal consistency (α) of 0.81. Convergent validity showed a fair correlation between self-perceived oral health rating and total ML COHIP-SF 19 scores, as well as the socio-emotional well-being subscale scores (rs = 0.38–0.42, p &lt; 0.01). Conclusions: The ML COHIP-SF 19 demonstrated reliable psychometric properties and acceptable four-factor model fits, indicating that it is a valid tool to measure the OHRQoL of Malaysian children aged from 9 to 16 years.

The relationship among heart health attitudes, socioeconomic factors, and HbA1c levels in adolescents with type 1 diabetes

Background Type 1 Diabetes is important chronic health problem that incidence increasing between the ages of 4–6 and 10–15, has multi-dimensional etiological factors. Cardiovascular diseases may develop due to diabetes and cause significant morbidity and mortality. Diabetes cause deterioration of vascular structure, and sudden onset of heart disease through various pathophysiological mechanisms. Controlling factors, especially diabetes management, is very important in preventing cardiovascular diseases. Objective The study aimed to investigate the relationship between heart health attitudes, socioeconomic factors, and HbA1c levels in adolescents with Type 1 Diabetes. Methods The study included 10–15-year-old adolescents with Type 1 Diabetes treated in pediatric endocrinology outpatient clinic provided they met the inclusion and exclusion criteria. Adolescents’ heart health attitudes were evaluated with the cardiovascular health promotion attitude scale for children. HbA1c levels and socioeconomic characteristics of the adolescents were recorded. Results The independent predictors of the group with favorable heart health attitudes were exercise duration, meal frequency, low economic status, and HbA1c levels. HbA1c levels were positively associated with nutrition, exercise, sedentary life, and smoking subscale scores as well as total scale scores. However, it was not associated with the scores of self-love and stress subscales. Low self-love and stress subscale scores were independent predictors of low economic status and explain why low economic status is a predictor of favorable heart health attitudes. Conclusions The cardiovascular health promotion attitude scale scores are associated with HbA1c levels, which is a predictor of increased cardiovascular diseases. This predictive ability of the scale makes its use meaningful.