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Lee S, Kang M. A Data-Driven Approach to Predicting Recreational Activity Participation Using Machine Learning. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-13. [PMID: 38875156 DOI: 10.1080/02701367.2024.2343815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/07/2024] [Indexed: 06/16/2024]
Abstract
Purpose: With the popularity of recreational activities, the study aimed to develop prediction models for recreational activity participation and explore the key factors affecting participation in recreational activities. Methods: A total of 12,712 participants, excluding individuals under 20, were selected from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. The mean age of the sample was 46.86 years (±16.97), with a gender distribution of 6,721 males and 5,991 females. The variables included demographic, physical-related variables, and lifestyle variables. This study developed 42 prediction models using six machine learning methods, including logistic regression, Support Vector Machine (SVM), decision tree, random forest, eXtreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM). The relative importance of each variable was evaluated by permutation feature importance. Results: The results illustrated that the LightGBM was the most effective algorithm for predicting recreational activity participation (accuracy: .838, precision: .783, recall: .967, F1-score: .865, AUC: .826). In particular, prediction performance increased when the demographic and lifestyle datasets were used together. Next, as the result of the permutation feature importance based on the top models, education level and moderate-vigorous physical activity (MVPA) were found to be essential variables. Conclusion: These findings demonstrated the potential of a data-driven approach utilizing machine learning in a recreational discipline. Furthermore, this study interpreted the prediction model through feature importance analysis to overcome the limitation of machine learning interpretability.
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Zhang W, Wang J, Xie F, Wang X, Dong S, Luo N, Li F, Li Y. Development and validation of machine learning models to predict frailty risk for elderly. J Adv Nurs 2024. [PMID: 38605460 DOI: 10.1111/jan.16192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/16/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024]
Abstract
AIMS Early identification and intervention of the frailty of the elderly will help lighten the burden of social medical care and improve the quality of life of the elderly. Therefore, we used machine learning (ML) algorithm to develop models to predict frailty risk in the elderly. DESIGN A prospective cohort study. METHODS We collected data on 6997 elderly people from Chinese Longitudinal Healthy Longevity Study wave 6-7 surveys (2011-2012, 2014). After the baseline survey in 1998 (wave 1), the project conducted follow-up surveys (wave 2-8) in 2000-2018. The osteoporotic fractures index was used to assess frailty. Four ML algorithms (random forest [RF], support vector machine, XGBoost and logistic regression [LR]) were used to develop models to identify the risk factors of frailty and predict the risk of frailty. Different ML models were used for the prediction of frailty risk in the elderly and frailty risk was trained on a cohort of 4385 elderly people with frailty (split into a training cohort [75%] and internal validation cohort [25%]). The best-performing model for each study outcome was tested in an external validation cohort of 6997 elderly people with frailty pooled from the surveys (wave 6-7). Model performance was assessed by receiver operating curve and F2-score. RESULTS Among the four ML models, the F2-score values were similar (0.91 vs. 0.91 vs. 0.88 vs. 0.90), and the area under the curve (AUC) values of RF model was the highest (0.75), followed by LR model (0.74). In the final two models, the AUC values of RF and LR model were similar (0.77 vs. 0.76) and their accuracy was identical (87.4% vs. 87.4%). CONCLUSION Our study developed a preliminary prediction model based on two different ML approaches to help predict frailty risk in the elderly. IMPACT The presented models from this study can be used to inform healthcare providers to predict the frailty probability among older adults and maybe help guide the development of effective frailty risk management interventions. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Detecting frailty at an early stage and implementing timely targeted interventions may help to improve the allocation of health care resources and to reduce frailty-related burden. Identifying risk factors for frailty could be beneficial to provide tailored and personalized care intervention for older adults to more accurately prevent or improve their frail conditions so as to improve their quality of life. REPORTING METHOD The study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Wei Zhang
- First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Junchao Wang
- China-Japan Union Hospital of Jilin University, Changchun, China
| | - Fang Xie
- Zhejiang University School of Medicine, Hangzhou, China
| | - Xinghui Wang
- School of Nursing, Jilin University, Changchun, China
| | - Shanshan Dong
- Hepatopancreatobiliary Surgery Department, General External Center, First Hospital of Jilin University, Changchun, China
| | - Nan Luo
- The Second Hospital of Jilin University, Changchun, China
| | - Feng Li
- School of Nursing, Jilin University, Changchun, China
| | - Yuewei Li
- School of Nursing, Jilin University, Changchun, China
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Boulanger B, Bégin C, Bédard A, Lévy-Ndejuru J, Carbonneau É, Lemieux S. A latent profile analysis based on diet quality and eating behaviours in participants of the PREDISE study characterized by a higher BMI. Appl Physiol Nutr Metab 2024. [PMID: 38527328 DOI: 10.1139/apnm-2023-0443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
The aim of this study was to identify eating-related latent profiles based on diet quality and eating behaviours within a population characterized by a body mass index (BMI) of at least 25 kg/m2, and to compare metabolic variables between profiles. This analysis was conducted in a sample of 614 adults (45.6% women; 44.8 ± 12.9 years) from the cross-sectional PREDISE study. Participants completed the Three-Factor Eating Questionnaire, the Intuitive Eating Scale-2, the Regulation of Eating Behavior Scale, and three self-administered 24 h food recalls. Waist circumference, blood lipids, blood pressure, and fasting glucose were measured to identify carriers of the metabolic syndrome. A latent profile analysis was performed, and cases of metabolic syndrome were compared between profiles. A three-profile solution was found. Profile 1 (22.8%) was characterized by lower diet quality, lower self-determined motivation for eating, lower restraint, and higher intuitive eating. Profile 2 (44.5%) was characterized by higher diet quality, higher self-determined motivation for eating, higher restraint, lower disinhibition, and higher intuitive eating. Profile 3 (32.7%) was characterized by intermediate diet quality, higher non-self-determined motivation for eating, higher restraint and disinhibition, and lower intuitive eating. We found fewer cases of metabolic syndrome among participants in profile 2 than in the other profiles (p = 0.0001). This study suggests that a profile characterized by a lower disinhibition and higher levels of restraint, intuitive eating, self-determined motivation, and diet quality is associated with a better metabolic health among individuals with a higher BMI.
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Affiliation(s)
- Benoît Boulanger
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Catherine Bégin
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Psychology, Université Laval, 2325 rue des Bibliothèques, Québec, QC G1V 0A6, Canada
| | - Alexandra Bédard
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
| | - Julia Lévy-Ndejuru
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Élise Carbonneau
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
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Lemans JVC, Top A, Tabeling CS, Scholten EP, Stempels HW, Schlösser TPC, Castelein RM, Kruyt MC. Health-related quality of life in early onset scoliosis patients treated with the spring distraction system: what to expect in the first 2 years after surgery. Spine Deform 2024; 12:489-499. [PMID: 37950830 PMCID: PMC10867097 DOI: 10.1007/s43390-023-00777-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/09/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE The Spring Distraction System (SDS) is a novel "growth-friendly" implant for the treatment of Early-Onset Scoliosis (EOS). This prospective study aims to determine the evolution of the "24-Item Early-Onset Scoliosis Questionnaire" (EOSQ-24) scores during 2-year follow-up after SDS surgery. Secondary aims include investigating the relation between EOSQ-24 scores and EOS etiology, and evaluating the impact of an unplanned return to the operating room (UPROR) on HRQoL. METHODS All SDS patients with at least 2-year follow-up were included. Caregivers completed the EOSQ-24 pre-operatively, post-operatively, and at 6, 12, and 24 month follow-up. Mean total and -domain scores were graphed over time. Repeated-measures ANOVA analyzed the influence of etiology on EOSQ-24 scores. Multiple regression analyzed associations between UPRORs and EOSQ-24 scores. RESULTS Forty-nine patients were included. Mean total EOSQ-24 scores decreased from 70 pre-operatively to 66 post-operatively, then gradually increased to 75 (24 months). Most domains exhibited changes over time, with initial declines, but eventually surpassing pre-operative levels after 2-year follow-up. Neuromuscular/Syndromic patients had lower scores, but showed similar improvements over time compared with other etiologies. Multiple regression showed lower Parental Burden domain score (- 14 points) in patients with UPRORs, although no significant reductions were found in total score, or in other domains. CONCLUSION HRQoL decreases immediately following SDS surgery but quickly recovers and exceeds pre-operative levels at 2-year follow-up in all domains. Neuromuscular/Syndromic patients have lower initial scores, but progress similarly over time. UPRORs do not influence EOSQ-24 scores, except for a negative impact on the Parental Burden domain in the short term. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Justin V C Lemans
- Department of Orthopaedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Anouk Top
- Department of Orthopaedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Casper S Tabeling
- Department of Orthopaedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - E Pauline Scholten
- Department of Orthopaedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Hilde W Stempels
- Department of Orthopaedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Tom P C Schlösser
- Department of Orthopaedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - René M Castelein
- Department of Orthopaedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
| | - Moyo C Kruyt
- Department of Orthopaedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands
- Department of Developmental BioEngineering, Twente University, Enschede, The Netherlands
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Douma JG, Vuijk PJ, Volkers KM, Scherder EJA. Observing videos of mastication in dementia: Results of a clustered randomised controlled trial. J Oral Rehabil 2024; 51:546-555. [PMID: 38041598 DOI: 10.1111/joor.13618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/24/2023] [Accepted: 10/28/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVES The aim of this study was to examine effects of the observation of video-recorded chewing in a daily setting on mixing ability, cognition, activities of daily living, depressive symptoms and quality of life of older adults with dementia. METHODS A clustered randomised controlled trial was carried out with residents from 14 residential care facilities. n = 56 participants' data were analysed. An experimental group watched videos of people chewing, displayed on tablet-PCs during lunch, while a control group watched videos of nature and buildings. This was scheduled to take place 5 days a week for 12 weeks. A two-colour chewing gum test was used to measure mixing ability, neuropsychological tests for cognition and questionnaires for the other outcomes. Effects were examined via hierarchical linear mixed model analyses for T1-T3 (i.e. pre-, halfway and post-intervention). When a significant interaction effect was found, T4 (follow-up) was also included. RESULTS The experimental (n = 27) and control (n = 28) groups differed on a few variables at baseline. A significant Time*Group interaction effect was found for the Mini-Mental State Examination only (b = 1.18, t(48.35) = 2.53, p = .015), in favour of the experimental group. A significant effect was also found, albeit smaller, when T4 was included. CONCLUSION One potential reason for the intervention effect on cognition is activation of specific brain areas. Some challenges associated with conducting this intervention in a daily setting are presented. Further research is required before a well-considered decision can be made regarding any potential implementation. TRIAL REGISTRATION Number: NTR5124. Date of registration: 30 March 2015, retrospectively registered (during participant inclusion).
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Affiliation(s)
- Johanna Gerdine Douma
- Clinical Neuropsychology, Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pieter Jelle Vuijk
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Karin Mariëlle Volkers
- Clinical Neuropsychology, Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Research Center, Philadelphia Care Foundation, Amersfoort, The Netherlands
| | - Erik Johan Anton Scherder
- Clinical Neuropsychology, Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Stadler C, Freitag CM, Popma A, Nauta-Jansen L, Konrad K, Unternaehrer E, Ackermann K, Bernhard A, Martinelli A, Oldenhof H, Gundlach M, Kohls G, Prätzlich M, Kieser M, Limprecht R, Raschle NM, Vriends N, Trestman RL, Kirchner M, Kersten L. START NOW: a cognitive behavioral skills training for adolescent girls with conduct or oppositional defiant disorder - a randomized clinical trial. J Child Psychol Psychiatry 2024; 65:316-327. [PMID: 37814906 DOI: 10.1111/jcpp.13896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2023] [Indexed: 10/11/2023]
Abstract
BACKGROUND Conduct disorder (CD) and oppositional defiant disorder (ODD) both convey a high risk for maladjustment later in life and are understudied in girls. Here, we aimed at confirming the efficacy of START NOW, a cognitive-behavioral, dialectical behavior therapy-oriented skills training program aiming to enhance emotion regulation skills, interpersonal and psychosocial adjustment, adapted for female adolescents with CD or ODD. METHODS A total of 127 girls were included in this prospective, cluster randomized, multi-center, parallel group, quasi-randomized, controlled phase III trial, which tested the efficacy of START NOW (n = 72) compared with standard care (treatment as usual, TAU, n = 55). All female adolescents had a clinical diagnosis of CD or ODD, were 15.6 (±1.5) years on average (range: 12-20 years), and were institutionalized in youth welfare institutions. The two primary endpoints were the change in number of CD/ODD symptoms between (1) baseline (T1) and post-treatment (T3), and (2) between T1 and 12-week follow-up (T4). RESULTS Both treatment groups showed reduced CD/ODD symptoms at T3 compared with T1 (95% CI: START NOW = -4.87, -2.49; TAU = -4.94, -2.30). There was no significant mean difference in CD/ODD symptom reduction from T1 to T3 between START NOW and TAU (-0.056; 95% CI = -1.860, 1.749; Hedge's g = -0.011). However, the START NOW group showed greater mean symptom reduction from T1 to T4 (-2.326; 95% CI = -4.274, -0.378; Hedge's g = -0.563). Additionally, secondary endpoint results revealed a reduction in staff reported aggression and parent-reported irritability at post assessment. CONCLUSIONS Although START NOW did not result in greater symptom reduction from baseline to post-treatment compared with TAU, the START NOW group showed greater symptom reduction from baseline to follow-up with a medium effect size, which indicates a clinically meaningful delayed treatment effect.
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Affiliation(s)
- Christina Stadler
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Arne Popma
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lucres Nauta-Jansen
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen & Research Centre Juelich, Juelich, Germany
| | - Eva Unternaehrer
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Katharina Ackermann
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anka Bernhard
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Anne Martinelli
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Helena Oldenhof
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Malou Gundlach
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Medical Faculty, University Hospital RWTH Aachen, Aachen, Germany
| | - Gregor Kohls
- Department of Child and Adolescent Psychiatry, Medical Faculty, TU Dresden, Dresden, Germany
| | - Martin Prätzlich
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Meinhard Kieser
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Ronald Limprecht
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Nora M Raschle
- Jacobs Center for Productive Youth Development, University of Zurich, Zurich, Switzerland
| | | | | | - Marietta Kirchner
- Institute of Medical Biometry (IMBI), University of Heidelberg, Heidelberg, Germany
| | - Linda Kersten
- University Psychiatric Clinics, University of Basel, Basel, Switzerland
- Department of Forensic Psychiatry, LVR-Klinik Viersen, Viersen, Germany
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van Oevelen M, Bonenkamp AA, van Eck van der Sluijs A, Bos WJW, Douma CE, van Buren M, Meuleman Y, Dekker FW, van Jaarsveld BC, Abrahams AC. Health-related quality of life and symptom burden in patients on haemodialysis. Nephrol Dial Transplant 2024; 39:436-444. [PMID: 37580140 PMCID: PMC10899770 DOI: 10.1093/ndt/gfad179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Patients on haemodialysis (HD) generally experience poor health-related quality of life (HRQoL) and a broad range of physical and mental symptoms, but it is unknown whether this differs between younger and older patients. We aimed to describe the trajectories of HRQoL and symptom burden of patients <70 and ≥70 years old and to assess the impact of symptom burden on HRQoL. METHODS In incident Dutch HD patients, HRQoL and symptoms were measured with the 12-item Short Form Health Survey and Dialysis Symptom Index. We used linear mixed models for examining the trajectories of HRQoL and symptom burden during the first year of dialysis and linear regression for the impact of symptom burden on HRQoL. RESULTS In 774 patients, the trajectories of physical HRQoL, mental HRQoL and symptom burden were stable during the first year of dialysis. Compared with patients <70 years of age, patients ≥70 years reported similar physical HRQoL {mean difference -0.61 [95% confidence interval (CI) -1.86-0.63]}, better mental HRQoL [1.77 (95% CI 0.54-3.01)] and lower symptom burden [-2.38 (95% CI -5.08-0.32)]. With increasing symptom burden, physical HRQoL declined more in older than in younger patients (β = -0.287 versus -0.189, respectively; P-value for interaction = .007). For mental HRQoL, this decrease was similar in both age groups (β = -0.295 versus -0.288, P = .847). CONCLUSION Older HD patients generally experience a better mental HRQoL and a (non-statistically significant) lower symptom burden compared with younger patients. Their physical HRQoL declines more rapidly with increasing symptom burden.
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Affiliation(s)
- Mathijs van Oevelen
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Anna A Bonenkamp
- Department of Internal Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands
- Department of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Anita van Eck van der Sluijs
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Internal Medicine, Deventer Hospital, Deventer, The Netherlands
| | - Willem Jan W Bos
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Caroline E Douma
- Department of Internal Medicine, Spaarne Gasthuis, Hoofddorp, The Netherlands
| | - Marjolijn van Buren
- Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Department of Nephrology, Haga Hospital, The Hague, The Netherlands
| | - Yvette Meuleman
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Brigit C van Jaarsveld
- Department of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Alferso C Abrahams
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
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Zhang J, Song L, Miller Z, Chan KCG, Huang KL. Machine learning models identify predictive features of patient mortality across dementia types. COMMUNICATIONS MEDICINE 2024; 4:23. [PMID: 38418871 PMCID: PMC10901806 DOI: 10.1038/s43856-024-00437-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Dementia care is challenging due to the divergent trajectories in disease progression and outcomes. Predictive models are needed to flag patients at risk of near-term mortality and identify factors contributing to mortality risk across different dementia types. METHODS Here, we developed machine-learning models predicting dementia patient mortality at four different survival thresholds using a dataset of 45,275 unique participants and 163,782 visit records from the U.S. National Alzheimer's Coordinating Center (NACC). We built multi-factorial XGBoost models using a small set of mortality predictors and conducted stratified analyses with dementiatype-specific models. RESULTS Our models achieved an area under the receiver operating characteristic curve (AUC-ROC) of over 0.82 utilizing nine parsimonious features for all 1-, 3-, 5-, and 10-year thresholds. The trained models mainly consisted of dementia-related predictors such as specific neuropsychological tests and were minimally affected by other age-related causes of death, e.g., stroke and cardiovascular conditions. Notably, stratified analyses revealed shared and distinct predictors of mortality across eight dementia types. Unsupervised clustering of mortality predictors grouped vascular dementia with depression and Lewy body dementia with frontotemporal lobar dementia. CONCLUSIONS This study demonstrates the feasibility of flagging dementia patients at risk of mortality for personalized clinical management. Parsimonious machine-learning models can be used to predict dementia patient mortality with a limited set of clinical features, and dementiatype-specific models can be applied to heterogeneous dementia patient populations.
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Affiliation(s)
- Jimmy Zhang
- Department of Genetics and Genomic Sciences, Center for Transformative Disease Modeling, Tisch Cancer Institute, Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
- Columbia University, New York, NY, 10027, USA
| | - Luo Song
- School of Medicine, The University of Queensland, Herston, QLD, 4006, Australia
| | - Zachary Miller
- National Alzheimer's Coordinating Center, University of Washington, Seattle, WA, 98195, USA
| | - Kwun C G Chan
- National Alzheimer's Coordinating Center, University of Washington, Seattle, WA, 98195, USA
| | - Kuan-Lin Huang
- Department of Genetics and Genomic Sciences, Center for Transformative Disease Modeling, Tisch Cancer Institute, Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA.
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Boulanger B, Bédard A, Carbonneau É, Pelletier L, Robitaille J, Lamarche B, Lemieux S. Social desirability, dietary intakes, and variables related to attitudes and behaviours towards eating among French-speaking adults from Quebec, Canada: The PREDISE study. Appl Physiol Nutr Metab 2024; 49:167-178. [PMID: 37929824 DOI: 10.1139/apnm-2023-0261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
The primary objective of this study was to examine how social desirability is associated with self-reported measures of dietary intakes and variables related to attitudes and behaviours towards eating. This analysis was conducted in 1083 adults (50.0% women) from the PREDISE study. Social desirability was assessed using the Balanced Inventory of Desirable Responding (BIDR) questionnaire, which includes two subscales: (1) self-deceptive enhancement (SDE), i.e., having an overly positive self-image and (2) impression management (IM), i.e., intentional response distortion to please. BIDR total score and IM subscore were positively associated with the Canadian Healthy Eating Index (C-HEI) (ß = 0.24 and ß = 0.50; p ≤ 0.0003), calculated using data from three self-administered 24 h food recalls. All BIDR scores were positively associated with self-determined motivation for eating regulation (0.03 ≤ ß ≤ 0.06; p < 0.0001), measured by the Regulation of Eating Behavior Scale, and with the intuitive eating score (0.02 ≤ ß ≤ 0.05; p < 0.0001). Also, all BIDR scores were negatively associated with hunger and disinhibition scores measured by the Three-Factor Eating Questionnaire (-0.17 ≤ ß ≤ -0.09; p < 0.0001). All these associations were adjusted for age, sex, BMI, and the education level. Furthermore, controlling for both dimensions of social desirability did not impact the magnitude of the association between self-determined motivation (the strongest predictor of healthy eating in the PREDISE study) and C-HEI. According to our results, associations are observed with diet quality, as well as with attitudes and behaviours towards eating; therefore, a measurement of social desirability responding would be pertinent in studies using those or related variables.
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Affiliation(s)
- Benoît Boulanger
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Alexandra Bédard
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
| | - Élise Carbonneau
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Luc Pelletier
- School of Psychology, University of Ottawa, 136 Jean-Jacques Lussier, Vanier Hall, Ottawa, ON K1N 6N5, Canada
| | - Julie Robitaille
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Benoît Lamarche
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, 2440 boulevard Hochelaga, Québec, QC G1V 0A6, Canada
- School of Nutrition, Université Laval, 2425 rue de l'Agriculture, Québec, QC G1V 0A6, Canada
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10
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Benau EM, Zavodnick JH, Jaffe RC. Initial evidence of reliability and validity of an implicit association test assessing attitudes toward individuals who use substances. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2024; 50:64-74. [PMID: 38295383 DOI: 10.1080/00952990.2023.2300398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 12/26/2023] [Indexed: 02/02/2024]
Abstract
Background: Substance use disorders (SUDs) are stigmatized conditions, with individual biases driving poor health outcomes. There are surprisingly few validated measures of bias or stigma toward individuals who use substances. Bias can be classified as explicit (self-report) or implicit (behaviorally based).Objectives: The goal of the present study was to establish preliminary indices of reliability and validity of an implicit association test (IAT) designed to measure implicit bias toward individuals who use substances.Methods: A large United States-based, crowd-sourced sample (n = 394, 51.5% male, 45.4% female, 2.5% nonbinary) completed the IAT and a small battery of survey instruments that assessed social distance to mental illness (including heroin use), attitude toward and perceived controllability of injection drug use, perception of public stigma, and social desirability.Results: Nearly all (92%; n = 363) scores on the IAT indicated greater negative than positive attitudes toward those who use substances. Spearman-Brown corrected split-half reliability on the IAT scores was excellent, r = .953. Controlling for social desirability, IAT scores positively correlated with all included measures pertaining to substance use as well as social distance for heroin and schizophrenia (but not diabetes). A principal component analysis resulted in two interpretable components representing disapproval (perceived controllability and negative attitudes) and perceived stigma (social stigma and social distance). Scores on the IAT positively correlated to scores on both components, again, controlling for social desirability.Conclusion: These results provide compelling preliminary evidence of validity of an IAT designed to measure bias toward individuals who use substances.
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Affiliation(s)
- Erik M Benau
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, USA
| | | | - Rebecca C Jaffe
- Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA
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11
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Xu EP, Li J, Zapetis SL, Keefe K, Trull TJ, Stange JP. Momentary impulsivity interferes with emotion regulation strategy prioritization in everyday life in remitted depression. Behav Res Ther 2024; 172:104424. [PMID: 38103360 PMCID: PMC10843662 DOI: 10.1016/j.brat.2023.104424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 09/19/2023] [Accepted: 10/19/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Selectively prioritizing some emotion regulation (ER) strategies over others has been shown to predict well-being; however, it is unclear what mechanisms underlie this process. Impulsivity, which captures both top-down control of and bottom-up reactivity to emotions, is one potential mechanism of interest. METHODS Using multilevel mediation modeling, we investigated whether lower ER strategy prioritization (i.e., lower between-strategy variability) mediates the relationship between greater momentary impulsivity and lower ER success in 82 individuals with remitted depression or no history of a mental disorder (1558 observations). To determine the specific effect of impulsivity, we covaried for mean regulatory effort and negative affect. RESULTS The indirect effect of impulsivity on ER success was significant at the within-person, but not between-person, level. Specifically, in moments when individuals endorsed more impulsivity than usual, they showed less ER strategy prioritization than usual, which predicted less successful ER. Individuals who, on average, reported more impulsivity indicated lower ER strategy prioritization, but no difference in ER success. CONCLUSION ER strategy prioritization mediated the within-person relationship between greater impulsivity and lower ER success. Interventions focused on training individuals to selectively prioritize ER strategies may improve ER success, particularly when individuals are feeling more impulsive than usual.
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Affiliation(s)
- Ellie P Xu
- Department of Psychology, University of Southern California, United States
| | - Jiani Li
- Department of Psychology, University of Southern California, United States
| | - Sarah L Zapetis
- Department of Psychology, University of Southern California, United States
| | - Kaley Keefe
- Department of Psychology, University of Southern California, United States
| | - Timothy J Trull
- Department of Psychology, University of Missouri, United States
| | - Jonathan P Stange
- Department of Psychology, University of Southern California, United States; Department of Psychiatry and Behavioral Sciences, University of Southern California, United States.
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12
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Veldman MHJ, van der Aa HPA, Knoop H, Bode C, Hulshof CTJ, van der Ham L, van Rens GHMB, Heymans MW, van Nispen RMA. Usability and feasibility of E-nergEYEze: a blended vision-specific E-health based cognitive behavioral therapy and self-management intervention to reduce fatigue in adults with visual impairment. BMC Health Serv Res 2023; 23:1271. [PMID: 37974261 PMCID: PMC10655361 DOI: 10.1186/s12913-023-10193-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 10/21/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Over 50% of adults with visual impairment experience severe fatigue. Therefore, we developed a guided E-health intervention based on cognitive behavioral therapy and self-management to reduce fatigue in this population. This pilot study evaluated the usability, feasibility, fidelity and potential effectiveness of E-nergEYEze. METHODS E-nergEYEze was developed by a design team and customized by conducting a pilot study using an iterative development strategy. The intervention was first tested in a usability study among adults with visual impairment (n = 5). Participants were asked to think-aloud while exploring the intervention features and a semi-structured interview was performed afterwards. Subsequently, the enhanced intervention was tested in a feasibility study. Adults with visual impairment and severe fatigue (n = 10) followed the intervention partially with guidance from a social worker and one-time computer trainer support. Fatigue severity (Checklist Individual Strength), fatigue impact (Modified Fatigue Impact Scale) and cognitive behavioral therapy skills (Competencies of Cognitive Therapy Scale-Self Report) were measured at baseline and at three months follow-up and analyzed with the Wilcoxon signed-rank test. The intervention was evaluated through evaluation forms. RESULTS The usability study resulted in adjustments to content and lay-out with regard to optically shortened text sentences, separate pages for information and assignments with one read-aloud audio and an additional descriptive explanation of page content. Digital challenges were overcome with mandatory computer training and e-platform modifications. The feasibility study showed a positive trend in reducing fatigue severity (Z -6.108; P < .001; SD 8.4), impact of fatigue (Z - 4.451; P < .001; SD 11.4) and cognitive behavioral therapy skills (Z -2.278; P = .023; SD 19.3). Participants gave useful feedback regarding accessibility, content and guidance, with an overall positive experience. The intervention was rated with a median score of 8 (range 7-10). CONCLUSION We developed, evaluated and optimized E-nergEYEze by applying a user-centered and iterative approach. E-nergEYEze showed a promising trend to reduce fatigue severity and impact of fatigue and to increase cognitive behavioral therapy skills. The study methods were feasible and the fidelity of the intervention protocol was suitable. Performing a randomized controlled trial is warranted to give insight into whether E-nergEYEze is cost-effective in reducing severe fatigue in adults with visual impairment. TRIAL REGISTRATION International Clinical Trial Registry Platform: NL7764. Date registered: 28-05-2019.
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Affiliation(s)
- M H J Veldman
- Ophthalmology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands.
| | - H P A van der Aa
- Ophthalmology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
| | - H Knoop
- Departments of Medical Psychology, Amsterdam Public Health research institute, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - C Bode
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - C T J Hulshof
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - L van der Ham
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G H M B van Rens
- Ophthalmology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - M W Heymans
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers Boelelaan, Amsterdam, The Netherlands
| | - R M A van Nispen
- Ophthalmology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Mental Health, Aging and Later Life, Amsterdam, The Netherlands
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13
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Li X, Hoogenveen R, El Alili M, Knies S, Wang J, Beulens JWJ, Elders PJM, Nijpels G, van Giessen A, Feenstra TL. Cost-Effectiveness of SGLT2 Inhibitors in a Real-World Population: A MICADO Model-Based Analysis Using Routine Data from a GP Registry. PHARMACOECONOMICS 2023; 41:1249-1262. [PMID: 37300652 PMCID: PMC10492753 DOI: 10.1007/s40273-023-01286-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/21/2023] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to reduce the risk of cardiovascular complications, which largely drive diabetes' health and economic burdens. Trial results indicated that SGLT2i are cost effective. However, these findings may not be generalizable to the real-world target population. This study aims to evaluate the cost effectiveness of SGLT2i in a routine care type 2 diabetes population that meets Dutch reimbursement criteria using the MICADO model. METHODS Individuals from the Hoorn Diabetes Care System cohort (N = 15,392) were filtered to satisfy trial inclusion criteria (including EMPA-REG, CANVAS, and DECLARE-TIMI58) or satisfy the current Dutch reimbursement criteria for SGLT2i. We validated a health economic model (MICADO) by comparing simulated and observed outcomes regarding the relative risks of events in the intervention and comparator arm from three trials, and used the validated model to evaluate the long-term health outcomes using the filtered cohorts' baseline characteristics and treatment effects from trials and a review of observational studies. The incremental cost-effectiveness ratio (ICER) of SGLT2i, compared with care-as-usual, was assessed from a third-party payer perspective, measured in euros (2021 price level), using a discount rate of 4% for costs and 1.5% for effects. RESULTS From Dutch individuals with diabetes in routine care, 15.8% qualify for the current Dutch reimbursement criteria for SGLT2i. Their characteristics were significantly different (lower HbA1c, higher age, and generally more preexisting complications) than trial populations. After validating the MICADO model, we found that lifetime ICERs of SGLT2i, when compared with usual care, were favorable (< €20,000/QALY) for all filtered cohorts, resulting in an ICER of €5440/QALY using trial-based treatment effect estimates in reimbursed population. Several pragmatic scenarios were tested, the ICERs remained favorable. CONCLUSIONS Although the Dutch reimbursement indications led to a target group that deviates from trial populations, SGLT2i are likely to be cost effective when compared with usual care.
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Affiliation(s)
- Xinyu Li
- University of Groningen, Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - Rudolf Hoogenveen
- Expertise Center for Methodology and Information Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Mohamed El Alili
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Zorginstituut Nederland, Diemen, The Netherlands
| | - Saskia Knies
- Zorginstituut Nederland, Diemen, The Netherlands
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Junfeng Wang
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Sciences, Amsterdam University Medical Center, Location Vrije Universiteit, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Petra J M Elders
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
- Department of General Practice, Amsterdam University Medical Center, Location Vrije Universiteit, Amsterdam, The Netherlands
| | - Giel Nijpels
- Amsterdam Public Health, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands
| | - Anoukh van Giessen
- Expertise Center for Methodology and Information Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Talitha L Feenstra
- University of Groningen, Faculty of Science and Engineering, Groningen Research Institute of Pharmacy, A. Deusinglaan 1, 9713 AV, Groningen, The Netherlands
- Center for Nutrition, Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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14
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Pauli R, Brazil IA, Kohls G, Klein-Flügge MC, Rogers JC, Dikeos D, Dochnal R, Fairchild G, Fernández-Rivas A, Herpertz-Dahlmann B, Hervas A, Konrad K, Popma A, Stadler C, Freitag CM, De Brito SA, Lockwood PL. Action initiation and punishment learning differ from childhood to adolescence while reward learning remains stable. Nat Commun 2023; 14:5689. [PMID: 37709750 PMCID: PMC10502052 DOI: 10.1038/s41467-023-41124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 08/24/2023] [Indexed: 09/16/2023] Open
Abstract
Theoretical and empirical accounts suggest that adolescence is associated with heightened reward learning and impulsivity. Experimental tasks and computational models that can dissociate reward learning from the tendency to initiate actions impulsively (action initiation bias) are thus critical to characterise the mechanisms that drive developmental differences. However, existing work has rarely quantified both learning ability and action initiation, or it has relied on small samples. Here, using computational modelling of a learning task collected from a large sample (N = 742, 9-18 years, 11 countries), we test differences in reward and punishment learning and action initiation from childhood to adolescence. Computational modelling reveals that whilst punishment learning rates increase with age, reward learning remains stable. In parallel, action initiation biases decrease with age. Results are similar when considering pubertal stage instead of chronological age. We conclude that heightened reward responsivity in adolescence can reflect differences in action initiation rather than enhanced reward learning.
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Affiliation(s)
- Ruth Pauli
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.
| | - Inti A Brazil
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Gregor Kohls
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU, Dresden, Germany
| | - Miriam C Klein-Flügge
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | - Jack C Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Dimitris Dikeos
- Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Roberta Dochnal
- Faculty of Medicine, Child and Adolescent Psychiatry, Department of the Child Health Center, Szeged University, Szeged, Hungary
| | | | | | - Beate Herpertz-Dahlmann
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
| | - Amaia Hervas
- University Hospital Mutua Terrassa, Barcelona, Spain
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany
- JARA-Brain Institute II, Molecular Neuroscience and Neuroimaging, RWTH Aachen and Research Centre Jülich, Jülich, Germany
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, VU University Medical Center, Amsterdam, Netherlands
| | - Christina Stadler
- Department of Child and Adolescent Psychiatry, Psychiatric University Hospital, University of Basel, Basel, Switzerland
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Stephane A De Brito
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Patricia L Lockwood
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK.
- Department of Experimental Psychology, University of Oxford, Oxford, UK.
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK.
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.
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15
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Robell KC, Norcross MF, Bohr AD, Harmon KG. Pac-12 Health Analytics Program: An Innovative Approach to Health Care Operations, Data Analytics, and Clinical Research in Intercollegiate Athletics. J Athl Train 2023; 58:655-663. [PMID: 36521171 PMCID: PMC10569253 DOI: 10.4085/1062-6050-0063.22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
The objective of this study was to describe the purpose, methods, and effects of the Pac-12 Health Analytics Program (HAP) approach on sports medicine informatics, research, analytics, and health care operations. Sports injury-surveillance initiatives have been supporting the clinical research community in sports medicine for nearly 4 decades. Whereas the initial systems tracked only a few sports, current surveillance programs have expanded to include entire professional and elite athlete organizations, providing important statistics on sports injury risk management. The HAP is a conference-wide data-sharing and-analytics program. It collects authorized, deidentified clinical data, encompassing multiple domains of sports medicine injury management, including sports injuries and illnesses, concussions, risk exposure, and COVID-19 testing elements. The HAP provides clinicians with access to curated data to inform evidence-based practice and support local health care operations with respect to emerging sports injury trends. The HAP supplies approved research groups with access to a data repository that describes a homogeneous, elite intercollegiate athlete sample, thereby supporting nonresearch clinical initiatives as well as contributions to peer-reviewed research that can improve the health and well-being of Pac-12 student-athletes. The HAP is a novel approach to sports injury epidemiology and surveillance that has allowed the Pac-12 Conference to meet larger objectives regarding improving the student-athlete experience and clinical research among its member schools. Data quality control has improved the accuracy of the data and value to clinical athletic trainers within the conference. Curated dashboards displaying aggregated project data offer clinicians data-driven decision-making tools that help inform sports injury risk management. As of 2021, the HAP had supported more than 3 dozen data requests. These investigations have resulted in numerous peer-reviewed research contributions to the sports medicine community with findings that have great potential to improve the health and well-being of Pac-12 student-athletes.
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Affiliation(s)
| | - Marc F. Norcross
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Adam D. Bohr
- Department of Integrative Physiology, University of Colorado Boulder
| | - Kimberly G. Harmon
- Department of Family Medicine, University of Washington School of Medicine, Seattle
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16
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May AK, Wessels SH, Norris SA, Richter LM, Lombard Z, Pitman MM. Early predictors of sensory processing sensitivity in members of the Birth to Twenty Plus cohort. JOURNAL OF RESEARCH IN PERSONALITY 2023. [DOI: 10.1016/j.jrp.2023.104370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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17
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Ben ÂJ, Pellekooren S, Bosmans JE, Ostelo RWJG, Maas ET, El Alili M, van Tulder MW, Huygen FJPM, Oosterhuis T, Apeldoorn AT, van Hooff ML, van Dongen JM. Mapping Oswestry Disability Index Responses to EQ-5D-3L Utility Values: Are Cost-Utility Results Valid? VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:873-882. [PMID: 36773782 DOI: 10.1016/j.jval.2023.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 12/23/2022] [Accepted: 01/19/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To develop and validate approaches for mapping Oswestry Disability Index responses to 3-level version of EQ-5D utility values and to evaluate the impact of using mapped utility values on cost-utility results compared with published regression models. METHODS Three response mapping approaches were developed in a random sample of 70% of 18 692 patients with low back pain: nonparametric approach (Non-p), nonparametric approach excluding logical inconsistencies (Non-peLI), and ordinal logistic regression (OLR). Performance was assessed in the remaining 30% using R-square (R2), root mean square error (RMSE), and mean absolute error (MAE). To evaluate whether MAEs and their 95% limits of agreement (LA) were clinically relevant, a minimally clinically important difference of 0.074 was used. Probabilities of cost-effectiveness estimated using observed and mapped utility values were compared in 2 economic evaluations. RESULTS The Non-p performed the best (R2 = 0.43; RMSE = 0.22; MAE = 0.03; 95% LA = -0.40 to 0.47) compared with the Non-peLI (R2 = 0.07; RMSE = 0.29; MAE = -0.15; 95% LA = -0.63 to 0.34) and OLR (R2 = 0.22; RMSE = 0.26; MAE = 0.02; 95% LA = -0.49 to 0.53). MAEs were lower than the minimally clinically important difference for the Non-p and OLR but not for the Non-peLI. Differences in probabilities of cost-effectiveness ranged from 1% to 4% (Non-p), 0.1% to 9% (Non-peLI), and 0.1% to 20% (OLR). CONCLUSIONS Results suggest that the developed response mapping approaches are not valid for estimating individual patients' 3-level version of EQ-5D utility values, and-depending on the approach-may considerably affect cost-utility results. The developed approaches did not perform better than previously published regression-based models and are therefore not recommended for use in economic evaluations.
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Affiliation(s)
- Ângela Jornada Ben
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
| | - Sylvia Pellekooren
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Department Human Movement Sciences, Faculty of Behavioral & Movement Sciences, Vrije Universiteit, Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Raymond W J G Ostelo
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
| | - Esther T Maas
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mohamed El Alili
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; National Health Care Institute, Diemen, The Netherlands
| | - Maurits W van Tulder
- Department Human Movement Sciences, Faculty of Behavioral & Movement Sciences, Vrije Universiteit, Amsterdam, Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands
| | | | - Teddy Oosterhuis
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Adri T Apeldoorn
- Rehabilitation Department, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands; Breederode Hogeschool, Rotterdam, Netherlands
| | - Miranda L van Hooff
- Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands; Department of Orthopedics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johanna M van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Prasath PR, Bhat CS, Manyam SB. Married Asian Indians on H-1B and H-4 Visas in the US: an Exploration of Depression, Anxiety, Stress, Well-being, and Marital Satisfaction. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2023; 45:1-19. [PMID: 37359033 PMCID: PMC10173925 DOI: 10.1007/s10447-023-09512-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2023] [Indexed: 06/28/2023]
Abstract
Asian Indians comprise the largest group of skilled workers entering the United States on temporary work visas (H-1B). There are few studies that examine the constraints placed on H-1B visa holders and their families on H-4 dependent visas, and the associated stressors. In this exploratory study, we examined self-reported depression, anxiety, stress, well-being, and marital satisfaction among married Asian Indians on H-1B and H-4 visas in the United States. Participants reported moderate levels of stress and depression and mild levels of anxiety. Using multiple regression, well-being emerged as the only significant factor to explain marital satisfaction among both H-1B and H-4 visa holders. Implications for mental health, employment, and career counselors working with this group are discussed.
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Affiliation(s)
- Priscilla Rose Prasath
- Department of Counseling, College of Education and Human Development, the University of Texas at San Antonio, 501 W César E Chávez Blvd, San Antonio, TX 79207 USA
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19
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de Koning LE, Warnink-Kavelaars J, van Rossum MA, Bosman D, Menke LA, Malfait F, de Boer R, Oosterlaan J, Engelbert RHH, Rombaut L. Somatic symptoms, pain, catastrophizing and the association with disability among children with heritable connective tissue disorders. Am J Med Genet A 2023. [PMID: 37186039 DOI: 10.1002/ajmg.a.63204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 03/21/2023] [Accepted: 03/26/2023] [Indexed: 05/17/2023]
Abstract
The aim of the present study was to investigate the nature and prevalence of nonspecific somatic symptoms, pain and catastrophizing in children with Heritable Connective Tissue Disorders (HCTD), and to determine their association with disability. This observational, multicenter study included 127 children, aged 4-18 years, with Marfan syndrome (MFS) (59%), Loeys-Dietz syndrome (LDS) (8%), Ehlers-Danlos syndromes (EDS) (12%) and hypermobile Ehlers-Danlos syndrome (hEDS) (23%). The assessments included the Children's Somatization Inventory or parent proxy (CSI, PCSI), pain visual-analogue scale (VAS), SUPERKIDZ body diagram, Pain Catastrophizing Scale Child or parent proxy (PCS-C, PCS-P) and Childhood Health Assessment Questionnaire (CHAQ-30). Data from children aged ≥8 years were compared to normative data. In children ≥ 8 years (n = 90), pain was present in 59%, with a median of 4 (IQR = 3-9) pain areas. Compared to normative data, the HCTD group reported significantly higher on the CSI (p ≤ 0.001, d = 0.85), VAS pain intensity (p ≤ 0.001, d = 1.22) and CHAQ-30 (p ≤ 0.001, d = 1.16) and lower on the PCS-C (p = 0.017, d = -0.82) and PCS-P (p ≤ 0.001, d = -0.49). The intensity of nonspecific somatic symptoms and pain explained 45% of the variance in disability (r2 = 0.45 F(2,48) = 19.70, p ≤ 0.001). In children ≤ 7 years (n = 37), pain was present in 35% with a median of 5(IQR = 1-13) pain areas. The mean(SD) VAS scores for pain intensity was 1.5(2.9). Functional disability was moderately correlated to the number of pain areas (r = 0.56, p ≤ 0.001), intensity of nonspecific somatic symptoms (r = 0.63, p ≤ 0.001) and pain (r = 0.83, p ≤ 0.001). In conclusion, this study supports the need for comprehensive assessment of nonspecific somatic symptoms, pain, and disability in children with HCTD to allow tailored treatment.
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Affiliation(s)
- Lisanne E de Koning
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
| | - Jessica Warnink-Kavelaars
- Department of Rehabilitation Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
| | - Marion A van Rossum
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
- Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
| | - Diederik Bosman
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Leonie A Menke
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Fransiska Malfait
- Center for Medical Genetics, Ghent University Hospital/Ghent University, Ghent, Belgium
| | - Rosa de Boer
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me Program & Emma Neuroscience Group, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Raoul H H Engelbert
- Centre of Expertise Urban Vitality, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Lies Rombaut
- Center for Medical Genetics, Ghent University Hospital/Ghent University, Ghent, Belgium
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20
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Beach B, Steptoe A, Zaninotto P. Depression and anxiety in people with cognitive impairment and dementia during the COVID-19 pandemic: Analysis of the English Longitudinal Study of Ageing. PLoS Med 2023; 20:e1004162. [PMID: 37093859 PMCID: PMC10124844 DOI: 10.1371/journal.pmed.1004162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Some studies have identified declines in mental health during the Coronavirus Disease 2019 (COVID-19) pandemic in different age groups, including older people. As anxiety and depression are common neuropsychiatric symptoms among people with cognitive impairment, the mental health experiences of older people during the pandemic should take cognitive function into consideration, along with assessments made prior to the pandemic. This study addresses evidence gaps to test whether changes in depression and anxiety among older people through the COVID-19 pandemic were associated with cognitive impairment. It also investigates whether associations varied according to key sources of sociodemographic inequality. METHODS AND FINDINGS Using data from the English Longitudinal Study of Ageing (ELSA) collected from 2018/2019 to November/December 2020, we estimated changes in depression and anxiety for people aged 50+ in England across 3 cognitive function groups: no impairment, mild cognitive impairment, and dementia. Conditional growth curve models were estimated for continuous measures over 3 time points (N = 5,286), with mixed-effects logistic regression used for binary measures. All models adjusted for demographics (age, gender, ethnicity, and cohabiting partnership), socioeconomics (education, wealth, and employment status), geography (urban/rural and English region), and health (self-rated and the presence of multimorbidity). We found that depression (measured with CES-D score) worsened from 2018/2019 to November/December 2020 for people with mild cognitive impairment (1.39 (95% CI: 1.29 to 1.49) to 2.16 (2.02 to 2.30)) or no impairment (1.17 (95%CI: 1.12 to 1.22) to 2.03 (1.96 to 2.10)). Anxiety, using a single-item rating of 0 to 10 also worsened among those with mild cognitive impairment (2.48 (2.30 to 2.66) to 3.14 (2.95 to 3.33)) or no impairment (2.20 (2.11 to 2.28) to 2.85 (2.77 to 2.95)). No statistically significant increases were found for those with dementia. Using a clinical cutoff for likely depression (CES-D ≥4), we found statistically significant increases in the probability of depression between 2018/2019 and November/December 2020 for those with no impairment (0.110 (0.099 to 0.120) to 0.206 (0.191 to 0.222)) and mild impairment (0.139 (0.120 to 0.159) to 0.234 (0.204 to 0.263)). We also found that differences according to cognitive function that existed before the pandemic were no longer present by June/July 2020, and there were no statistically significant differences in depression or anxiety among cognitive groups in November/December 2020. Wealth and education appeared to be stronger drivers for depression and anxiety, respectively, than cognitive impairment. For example, those with no impairment in the richest two-thirds scored 1.76 (1.69 to 1.82) for depression in June/July, compared to 2.01 (1.91 to 2.12) for those with no impairment in the poorest third and 2.03 (1.87 to 2.19) for those with impairment in the poorest third. Results may be limited by the small number of people with dementia and are generalizable only to people living in the community, not to those in institutional care settings. CONCLUSIONS Our findings suggest a convergence in mental health across cognitive function groups during the pandemic. This suggests mental health services will need to meet an increased demand from older adults, especially those not living with cognitive impairment. Further, with little significant change among those with dementia, their existing need for support will remain; policymakers and care practitioners should ensure this group continues to have equitable access to mental health support.
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Affiliation(s)
- Brian Beach
- Research Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London, United Kingdom
| | - Andrew Steptoe
- Research Department of Behavioural Science & Health, Institute of Epidemiology & Health Care, University College London, London, United Kingdom
| | - Paola Zaninotto
- Research Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London, United Kingdom
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Florean IS, Dobrean A, Balazsi R, Roșan A, Păsărelu CR, Predescu E, Rad F. Measurement Invariance of Alabama Parenting Questionnaire Across Age, Gender, Clinical Status, and Informant. Assessment 2023; 30:728-743. [PMID: 34991372 DOI: 10.1177/10731911211068178] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This study aimed to investigate the measurement invariance of the Alabama Parenting Questionnaire (for both long [APQ-lg] and short [APQ-9] forms) across age, gender, clinical status, and informant (i.e., parent vs. child reports). The sample was composed of adolescents (community sample: N = 1,746; clinical sample: N = 166) and parents (N = 149). The analyses were conducted in R. Measurement invariance was assessed via multi-group confirmatory factor analysis, equivalence test, and subsampling approach. The original model of APQ-lg (five factors) showed a significantly better fit than other concurrent models (five concurrent models were specified, based on prior literature). For APQ-lg, we found measurement invariance across gender and partial measurement invariance across age, clinical status, and informant. For APQ-9, we confirmed the measurement invariance across gender and clinical status, while across age and informant partial measurement invariance was attested. Overall, our study indicated that APQ-lg and APQ-9 are two valid tools for measuring parenting practices with some caveats.
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Affiliation(s)
| | | | | | | | | | - Elena Predescu
- Iuliu Hațieganu University of Medicine and Pharmacology, Cluj Napoca, Romania
| | - Florina Rad
- Carol Davila University of Medicine and Pharmacology, Bucharest, Romania
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22
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Pfattheicher S, Lazarević LB, Nielsen YA, Westgate EC, Krstić K, Schindler S. I enjoy hurting my classmates: On the relation of boredom and sadism in schools. J Sch Psychol 2023; 96:41-56. [PMID: 36641224 DOI: 10.1016/j.jsp.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/06/2022] [Accepted: 10/25/2022] [Indexed: 12/23/2022]
Abstract
Schools can be a place of both love and of cruelty. We examined one type of cruelty that occurs in the school context: sadism, that is, harming others for pleasure. Primarily, we proposed and tested whether boredom plays a crucial role in the emergence of sadistic actions at school. In two well-powered studies (N = 1038; student age range = 10-18 years) using both self- and peer-reports of students' boredom levels and their sadistic tendencies, we first document that sadistic behavior occurs at school, although at a low level. We further show that those students who are more often bored at school are more likely to engage in sadistic actions (overall r = .36, 95% CI [0.24, 0.49]). In sum, the present work contributes to a better understanding of sadism in schools and points to boredom as one potential motivator. We discuss how reducing boredom might help to prevent sadistic tendencies at schools.
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23
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Zhang J, Song L, Chan K, Miller Z, Huang KL. Predictive Models and Features of Patient Mortality across Dementia Types. RESEARCH SQUARE 2023:rs.3.rs-2350961. [PMID: 36711767 PMCID: PMC9882612 DOI: 10.21203/rs.3.rs-2350961/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Dementia care is challenging due to the divergent trajectories in disease progression and outcomes. Predictive models are needed to identify patients at risk of near-term mortality. Here, we developed machine learning models predicting survival using a dataset of 45,275 unique participants and 163,782 visit records from the U.S. National Alzheimer's Coordinating Center (NACC). Our models achieved an AUC-ROC of over 0.82 utilizing nine parsimonious features for all one-, three-, five-, and ten-year thresholds. The trained models mainly consisted of dementia-related predictors such as specific neuropsychological tests and were minimally affected by other age-related causes of death, e.g., stroke and cardiovascular conditions. Notably, stratified analyses revealed shared and distinct predictors of mortality across eight dementia types. Unsupervised clustering of mortality predictors grouped vascular dementia with depression and Lewy body dementia with frontotemporal lobar dementia. This study demonstrates the feasibility of flagging dementia patients at risk of mortality for personalized clinical management.
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Affiliation(s)
| | - Luo Song
- School of Medicine, The University of Queensland
| | - Kwun Chan
- National Alzheimer's Coordinating Center, University of Washington
| | - Zachary Miller
- National Alzheimer's Coordinating Center, University of Washington
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24
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Chen BS, Yu-Wai-Man P, Horton M. Psychometric Validity of the Visual Function Index in Leber Hereditary Optic Neuropathy. Transl Vis Sci Technol 2023; 12:23. [PMID: 36662512 PMCID: PMC9872840 DOI: 10.1167/tvst.12.1.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Purpose The purpose of this study was to determine the psychometric validity of the Visual Function Index (VF-14) for use by patients with Leber hereditary optic neuropathy (LHON). Methods Rasch analysis was conducted in two stages using data for 196 individuals (74.5% male) carrying one of the three primary LHON mutations and affected by vision loss. In stage 1, scale unidimensionality, scale-to-sample targeting, response category threshold ordering, item fit statistics, local dependency, and reliability were assessed. In stage 2, iterative post-hoc revisions of the VF-14 structure (VF-14R) were applied and psychometrically re-evaluated. Results Issues identified with the VF-14 included disordered response thresholds (12/14 items), local dependency (10/91 pairwise dependencies), and evidence of multidimensionality. However, the distribution of person estimates and item thresholds were fairly well matched, only one item showed misfit to the Rasch model, and there was good reliability (Person Separation Index 0.84). Rasch-informed VF-14 revisions included removing both driving items and the misfitting sports item, rescoring response options across all items by merging two response categories, and accounting for the dependency between two reading items. The VF-14R demonstrated improved psychometric validity. Conclusions Clinicians and researchers using the VF-14 with LHON patients should be aware of its limitations. Compared to the original version, the proposed Rasch-based structure of the VF-14R appears to offer improved psychometric performance and interpretation of vision-related activity limitation. Translational Relevance The original version of the VF-14 exhibits several limitations that undermines its psychometric validity as a patient-reported outcome measure for patients with LHON.
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Affiliation(s)
- Benson S Chen
- John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
- https://orcid.org/0000-0001-8214-0186
| | - Patrick Yu-Wai-Man
- John van Geest Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Institute of Ophthalmology, University College London, London, UK
| | - Mike Horton
- Psychometric Laboratory for Health Sciences, University of Leeds, UK
- https://orcid.org/0000-0002-6675-7335
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de Koning L, Warnink-Kavelaars J, van Rossum M, Limmen S, Van der Looven R, Muiño-Mosquera L, van der Hulst A, Oosterlaan J, Rombaut L, Engelbert R. Physical activity and physical fitness in children with heritable connective tissue disorders. Front Pediatr 2023; 11:1057070. [PMID: 37009265 PMCID: PMC10065825 DOI: 10.3389/fped.2023.1057070] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/21/2023] [Indexed: 04/04/2023] Open
Abstract
Objectives Health problems in patients with heritable connective tissue disorders (HCTD) are diverse and complex and might lead to lower physical activity (PA) and physical fitness (PF). This study aimed to investigate the PA and PF of children with heritable connective tissue disorders (HCTD). Methods PA was assessed using an accelerometer-based activity monitor (ActivPAL) and the mobility subscale of the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT). PF was measured in terms of cardiovascular endurance using the Fitkids Treadmill Test (FTT); maximal hand grip strength, using hand grip dynamometry (HGD) as an indicator of muscle strength; and motor proficiency, using the Bruininks-Oseretsky Test of Motor Proficiency-2 (BOTMP-2). Results A total of 56 children, with a median age of 11.6 (interquartile range [IQR], 8.8-15.8) years, diagnosed with Marfan syndrome (MFS), n = 37, Loeys-Dietz syndrome (LDS), n = 6, and genetically confirmed Ehlers-Danlos (EDS) syndromes, n = 13 (including classical EDS n = 10, vascular EDS n = 1, dermatosparaxis EDS n = 1, arthrochalasia EDS n = 1), participated. Regarding PA, children with HCTD were active for 4.5 (IQR 3.5-5.2) hours/day, spent 9.2 (IQR 7.6-10.4) hours/day sedentary, slept 11.2 (IQR 9.5-11.5) hours/day, and performed 8,351.7 (IQR 6,456.9-1,0484.6) steps/day. They scored below average (mean (standard deviation [SD]) z-score -1.4 (1.6)) on the PEDI-CAT mobility subscale. Regarding PF, children with HCTD scored well below average on the FFT (mean (SD) z-score -3.3 (3.2)) and below average on the HGD (mean (SD) z-score -1.1 (1.2)) compared to normative data. Contradictory, the BOTMP-2 score was classified as average (mean (SD) z-score.02 (.98)). Moderate positive correlations were found between PA and PF (r(39) = .378, p < .001). Moderately sized negative correlations were found between pain intensity and fatigue and time spent actively (r(35) = .408, p < .001 and r(24) = .395 p < .001, respectively). Conclusion This study is the first to demonstrate reduced PA and PF in children with HCTD. PF was moderately positively correlated with PA and negatively correlated with pain intensity and fatigue. Reduced cardiovascular endurance, muscle strength, and deconditioning, combined with disorder-specific cardiovascular and musculoskeletal features, are hypothesized to be causal. Identifying the limitations in PA and PF provides a starting point for tailor-made interventions.
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Affiliation(s)
- Lisanne de Koning
- Center of Expertise Urban Vitality, Faculty of Health, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Correspondence: Lisanne de Koning
| | - Jessica Warnink-Kavelaars
- Department of Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, Netherlands
| | - Marion van Rossum
- Department of Pediatrics, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, Netherlands
| | - Selina Limmen
- Center of Expertise Urban Vitality, Faculty of Health, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
| | - Ruth Van der Looven
- Department of Physical and Rehabilitation Medicine, Child Rehabilitation, Ghent University Hospital, Ghent, Belgium
| | - Laura Muiño-Mosquera
- Department of Pediatrics, Division of Pediatric Cardiology, Ghent University Hospital, Ghent, Belgium
- Center for Medical Genetics, Ghent University Hospital/Ghent University, Ghent, Belgium
| | - Annelies van der Hulst
- Department of Pediatric Cardiology, Amsterdam UMC, Location University of Amsterdam, Amsterdam, Netherlands
| | - Jaap Oosterlaan
- Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me Program & Emma Neuroscience Group, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, Netherlands
| | - Lies Rombaut
- Center for Medical Genetics, Ghent University Hospital/Ghent University, Ghent, Belgium
| | - Raoul Engelbert
- Center of Expertise Urban Vitality, Faculty of Health, University of Applied Sciences Amsterdam, Amsterdam, Netherlands
- Department of Rehabilitation Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, Netherlands
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Ren L, Seklouli AS, Zhang H, Wang T, Bouras A. An adaptive Laplacian weight random forest imputation for imbalance and mixed-type data. INFORM SYST 2023. [DOI: 10.1016/j.is.2022.102122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Susanne A, Aileen B, Helen O, Susanne G, Anne-Marie B. Individual and organisational factors in the psychosocial work environment are associated with home care staffs' job strain: a Swedish cross-sectional study. BMC Health Serv Res 2022; 22:1418. [PMID: 36434716 PMCID: PMC9701045 DOI: 10.1186/s12913-022-08699-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/18/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Home care staff (HCS) provide essential service to enable older adults to age in place. However, unreasonable demands in the work environment to deliver a safe, effective service with high quality has a negative impact on the individual employee's well-being and the care provided to the older adults. The psychosocial work environment is associated with employees´ well-being, although, knowledge regarding which individual and organisational factors that contribute to job strain for HCS is limited. These factors need to be identified to develop targeted interventions and create sustainable work situations for HCS. This study aimed to explore how HCS´s perceived job strain is associated with, and to what extent can be explained by, individual and organisational factors of the psychosocial work environment and psychosomatic health. METHOD An explorative cross-sectional questionnaire survey design was used in a large Swedish county. Five home care agencies with a total of 481 HCS were asked to respond to a questionnaire regarding their perceived level of job strain (Strain in Dementia Care Scale), psychosocial work environment (QPSNordic34+), and psychosomatic health (Satisfaction with Work Questionnaire). Multiple linear regression (MLR) analyses were conducted to explore the association between job strain and individual and organisational factors. RESULTS In total, 226 (46%) HCS responded to the questionnaire. Both individual and organisational factors were significant predictors of job strain and explained a variance ranging between 39 to 51% (p = 0.001). The organisational factor job demand and the individual factor feeling worried and restless was most frequently represented in these MRL models. A higher job strain was also associated with adverse outcomes regarding leadership, organisational culture and climate, and control at work. CONCLUSION This study indicates that there is an intertwined complexity of individual and organisational factors that are associated with the HCS´s perception of job strain. Implementation of new multidimensional work strategies, such as a reablement approach, could support the development of efficient strategies for HCS and reduce the level of job strain. Policy changes for the provision of home care are also needed to support the development of a sustainable and healthy psychosocial work environment.
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Affiliation(s)
- Assander Susanne
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Bergström Aileen
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Olt Helen
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Guidetti Susanne
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Theme Women´S Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Boström Anne-Marie
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden ,Research & Development Unit, Stockholms Sjukhem, Stockholm, Sweden
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Ramos-Pibernus A, Rodríguez-Madera S, Rosario-Hernández E, Moreta-Ávila F, Silva-Reteguis J, Rivera-Segarra E. COVID-19 impact on the psychological health of Latinx transgender and non-binary individuals in mainland United States and Puerto Rico: a mixed-methods study. BMC Public Health 2022; 22:2017. [PMID: 36333681 PMCID: PMC9636836 DOI: 10.1186/s12889-022-14375-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic continues to generate an unprecedented impact on all aspects of everyday life across the world. However, those with historically and currently marginalized identities (i.e., gender or ethnicity) who already experience a wide range of structural inequities have been disproportionally impacted. LTNB are a particularly at-risk population as they lie at the intersection of race/ethnicity, gender identity, language, migration status, geographical location, among others, which could further increase their COVID-19 and other health-related risks and disparities. The objective of this study was to examine the impact of key social determinants of health (i.e., gender identity, country, health insurance, employment) among a sample of LTNB individuals. METHODS The team implemented a cross-sectional exploratory design with an online survey technique using the secure web platforms REDcap and SurveyMonkey. A total of 133 participants completed the online survey. Most of the sample self-identified as transwomen (38.8%), transmen (26.3%), and non-binary (21.8%) between the ages of 21 to 72. All participants were Latinx living in either Puerto Rico (47.7%) or mainland United States (52.3%). Descriptive statistics, reliability tests, Mann-Whitney and rapid thematic analysis test were conducted. RESULTS Findings show that most participants were always (38.1%) or almost always (33.3%) worried about contracting COVID-19. Individuals living in Puerto Rico reported more difficulties than those residing in the mainland US regarding COVID-19 impact on psychosocial, emotional, and COVID-related thinking. Most participants' answers for the COVID-19 open-ended questions focused on three main domains: income, access to trans-affirmative health care, and coping strategies. DISCUSSION Findings evidence that although most of LTNB participants were negatively impacted by the COVID-19 pandemic in multiple aspects of their lives, those living in Puerto Rico experienced these differently when compared to those in mainland US. More research is needed to understand better the mechanisms and pathways through which this context specifically impacts LTNB health and wellbeing, particularly in Puerto Rico. This study could help shape the public health response taking into account the geographical location and other intersectional identities that play critical roles in the production and reproduction of inequities.
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Affiliation(s)
- Alíxida Ramos-Pibernus
- Ponce Health Sciences University, School of Behavioral and Brain Sciences, 92 Dr. Luis F. Sala, Ponce, 00732, Puerto Rico.
| | | | - Ernesto Rosario-Hernández
- Ponce Health Sciences University, School of Behavioral and Brain Sciences, 92 Dr. Luis F. Sala, Ponce, 00732, Puerto Rico
| | | | | | - Eliut Rivera-Segarra
- Ponce Health Sciences University, School of Behavioral and Brain Sciences, 92 Dr. Luis F. Sala, Ponce, 00732, Puerto Rico
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Handling missing data in clinical research. J Clin Epidemiol 2022; 151:185-188. [PMID: 36150546 DOI: 10.1016/j.jclinepi.2022.08.016] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/14/2022] [Accepted: 08/31/2022] [Indexed: 12/25/2022]
Abstract
Because missing data are present in almost every study, it is important to handle missing data properly. First of all, the missing data mechanism should be considered. Missing data can be either completely at random (MCAR), at random (MAR), or not at random (MNAR). When missing data are MCAR, a complete case analysis can be valid. Also when missing data are MAR, in some situations a complete case analysis leads to valid results. However, in most situations, missing data imputation should be used. Regarding imputation methods, it is highly advised to use multiple imputations because multiple imputations lead to valid estimates including the uncertainty about the imputed values. When missing data are MNAR, also multiple imputations do not lead to valid results. A complication hereby is that it not possible to distinguish whether missing data are MAR or MNAR. Finally, it should be realized that preventing to have missing data is always better than the treatment of missing data.
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Rezvan PH, Comulada WS, Fernández MI, Belin TR. Assessing Alternative Imputation Strategies for Infrequently Missing Items on Multi-item Scales. COMMUNICATIONS IN STATISTICS. CASE STUDIES, DATA ANALYSIS AND APPLICATIONS 2022; 8:682-713. [PMID: 36467970 PMCID: PMC9718541 DOI: 10.1080/23737484.2022.2115430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Health-science researchers often measure psychological constructs using multi-item scales and encounter missing items on some participants. Multiple imputation (MI) has emerged as an alternative to ad-hoc methods (e.g., mean substitution) for handling incomplete data on multi-item scales, appealingly reflecting available information while accounting for uncertainty due to missing values in a unified inferential framework. However, MI can be implemented in a variety of ways. When the number of variables to impute gets large, some strategies yield unstable estimates of quantities of interest while others are not technically feasible to implement. These considerations raise pragmatic questions about the extent to which ad-hoc procedures would yield statistical properties that are competitive with theoretically motivated methods. Drawing on an HIV study where depression and anxiety symptoms are measured with multi-item scales, this empirical investigation contrasts ad-hoc methods for handling missing items with various MI implementations that differ as to whether imputation is at the item-level or scale-level and how auxiliary variables are incorporated. While the findings are consistent with previous reports favoring item-level imputation when feasible to implement, we found only subtle differences in statistical properties across procedures, suggesting that weaknesses of ad-hoc procedures may be muted when missing data percentages are modest.
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Affiliation(s)
- Panteha Hayati Rezvan
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, U.S.A
| | - W. Scott Comulada
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, U.S.A
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, U.S.A
| | - M. Isabel Fernández
- College of Osteopathic Medicine, Nova Southeastern University, Miami, Florida, U.S.A
| | - Thomas R. Belin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, U.S.A
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California, U.S.A
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Ling X, Gabrio A, Mason A, Baio G. A Scoping Review of Item-Level Missing Data in Within-Trial Cost-Effectiveness Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:1654-1662. [PMID: 35341690 DOI: 10.1016/j.jval.2022.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 02/02/2022] [Accepted: 02/16/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES Cost-effectiveness analysis (CEA) alongside randomized controlled trials often relies on self-reported multi-item questionnaires that are invariably prone to missing item-level data. The purpose of this study is to review how missing multi-item questionnaire data are handled in trial-based CEAs. METHODS We searched the National Institute for Health Research journals to identify within-trial CEAs published between January 2016 and April 2021 using multi-item instruments to collect costs and quality of life (QOL) data. Information on missing data handling and methods, with a focus on the level and type of imputation, was extracted. RESULTS A total of 87 trial-based CEAs were included in the review. Complete case analysis or available case analysis and multiple imputation (MI) were the most popular methods, selected by similar numbers of studies, to handle missing costs and QOL in base-case analysis. Nevertheless, complete case analysis or available case analysis dominated sensitivity analysis. Once imputation was chosen, missing costs were widely imputed at item-level via MI, whereas missing QOL was usually imputed at the more aggregated time point level during the follow-up via MI. CONCLUSIONS Missing costs and QOL tend to be imputed at different levels of missingness in current CEAs alongside randomized controlled trials. Given the limited information provided by included studies, the impact of applying different imputation methods at different levels of aggregation on CEA decision making remains unclear.
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Affiliation(s)
- Xiaoxiao Ling
- Department of Statistical Science, University College London, London, England, UK.
| | - Andrea Gabrio
- Department of Methodology and Statistics, Faculty of Health Medicine and Life Science, Maastricht University, Maastricht, Limburg, The Netherlands
| | - Alexina Mason
- London School of Hygiene and Tropical Medicine, London, England, UK
| | - Gianluca Baio
- Department of Statistical Science, University College London, London, England, UK
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Veličković K, Borrebaeck CAK, Bendahl PO, Hegardt C, Johnsson P, Richter C, Rydén L, Hallberg IR. One-year recovery from breast cancer: Importance of tumor and treatment-related factors, resilience, and sociodemographic factors for health-related quality of life. Front Oncol 2022; 12:891850. [PMID: 36052232 PMCID: PMC9425776 DOI: 10.3389/fonc.2022.891850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
AimThis study investigated the changes in health-related quality of life from diagnosis to 1 year after diagnosis in breast cancer (BC) patients and the influence of clinical, psychological, and sociodemographic variables. An additional aim was to explore the mediating and moderating effects of resilience on changes in health-related quality of life.MethodsA longitudinal population-based study was conducted in southern Sweden. Newly diagnosed BC patients filled in measures of health-related quality of life, resilience, and sociodemographic variables at diagnosis (N = 980) and 1 year post-diagnosis (N = 780). Clinical variables were extracted from the Swedish national breast cancer quality registry. Mixed-model analyses were performed.ResultsMost health-related quality of life outcomes declined from diagnosis to 1 year post-diagnosis. Role limitations due to emotional problems remained the same, whereas mental health improved. Lower health-related quality of life outcomes were associated with symptomatic detection and axillary dissection. Patients with a higher TNM stage and histologic grade and estrogen receptor (ER)-negative and human epidermal growth factor 2 (HER2)-positive status, who received chemotherapy, antibody therapy, or bisphosphonate therapy, had a steeper decline in outcomes. Changes in resilience were positively associated with all outcomes but did not mediate or moderate changes in any. Resilience at baseline moderated changes in bodily pain, vitality, and mental health, with higher baseline resilience being associated with a steeper decline, possibly due to floor or ceiling effects. Patients with lower socioeconomic status, educational level, and older age had a lower health-related quality of life.ConclusionPhysical health-related quality of life among breast cancer patients declined 1 year post-diagnosis, whereas mental health-related quality of life improved. Low resilient patients may be especially vulnerable at diagnosis. Biopsychosocial assessment at diagnosis can help identify patients who may require additional support. A multidimensional treatment plan should be started early to help overcome the problems in everyday activities.
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Affiliation(s)
- Katarina Veličković
- Department of Psychology, Lund University, Lund, Sweden
- *Correspondence: Katarina Veličković,
| | - Carl A. K. Borrebaeck
- Department of Immunotechnology and CREATE Health Translational Cancer Center, Lund University, Lund, Sweden
| | - Pär-Ola Bendahl
- Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden
| | - Cecilia Hegardt
- Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden
| | - Per Johnsson
- Department of Psychology, Lund University, Lund, Sweden
| | - Corinna Richter
- Department of Immunotechnology and CREATE Health Translational Cancer Center, Lund University, Lund, Sweden
| | - Lisa Rydén
- Department of Clinical Sciences Lund, Division of Surgery, Lund University, Lund, Sweden
- Department of Surgery, Skåne University Hospital, Lund, Sweden
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Panken AM, Heymans MW. A simple pooling method for variable selection in multiply imputed datasets outperformed complex methods. BMC Med Res Methodol 2022; 22:214. [PMID: 35927610 PMCID: PMC9351113 DOI: 10.1186/s12874-022-01693-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 07/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For the development of prognostic models, after multiple imputation, variable selection is advised to be applied from the pooled model. The aim of this study is to evaluate by using a simulation study and practical data example the performance of four different pooling methods for variable selection in multiple imputed datasets. These methods are the D1, D2, D3 and recently extended Median-P-Rule (MPR) for categorical, dichotomous, and continuous variables in logistic regression models. METHODS Four datasets (n = 200 and n = 500), with 9 variables and correlations of respectively 0.2 and 0.6 between these variables, were simulated. These datasets included 2 categorical and 2 continuous variables with 20% missing at random data. Multiple Imputation (m = 5) was applied, and the four methods were compared with selection from the full model (without missing data). The same analyzes were repeated in five multiply imputed real-world datasets (NHANES) (m = 5, p = 0.05, N = 250/300/400/500/1000). RESULTS In the simulated datasets, the differences between the pooling methods were most evident in the smaller datasets. The MPR performed equal to all other pooling methods for the selection frequency, as well as for the P-values of the continuous and dichotomous variables, however the MPR performed consistently better for pooling and selecting categorical variables in multiply imputed datasets and also regarding the stability of the selected prognostic models. Analyzes in the NHANES-dataset showed that all methods mostly selected the same models. Compared to each other however, the D2-method seemed to be the least sensitive and the MPR the most sensitive, most simple, and easy method to apply. CONCLUSIONS Considering that MPR is the most simple and easy pooling method to use for epidemiologists and applied researchers, we carefully recommend using the MPR-method to pool categorical variables with more than two levels after Multiple Imputation in combination with Backward Selection-procedures (BWS). Because MPR never performed worse than the other methods in continuous and dichotomous variables we also advice to use MPR in these types of variables.
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Affiliation(s)
- A M Panken
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. .,Physical Therapy Practice Panken, Roermond, The Netherlands.
| | - M W Heymans
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Jacoby P, Whitehouse A, Leonard H, Saldaris J, Demarest S, Benke T, Downs J. Devising a Missing Data Rule for a Quality of Life Questionnaire-A Simulation Study. J Dev Behav Pediatr 2022; 43:e414-e418. [PMID: 35075044 PMCID: PMC9308825 DOI: 10.1097/dbp.0000000000001061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 12/30/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to devise an evidence-based missing data rule for the Quality of Life Inventory-Disability (QI-Disability) questionnaire specifying how many missing items are permissible for domain and total scores to be calculated using simple imputation. We sought a straightforward rule that can be used in both research and clinical monitoring settings. METHOD A simulation study was conducted involving random selection of missing items from a complete data set of questionnaire responses. This comprised 520 children with intellectual disability from 5 diagnostic groups. We applied a simple imputation scheme, and the simulated distribution of errors induced by imputation was compared with the previously estimated standard error of measurement (SEM) for each domain. RESULTS Using a stringent criterion, which requires that the 95th percentile of absolute error be less than the SEM, 1 missing item should be permitted for 2 of the 6 QI-Disability subdomain scores to be calculated and 1 missing item per domain for the total score to be calculated. Other, less stringent criteria would allow up to 2 missing items per domain. CONCLUSION Empirical evidence about the impact of imputing missing questionnaire responses can be gathered using simulation methods applied to a complete data set. We recommend that such evidence be used in devising a rule that specifies how many items can be imputed for a valid score to be calculated.
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Affiliation(s)
- Peter Jacoby
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Andrew Whitehouse
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Helen Leonard
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Jacinta Saldaris
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
| | - Scott Demarest
- Children’s Hospital Colorado, Paediatric Neurology, University of Colorado School of Medicine, Aurora, Colorado
| | - Tim Benke
- Children’s Hospital Colorado, Paediatric Neurology, University of Colorado School of Medicine, Aurora, Colorado
| | - Jenny Downs
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
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Negi S, Benau EM, Strowger M, Grammer AC, Timko CA. Internalization of Appearance Ideals and Not Religiosity Indirectly Impacts the Relationship Between Acculturation and Disordered Eating Risk in South and Southeast Asian Women Living in the United States. Front Psychol 2022; 13:843717. [PMID: 35923740 PMCID: PMC9341433 DOI: 10.3389/fpsyg.2022.843717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 04/29/2022] [Indexed: 12/02/2022] Open
Abstract
Objective Studies that examine disordered eating in samples of Asian individuals living in the United States frequently combine all individuals of Asian descent into a single group, which can obscure important differences between groups and their experiences of acculturation. The goal of the present study was to establish the relation of acculturation, internalization of appearance ideals, and religiosity as predicting body dissatisfaction and disordered eating in women of South and Southeast Asian (SSEA) descent. Method Women of SSEA descent (N = 112) aged 18-51 years (M = 23.10, SD = 6.4) completed a battery of questionnaires that inquire about these variables. A path analysis was conducted with acculturation serving as the independent (exogenous) variable, religiosity and internalization of the thin ideal as mediators, and body dissatisfaction and disordered eating as dependent (endogenous) variables. Results Direct paths from acculturation to both body dissatisfaction and disordered eating were not significant. Thin ideal internalization completely accounted for the path from acculturation to both endogenous variables; whereas, religiosity did not significantly account for any indirect effect. Discussion For SSEA women, internalization of appearance ideals is a potentially greater risk factor for disordered eating than acculturation or religiosity. As this was an atemporal mediation analysis, more work needs to be done exploring predictors of internalization in this population and how that may impact the development of disordered eating.
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Affiliation(s)
- Sonakshi Negi
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Psychology, University of Kansas, Lawrence, KS, United States
| | - Erik M. Benau
- Department of Psychology, SUNY Old Westbury, Old Westbury, NY, United States
| | - Megan Strowger
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, PA, United States
- Department of Psychology, Old Dominion University, Norfolk, VA, United States
| | - Anne Claire Grammer
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - C. Alix Timko
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Behavioral and Social Sciences, University of the Sciences, Philadelphia, PA, United States
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Ayilara OF, Sajobi TT, Barclay R, Jafari Jozani M, Lix LM. Estimating longitudinal change in latent variable means: a comparison of non-negative matrix factorization and other item non-response methods. J STAT COMPUT SIM 2022. [DOI: 10.1080/00949655.2022.2098499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Olawale F. Ayilara
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Tolulope T. Sajobi
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Ruth Barclay
- Department of Physical Therapy, University of Manitoba, Winnipeg, Canada
| | | | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
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Ermis-Demirtas H, Smith RL, Watson JC. Development and Initial Validation of the Multidimensional Sense of Emptiness Scale. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000221110847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study describes the development and initial validation of the Multidimensional Sense of Emptiness Scale, a measure based on a theoretically and empirically grounded conceptualization of emptiness. In the first sample ( n = 541), an exploratory factor analysis yielded three factors, Sense of Inner Emptiness, Sense of Absence of Relatedness, and Sense of Meaninglessness, explaining 82.8% of the variance with 13 items. In an additional sample ( n = 212), a confirmatory factor analysis supported this three-factorial solution's stability. Furthermore, all subscales were significantly related to a single, second-order factor. In the total sample ( N = 753), subscale and full-scale items offered evidence of satisfactory internal consistency and convergent validity. We discuss study limitations and implications for counseling practice, advocacy, education, training, and research.
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Affiliation(s)
| | - Robert L. Smith
- Department of Counseling & Educational Psychology, Texas A&M University-Corpus Christi
| | - Joshua C. Watson
- Department of Counseling & Educational Psychology, Texas A&M University-Corpus Christi
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Dunn A, Alvarez J, Arbon A, Bremner S, Elsby-Pearson C, Emsley R, Jones C, Lawrence P, Lester KJ, Majdandžić M, Morson N, Perry N, Simner J, Thomson A, Cartwright-Hatton S. Effectiveness of an Online Intervention to Prevent Anxiety in the Children of Anxious Parents: A Study Protocol for a Randomised Controlled Trial. (Preprint). JMIR Res Protoc 2022; 11:e40707. [PMID: 36355406 PMCID: PMC9693706 DOI: 10.2196/40707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/25/2022] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background Anxiety is the most common childhood mental health condition and is associated with impaired child outcomes, including increased risk of mental health difficulties in adulthood. Anxiety runs in families: when a parent has anxiety, their child has a 50% higher chance of developing it themselves. Environmental factors are predominant in the intergenerational transmission of anxiety and, of these, parenting processes play a major role. Interventions that target parents to support them to limit the impact of any anxiogenic parenting behaviors are associated with reduced anxiety in their children. A brief UK-based group intervention delivered to parents within the UK National Health Service led to a 16% reduction in children meeting the criteria for an anxiety disorder. However, this intervention is not widely accessible. To widen access, a 9-module web-based version of this intervention has been developed. This course comprises psychoeducation and home practice delivered through text, video, animations, and practice tasks. Objective This study seeks to evaluate the feasibility of delivering this web-based intervention and assess its effectiveness in reducing child anxiety symptoms. Methods This is the protocol for a randomized controlled trial (RCT) of a community sample of 1754 parents with self-identified high levels of anxiety with a child aged 2-11 years. Parents in the intervention arm will receive access to the web-based course, which they undertake at a self-determined rate. The control arm receives no intervention. Follow-up data collection is at months 6 and months 9-21. Intention-to-treat analysis will be conducted on outcomes including child anxiety, child mental health symptoms, and well-being; parental anxiety and well-being; and parenting behaviors. Results Funding was received in April 2020, and recruitment started in February 2021 and is projected to end in October 2022. A total of 1350 participants have been recruited as of May 2022. Conclusions The results of this RCT will provide evidence on the utility of a web-based course in preventing intergenerational transmission of anxiety and increase the understanding of familial anxiety. Trial Registration ClinicalTrials.gov NCT04755933; https://clinicaltrials.gov/ct2/show/NCT04755933 International Registered Report Identifier (IRRID) DERR1-10.2196/40707
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Affiliation(s)
- Abigail Dunn
- Department of Psychology, University of Sussex, Brighton, United Kingdom
| | - James Alvarez
- Department of Psychology, University of Sussex, Brighton, United Kingdom
| | - Amy Arbon
- University Hospitals Sussex NHS Foundation Trust, The Brighton and Sussex Clinical Trials Unit, Brighton, United Kingdom
| | - Stephen Bremner
- Brighton and Sussex Medical School, Brighton, United Kingdom
| | | | - Richard Emsley
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Peter Lawrence
- Department of Psychology, University of Southampton, Southampton, United Kingdom
| | - Kathryn J Lester
- Department of Psychology, University of Sussex, Brighton, United Kingdom
| | - Mirjana Majdandžić
- Department of Child Development and Education, University of Amsterdam, Amsterdam, Netherlands
| | - Natalie Morson
- Department of Psychology, University of Sussex, Brighton, United Kingdom
| | - Nicky Perry
- University Hospitals Sussex NHS Foundation Trust, The Brighton and Sussex Clinical Trials Unit, Brighton, United Kingdom
| | - Julia Simner
- Department of Psychology, University of Sussex, Brighton, United Kingdom
| | - Abigail Thomson
- Department of Psychology, University of Sussex, Brighton, United Kingdom
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A novel model to optimize multiple imputation algorithm for missing data using evolution methods. Biomed Signal Process Control 2022. [DOI: 10.1016/j.bspc.2022.103661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Groothuis RJ, van Keeken HG, de Vries AE, Dijkstra PU. Self-report Versus Measured Physical Activity Levels During Outpatient Cardiac Rehabilitation. J Cardiopulm Rehabil Prev 2022; 42:172-177. [PMID: 34793358 DOI: 10.1097/hcr.0000000000000642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Many patients with coronary artery disease (CAD) do not achieve the recommended physical activity (PA) levels during and after cardiac rehabilitation (CR). The aim of this study was to analyze moderate to vigorous physical activity (MVPA) levels and the differences between perceived (self-reported) and measured (activity monitor) MVPA in CAD patients during CR. The second aim was to analyze which patient characteristics were associated with this difference. METHODS A two-center observational-sectional study was conducted within the Department of Rehabilitation Medicine of the University Medical Center Groningen between January and April 2018. Adults with CAD, following an outpatient CR program, were included. Perceived MVPA was assessed with the Short Questionnaire to Assess Health-enhancing Physical Activity and compared with ActivPAL3 activity monitor outcomes over a period of 7 d. RESULTS Fifty-one patients with CAD (age 59.4 ± 7.1 yr, eight females) were recruited. Four patients (8%) did not achieve the recommended guideline level of ≥150 min/wk of MVPA. Patients spent ≥80% of the week in sedentary activities. Patients overestimated MVPA with a median of 805 (218, 1363) min/wk (P< .001). The selected patient characteristics (age, body mass index, type of CAD, type of CR, social support, and self-efficacy) were not associated with this overestimation. CONCLUSIONS Most patients with CAD, participating in an outpatient CR program, do achieve MVPA exercise recommendations but spend simultaneously too much time in sedentary activities.
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Affiliation(s)
- Rutger J Groothuis
- Department of Rehabilitation Medicine and Comprehensive Transplant Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (Mr Groothuis); Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (Dr van Keeken); and Departments of Cardiology (Dr de Vries) and Rehabilitation Medicine and Oral and Maxillofacial Surgery (Dr Dijkstra), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Post-Hurricane Distress Scale (PHDS): Determination of General and Disorder-Specific Cutoff Scores. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095204. [PMID: 35564598 PMCID: PMC9100105 DOI: 10.3390/ijerph19095204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/11/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022]
Abstract
The Post-Hurricane Distress Scale (PHDS) was developed to assess mental health risk in the aftermath of hurricanes. We derive both disorder-specific cutoff values and a single nonspecific cutoff for the PHDS for field use by disaster relief and mental health workers. Data from 672 adult residents of Puerto Rico, sampled 3 to 12 months after Hurricane Maria, were collected. Participants completed a five-tool questionnaire packet: PHDS, Kessler K6, Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, and Post-Traumatic Stress Disorder Checklist for DSM V (PCL-5). ROC curves, AUC values, sensitivities, specificities, Youden’s index, and LR+ ratios are reported. The recommended single cutoff value for the PHDS is 41, whereby a respondent with a PHDS score of 41 or above is deemed high-risk for a mental health disorder. The single field use PHDS cutoff demonstrated high specificity (0.80), an LR + ratio (2.84), and a sensitivity of 0.56. The mean ROC values of PHDS for Kessler K6, Patient Health Questionnaire 9, Generalized Anxiety Disorder 7, and PCL-5 were all above 0.74. The derived cutoff for the PHDS allows efficient assessment of respondents’ and/or a community’s risk status for mental health disorders in the aftermath of hurricanes and natural disasters.
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Warnink-Kavelaars J, de Koning LE, Rombaut L, Menke LA, Alsem MW, van Oers HA, Buizer AI, Engelbert RHH, Oosterlaan J. Heritable connective tissue disorders in childhood: Decreased health-related quality of life and mental health. Am J Med Genet A 2022; 188:2096-2109. [PMID: 35393672 PMCID: PMC9321696 DOI: 10.1002/ajmg.a.62750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/23/2022] [Accepted: 03/22/2022] [Indexed: 11/28/2022]
Abstract
The psychosocial consequences of growing up with Heritable Connective Tissue Disorders (HCTD) are largely unknown. We aimed to assess Health‐Related Quality of Life (HRQoL) and mental health of children and adolescents with HCTD. This observational multicenter study included 126 children, aged 4–18 years, with Marfan syndrome (MFS, n = 74), Loeys–Dietz syndrome (n = 8), molecular confirmed Ehlers–Danlos syndromes (n = 15), and hypermobile Ehlers–Danlos syndrome (hEDS, n = 29). HRQoL and mental health were assessed through the parent and child‐reported Child Health Questionnaires (CHQ‐PF50 and CHQ‐CF45, respectively) and the parent‐reported Strengths and Difficulties Questionnaire. Compared with a representative general population sample, parent‐reported HRQoL of the HCTD‐group showed significantly decreased Physical sum scores (p < 0.001, d = 0.9) and Psychosocial sum scores (p = 0.024, d = 0.2), indicating decreased HRQoL. Similar findings were obtained for child‐reported HRQoL. The parent‐reported mental health of the HCTD‐group showed significantly increased Total difficulties sum scores (p = 0.01, d = 0.3), indicating decreased mental health. While the male and female MFS‐ and hEDS‐subgroups both reported decreased HRQoL, only the hEDS‐subgroup reported decreased mental health. In conclusion, children and adolescents with HCTD report decreased HRQoL and mental health, with most adverse outcomes reported in children with hEDS and least in those with MFS. These findings call for systematic monitoring and tailored interventions.
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Affiliation(s)
- Jessica Warnink-Kavelaars
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
| | - Lisanne E de Koning
- Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, The Netherlands
| | - Lies Rombaut
- Ghent University Hospital, Ghent University, Center for Medical Genetics, Ghent, Belgium
| | - Leonie A Menke
- Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Pediatrics, Amsterdam, The Netherlands
| | - Mattijs W Alsem
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands
| | - Hedy A van Oers
- Amsterdam UMC, location University of Amsterdam, Emma Children's Hospital, Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Annemieke I Buizer
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.,Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Raoul H H Engelbert
- Amsterdam UMC location University of Amsterdam, Department of Rehabilitation Medicine, Amsterdam, The Netherlands.,Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, The Netherlands.,Center of Expertise Urban Vitality, Amsterdam University of Applied Sciences, Faculty of Health, Amsterdam, The Netherlands.,Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap Oosterlaan
- Emma Children's Hospital, Amsterdam UMC location University of Amsterdam, Department of Pediatrics, Emma Children's Hospital Amsterdam UMC Follow-Me program & Emma Neuroscience Group, Amsterdam, The Netherlands.,Amsterdam Reproduction and Development research institute, Amsterdam, The Netherlands
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43
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A comparison of methods to address item non-response when testing for differential item functioning in multidimensional patient-reported outcome measures. Qual Life Res 2022; 31:2837-2848. [PMID: 35389187 DOI: 10.1007/s11136-022-03129-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Item non-response (i.e., missing data) may mask the detection of differential item functioning (DIF) in patient-reported outcome measures or result in biased DIF estimates. Non-response can be challenging to address in ordinal data. We investigated an unsupervised machine-learning method for ordinal item-level imputation and compared it with commonly-used item non-response methods when testing for DIF. METHODS Computer simulation and real-world data were used to assess several item non-response methods using the item response theory likelihood ratio test for DIF. The methods included: (a) list-wise deletion (LD), (b) half-mean imputation (HMI), (c) full information maximum likelihood (FIML), and (d) non-negative matrix factorization (NNMF), which adopts a machine-learning approach to impute missing values. Control of Type I error rates were evaluated using a liberal robustness criterion for α = 0.05 (i.e., 0.025-0.075). Statistical power was assessed with and without adoption of an item non-response method; differences > 10% were considered substantial. RESULTS Type I error rates for detecting DIF using LD, FIML and NNMF methods were controlled within the bounds of the robustness criterion for > 95% of simulation conditions, although the NNMF occasionally resulted in inflated rates. The HMI method always resulted in inflated error rates with 50% missing data. Differences in power to detect moderate DIF effects for LD, FIML and NNMF methods were substantial with 50% missing data and otherwise insubstantial. CONCLUSION The NNMF method demonstrated comparable performance to commonly-used non-response methods. This computationally-efficient method represents a promising approach to address item-level non-response when testing for DIF.
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44
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Nowak J, Emmermacher A, Wendsche J, Döbler AS, Wegge J. Presenteeism and absenteeism in the manufacturing sector: A multilevel approach identifying underlying factors and relations to health. CURRENT PSYCHOLOGY 2022; 42:1-19. [PMID: 35400978 PMCID: PMC8976112 DOI: 10.1007/s12144-022-03013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 11/24/2022]
Abstract
Presenteeism is problematic since it relates to lower health and productivity. Prior research examined many work and attitudinal variables relating to presenteeism at the individual level. Here, we conceptualize presenteeism as multilevel phenomenon also shaped by the overall attendance behavior (absenteeism and presenteeism) at the work unit. We surveyed employees at a manufacturing plant on presenteeism, health-related lost productive time (HLPT) and absenteeism (N = 911, 22 units) and collected preceding (past 12-7 and 6 months) objective absence data aggregating it at unit level. Considering the individual-level antecedents only higher physical demands predicted higher absence duration. Presenteeism related positively to physical demands, a burdensome social environment, and organizational identification and negatively to ease of replacement, and core self-evaluations. These relationships were similar for HLPT as outcome. Regarding unit-level factors, preceding unit-level absence frequency (but not duration) negatively related to presenteeism. The negative relationship between core self-evaluations and individual presenteeism decreased under a stronger presenteeism context supporting the hypothesized cross-level effect of unit-level presenteeism context strength. Moreover, individual and unit-level presenteeism correlated, as expected, more strongly with health complaints than absenteeism. Our study demonstrates the value of a contextual, multilevel approach for understanding antecedents and consequences of attendance behavior.
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Affiliation(s)
- Joshua Nowak
- Present Address: Faculty of Psychology, TU Dresden, Dresden, Germany
- Present Address: Department of Product, Grover Group GmbH, Berlin, Germany
| | - Andre Emmermacher
- Present Address: Siemens Energy Global GmbH & Co.KG, Berlin/München, Germany
| | - Johannes Wendsche
- Present Address: Faculty of Psychology, TU Dresden, Dresden, Germany
- Federal Institute for Occupational Safety and Health, Fabricestr 8, 01099 Dresden, Germany
| | - Antonia-Sophie Döbler
- Present Address: Faculty of Psychology, TU Dresden, Dresden, Germany
- Present Address: Department of People Development, Bechtle AG, Neckarsulm, Germany
| | - Jürgen Wegge
- Present Address: Faculty of Psychology, TU Dresden, Dresden, Germany
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45
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Garrido LE, Frías-Hiciano M, Moreno-Jiménez M, Cruz GN, García-Batista ZE, Guerra-Peña K, Medrano LA. Focusing on cybersickness: pervasiveness, latent trajectories, susceptibility, and effects on the virtual reality experience. VIRTUAL REALITY 2022; 26:1347-1371. [PMID: 35250349 PMCID: PMC8886867 DOI: 10.1007/s10055-022-00636-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 02/03/2022] [Indexed: 06/14/2023]
Abstract
UNLABELLED Although virtual reality (VR) usage has become widespread in the last decade, its adoption has been hampered by experiences of user discomfort known as cybersickness. The present study, in line with the "2020 cybersickness R&D agenda", sought to provide a broad examination of the cybersickness phenomenon, assessing its pervasiveness, latent trajectories, impacts on the VR experience, and predictor variables. The study was composed of 92 participants living in the Dominican Republic with ages ranging from 18 to 52 years (M = 26.22), who experienced a 10-min VR immersion in two environments designed for psychotherapy. The results indicated that cybersickness was pervasive, with 65.2% of the participants experiencing it, and 23.9% severely. Additionally, the latent trajectories of cybersickness were positive and curvilinear, with large heterogeneity across individuals. Cybersickness also had a substantive negative impact on the user experience and the intentions to adopt the VR technology. Finally, motion sickness susceptibility, cognitive stress, and recent headaches uniquely predicted greater severity of cybersickness, while age was negatively related. These combined results highlight the critical role that cybersickness plays on the VR experience and underscore the importance of finding solutions to the problems, such as technological advancements or special usage protocols for the more susceptible individuals. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10055-022-00636-4.
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Affiliation(s)
- Luis Eduardo Garrido
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Maite Frías-Hiciano
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Mariano Moreno-Jiménez
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Gabriella Nicole Cruz
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Zoilo Emilio García-Batista
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Kiero Guerra-Peña
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Leonardo Adrián Medrano
- Department of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
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46
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Paradis F, Lamarche B, Robitaille J, Couillard C, Lafrenière J, Tremblay AJ, Corneau L, Lemieux S. Validation of an automated self-administered 24-hour dietary recall web application against urinary recovery biomarkers in a sample of French-speaking adults of the province of Québec, Canada. Appl Physiol Nutr Metab 2022; 47:173-182. [PMID: 35057638 DOI: 10.1139/apnm-2021-0445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The objective of this study was to validate an automated self-administered 24-hour dietary recall web application (R24W) against recovery biomarkers for sodium, potassium and protein intakes and to identify individual characteristics associated with misreporting in a sample of 61 men and 69 women aged 20-65 years from Québec City, Canada. Each participant completed 3 dietary recalls using the R24W, provided two 24-hour urinary samples and completed questionnaires to document psychosocial factors. Mean reported intakes were 2.2%, 2.1% and 5.0% lower than the urinary reference values, respectively, for sodium, potassium and proteins (significant difference for proteins only (p = 0.04)). Deattenuated correlations between the self-reported intake and biomarkers were significant for sodium (r = 0.48), potassium (r = 0.56) and proteins (r = 0.68). Cross-classification showed that 39.7% (sodium), 42.9% (potassium) and 42.1% (proteins) of participants were ranked into the same quartile with both methods and only 4.8% (sodium), 3.2% (potassium) and 0.8% (proteins) were ranked in opposite quartiles. Lower body esteem related to appearance was associated with sodium underreporting in women (r = 0.33, p = 0.006). No other individual factor was found to be associated with misreporting. These results suggest that the R24W has a good validity for the assessment of sodium, potassium and protein intakes in a sample of French-speaking adults. Novelty: The validity of an automated self-administered 24-hour dietary recall web application named the R24W was tested using urinary biomarkers. According to 7 criteria, the R24W was found to have a good validity to assess self-reported intakes of sodium, potassium and proteins.
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Affiliation(s)
- Frédérique Paradis
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Benoît Lamarche
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Julie Robitaille
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Charles Couillard
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
| | - Jacynthe Lafrenière
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
| | - André J Tremblay
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
| | - Louise Corneau
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada
| | - Simone Lemieux
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada.,École de nutrition, Université Laval, Québec, QC G1V 0A6, Canada
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47
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MacDonald-Phillips KA, McKenna SLB, Shaw DH, Keefe GP, VanLeeuwen J, Artemiou E, Adams CL. Communication skills training and assessment of food animal production medicine veterinarians: A component of a voluntary Johne's disease control program. J Dairy Sci 2022; 105:2487-2498. [PMID: 34998564 DOI: 10.3168/jds.2021-20677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 10/13/2021] [Indexed: 11/19/2022]
Abstract
In food animal production medicine (FAPM), the success of control programs for infectious diseases that have serious animal health and economic consequences frequently rely on the veterinarian's effective communication and producer adherence to veterinary recommendations. However, little research has been conducted on communication skills of practicing FAPM veterinarians. During this study, we developed a communication training workshop intervention to support the Atlantic Johne's Disease Initiative. Seventeen FAPM veterinarians across 10 clinics practicing within Maritime Canada participated in a pre-post intervention study design. Communication skills were evaluated utilizing 3 assessment tools; an objective structured clinical exam (OSCE), standardized client feedback, and an instrument designed for veterinary participants to assess their self-efficacy. Study results showed that before training, communication skills of participating veterinarians had limitations, including skill deficits in communication tasks strongly associated with increased adherence to veterinary recommendations. Based on the 3 assessment tools, communication skills of participating veterinarians improved with the training provided. Significant increases were detected in pre- to postintervention self-efficacy percentage scores, OSCE percentage and global scores from expert raters, and OSCE percentage and global scores from standardized client feedback. These improvements emphasize the importance of communication skills training specific to FAPM.
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Affiliation(s)
- Karen A MacDonald-Phillips
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, Canada C1A 4P3.
| | - Shawn L B McKenna
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, Canada C1A 4P3
| | - Darcy H Shaw
- Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, Canada C1A 4P3
| | - Greg P Keefe
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, Canada C1A 4P3
| | - John VanLeeuwen
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island, Canada C1A 4P3
| | - Elpida Artemiou
- Ross University School of Veterinary Medicine, West Farm, Basseterre, PO Box 334, St. Kitts and Nevis
| | - Cindy L Adams
- Department of Veterinary Clinical and Diagnostic Services, University of Calgary, Veterinary Medicine, 11877 85 St. NW, Calgary, AB, Canada T3R 1J3
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48
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Verhoeff MC, Lobbezoo F, van Leeuwen AM, Schuller AA, Koutris M. Oral health-related quality of life in patients with Parkinson's disease. J Oral Rehabil 2022; 49:398-406. [PMID: 35000220 PMCID: PMC9306816 DOI: 10.1111/joor.13304] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/24/2021] [Accepted: 01/05/2022] [Indexed: 12/02/2022]
Abstract
Background Parkinson's disease (PD) is a neurodegenerative condition affecting the quality of life. Due to a worsening of oral health in PD patients with the progression of the disease, oral health‐related quality of life (OHRQoL) could be impaired as well. Objectives To assess whether PD patients in The Netherlands experience worse OHRQoL than historical controls, and to investigate which factors are associated with OHRQoL in PD patients. Materials & Methods In total, 341 PD patients (65.5 ± 8.4 years) and 411 historical controls (62.6 ± 5.3 years) participated. Both groups completed a questionnaire. The PD patients were asked questions regarding demographics, PD, oral health, and OHRQoL. The historical controls filled in demographic information and questions regarding OHRQoL. The latter construct was assessed using the Dutch 14‐item version of the Oral Health Impact Profile (OHIP‐14). Data were analysed using independent samples t‐tests and univariate and multivariate linear regression analysis. Results The mean OHIP‐14 score was higher in PD patients (19.1 ± 6.7) than in historical controls (16.5 ± 4.4) (t(239) = 6.5; p < .001). OHRQoL in PD patients was statistically significant associated with motor aspects of experiences of daily living (B = 0.31; t(315) = 7.03; p < .001), worsening of the oral environment during disease course (B = 3.39; t(315) = 4.21; p < .001), being dentate (B = −5.60; t(315) = −4.5; p < .001), tooth wear (B = 2.25; t(315) = 3.29; p = .001), and possible burning mouth syndrome (B = 5.87; t(315) = 2.87; p = .004). Conclusion PD patients had a lower OHRQoL than historical controls. Besides, PD‐related variables and oral health‐related variables were associated with OHRQoL.
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Affiliation(s)
- Merel C Verhoeff
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Astrid M van Leeuwen
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemarie A Schuller
- TNO Child Health - Behavioral and Societal Sciences, Leiden, The Netherlands.,Center for Dentistry and Oral Hygiene, University Medical Center Groningen, Groningen, The Netherlands
| | - Michail Koutris
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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49
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Rothschild LB, Ratto AB, Kenworthy L, Hardy KK, Verbalis A, Pugliese C, Strang JF, Safer-Lichtenstein J, Anthony BJ, Anthony LG, Guter MM, Haaga DAF. Parents matter: Parent acceptance of school-based executive functions interventions relates to improved child outcomes. J Clin Psychol 2022; 78:1388-1406. [PMID: 34997971 DOI: 10.1002/jclp.23309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES School-based interventions with parent-training components might improve access among lower-income families to effective help for children with neurodevelopmental disorders. This potential might be realized, however, only if parents perceive the interventions as acceptable and therefore engage with treatment. METHODS Parents (N = 124) of 3rd-5th grade students diagnosed with Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder rated the acceptability of their child's treatment (one of two culturally responsive behavioral interventions). Parent engagement was measured through attendance at parent training sessions and the extent to which they read a corresponding workbook. RESULTS Education and income correlated inversely with parent perceptions of treatment acceptability. Acceptability correlated positively with engagement, more strongly among lower-income families. Acceptability had an indirect effect on treatment outcome, mediated by parent engagement. CONCLUSIONS Treatment providers should focus on strategies to increase parent acceptability, with particular attention to improving access for lower-income families.
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Affiliation(s)
- Leah B Rothschild
- Department of Psychology, Asbury Building, American University, Washington, District of Columbia, USA
| | - Allison B Ratto
- Center for Autism Spectrum Disorders, Children's National Hospital, Rockville, Maryland, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Department of Psychiatry, The George Washington University School of Medicine
| | - Lauren Kenworthy
- Center for Autism Spectrum Disorders, Children's National Hospital, Rockville, Maryland, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Department of Psychiatry, The George Washington University School of Medicine
| | - Kristina K Hardy
- Center for Autism Spectrum Disorders, Children's National Hospital, Rockville, Maryland, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Department of Psychiatry, The George Washington University School of Medicine
| | - Alyssa Verbalis
- Center for Autism Spectrum Disorders, Children's National Hospital, Rockville, Maryland, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Department of Psychiatry, The George Washington University School of Medicine
| | - Cara Pugliese
- Center for Autism Spectrum Disorders, Children's National Hospital, Rockville, Maryland, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Department of Psychiatry, The George Washington University School of Medicine
| | - John F Strang
- Center for Autism Spectrum Disorders, Children's National Hospital, Rockville, Maryland, USA.,Division of Pediatric Neuropsychology, Children's National Health System, Department of Psychiatry, The George Washington University School of Medicine
| | | | - Bruno J Anthony
- Department of Psychiatry, CU Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado, USA.,University of Colorado School of Medicine and the Children's Hospital of Colorado, Aurora, Colorado, USA
| | - Laura G Anthony
- Department of Psychiatry, CU Anschutz Medical Campus, Children's Hospital Colorado, Aurora, Colorado, USA.,University of Colorado School of Medicine and the Children's Hospital of Colorado, Aurora, Colorado, USA
| | - Madison M Guter
- Department of Psychology, Asbury Building, American University, Washington, District of Columbia, USA
| | - David A F Haaga
- Department of Psychology, Asbury Building, American University, Washington, District of Columbia, USA
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50
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Monden R, Rosmalen JGM, Wardenaar KJ, Creed F. Predictors of new onsets of irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia: the lifelines study. Psychol Med 2022; 52:112-120. [PMID: 32546287 PMCID: PMC8711101 DOI: 10.1017/s0033291720001774] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 05/08/2020] [Accepted: 05/16/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND It has been claimed that functional somatic syndromes share a common etiology. This prospective population-based study assessed whether the same variables predict new onsets of irritable bowel syndrome (IBS), chronic fatigue syndrome (CFS) and fibromyalgia (FM). METHODS The study included 152 180 adults in the Dutch Lifelines study who reported the presence/absence of relevant syndromes at baseline and follow-up. They were screened at baseline for physical and psychological disorders, socio-demographic, psycho-social and behavioral variables. At follow-up (mean 2.4 years) new onsets of each syndrome were identified by self-report. We performed separate analyses for the three syndromes including participants free of the relevant syndrome or its key symptom at baseline. LASSO logistic regressions were applied to identify which of the 102 baseline variables predicted new onsets of each syndrome. RESULTS There were 1595 (1.2%), 296 (0.2%) and 692 (0.5%) new onsets of IBS, CFS, and FM, respectively. LASSO logistic regression selected 26, 7 and 19 predictors for IBS, CFS and FM, respectively. Four predictors were shared by all three syndromes, four predicted IBS and FM and two predicted IBS and CFS but 28 predictors were specific to a single syndrome. CFS was more distinct from IBS and FM, which predicted each other. CONCLUSIONS Syndrome-specific predictors were more common than shared ones and these predictors might form a better starting point to unravel the heterogeneous etiologies of these syndromes than the current approach based on symptom patterns. The close relationship between IBS and FM is striking and requires further research.
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Affiliation(s)
- Rei Monden
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Klaas J Wardenaar
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Francis Creed
- Neuroscience and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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