Translation and validation of the Hungarian version of the Birth Satisfaction Scale-Revised (BSS-R)

BACKGROUND

Evidence relating maternal birth experience to a range of maternal and neonatal outcomes is increasingly compelling. Consequently valid and reliable self-report of birth experience from the mothers perspective is critical.

AIM

The current study sought to translate and validate a Hungarian-language version of the Birth Satisfaction Scale-Revised (BSS-R).

METHOD

Following forward and backwards translation into Hungarian, the Hungarian BSS-R (HU-BSS-R) was administered to women in a major Transylvanian hospital maternity unit within 72 h postpartum. Key psychometric characteristics were then examined in relation to factor structure, divergent and convergent validity, internal consistency, and known-groups discriminant validity.

RESULTS

Two-hundred and thirty-two women completed the HU-BSS-R. Confirmatory factor analysis revealed the HU-BSS-R to offer an excellent fit to data for the established tri-dimensional measurement model. The HU-BSS-R was also found to offer excellent convergent and divergent validity and known-groups discriminant validity. No significant differences were observed between internal consistency observations between the current study and the original UK validation study.

CONCLUSIONS

The HU-BSS-R is a valid and reliable translation of the original BSS-R, it has proved itself to have excellent psychometric properties and is suitable for use in the Hungarian maternity context.

Vertebrate mineralized tissues: A modular structural analysis

Vertebrate mineralized tissues, present in bones, teeth and scales, have complex 3D hierarchical structures. As more of these tissues are characterized in 3D using mainly FIB SEM at a resolution that reveals the mineralized collagen fibrils and their organization into collagen fibril bundles, highly complex and diverse structures are being revealed. In this perspective we propose an approach to analyzing these tissues based on the presence of modular structures: material textures, pore shapes and sizes, as well as extents of mineralization. This modular approach is complimentary to the widely used hierarchical approach for describing these mineralized tissues. We present a series of case studies that show how some of the same structural modules can be found in different mineralized tissues, including in bone, dentin and scales. The organizations in 3D of the various structural modules in different tissues may differ. This approach facilitates the framing of basic questions such as: are the spatial relations between modular structures the same or similar in different mineralized tissues? Do tissues with similar sets of modules carry out similar functions or can similar functions be carried out using a different set of modular structures? Do mineralized tissues with similar sets of modules have a common developmental or evolutionary pathway? STATEMENT OF SIGNIFICANCE: 3D organization studies of diverse vertebrate mineralized tissues are revealing detailed, but often confusing details about the material textures, the arrangements of pores and differences in the extent of mineralization within a tissue. The widely used hierarchical scheme for describing such organizations does not adequately provide a basis for comparing these tissues, or addressing issues such as structural components thought to be characteristic of bone, being present in dermal tissues and so on. The classification scheme we present is based on identifying structural components within a tissue that can then be systematically compared to other vertebrate mineralized tissues. We anticipate that this classification approach will provide insights into structure-function relations, as well as the evolution of these tissues.

Academic stress in college students: descriptive analyses and scoring of the SISCO-II inventory

In a competitive and demanding world, academic stress is of increasing concern to students. This systemic, adaptive, and psychological process is composed of stressful stimuli, imbalance symptoms, and coping strategies. The SISCO-II Academic Stress Inventory (SISCO-II-AS) is a psychometric instrument validated in Chile. It evaluates stressors, symptoms, and coping, both individually and globally. For its practical interpretation, a scale is required. Therefore, this study aims to descriptively analyze the SISCO-II-AS and to obtain its corresponding scales. Employing a non-experimental quantitative approach, we administered the SISCO-II-AS to 1,049 second and third-year students from three Chilean universities, with a disproportionate gender representation of 75.21% female to 24.79% male participants. Through descriptive and bivariate analysis, we established norms based on percentiles. For the complete instrument and its subscales, significant differences by sex were identified, with magnitudes varying from small to moderate. For the full instrument and its subscales, bar scale norms by percentile and sex are presented. Each subscale (stressors, physical and psychological reactions, social behavioural reactions, total reaction, and coping) has score ranges defined for low, medium, and high levels. These ranges vary according to the sex of the respondent, with notable differences in stressors and physical, psychological, and social behavioural reactions. This study stands out for its broad and heterogeneous sample, which enriches the representativeness of the data. It offers a comprehensive view of academic stress in college students, identifying distinctive factors and highlighting the importance of gender-sensitive approaches. Its findings contribute to understanding and guide future interventions. By offering a descriptive analysis of the SISCO-II-AS inventory and establishing bar norms, this research aids health professionals and educators in better assessing and addressing academic stress in the student population.

Post-what stress? A review of methods of research on posttraumatic stress during COVID-19

BACKGROUND

Post-traumatic stress (PTS) was extensively investigated during the COVID-19 pandemic. However, numerous researchers have raised concerns regarding the adherence of many of these studies to the diagnostic criteria for PTSD as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases (ICD). This review aimed to provide insight into the methodology of research on PTS during the COVID-19 pandemic.

METHODS

Two independent reviewers examined a total of 1129 studies published between 1/01/2020 and 1/07/2023. The investigation focused on the scales employed to assess PTS, the diagnostic framework used (DSM or ICD), whether there was referral to an index-event in the PTS measurement and country where data collection took place.

RESULTS

Among the 1129 studies, 70.0% did not provide any indication of an index-event to which PTS symptoms were attributed. Only 11.3% of the studies explicitly indicated an index-event associated with the PTS symptoms. Furthermore, 54.1% of the studies utilized scales based on DSM-IV criteria. Finally, the majority of PTS-studies had data collections in China, United States and Italy.

CONCLUSION

A limited number of studies conducted during the COVID-19 pandemic reported use of an index-event in their PTS measurement. Furthermore, most studies used scales based on a previous iteration of the most used diagnostical system, namely the DSM. This delay in the implementation of new diagnostic criteria, may impair the clinical relevance of scientific studies.

Overcoming drug resistance with specific nano scales to targeted therapy: Focused on metastatic cancers

Metastatic cancer, which accounts for the majority of cancer fatalities, is a difficult illness to treat. Currently used cancer treatments include radiation therapy, chemotherapy, surgery, and targeted treatment (immune, gene, and hormonal). The disadvantages of these treatments include a high risk of tumor recurrence and surgical complications that may result in permanent deformities. On the other hand, most chemotherapy drugs are small molecules, which usually have unfavorable side effects, low absorption, poor selectivity, and multi-drug resistance. Anticancer drugs can be delivered precisely to the cancer spot by encapsulating them to reduce side effects. Stimuli-responsive nanocarriers can be used for drug release at cancer sites and provide target-specific delivery. As previously stated, metastasis is the primary cause of cancer-related mortality. We have evaluated the usage of nano-medications in the treatment of some metastatic tumors.

Translation and cross-cultural adaptation of seventeen widely-used assessment instruments for child and adolescent mental health in Greece

BACKGROUND

In the context of Greece, many instruments measuring constructs pertinent to child and adolescent mental health lacked a locally-validated, freely-available version. As part of a nationwide survey, we translated and cross-culturally adapted a collection of seventeen brief, largely-employed assessment tools that can be used at scale.

METHODS

This study is part of the Child and Adolescent Mental Health Initiative in Greece (CAMHI), a capacity-building program focusing on enhancing mental health care for children and adolescents living in Greece. We conducted a nationwide survey assessing mental health symptoms, parenting practices, service availability and quality, mental health literacy and stigma, and professional practices within the country. As part of this process, we selected outcomes and instruments after consulting the International Consortium for Health Outcomes Measurement (ICHOM) and the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). From our selection, we identified 17 instruments that did not have a Greek-validated version available for use. These instruments were translated and cross-culturally adapted following a structured procedure, including independent back-and-forth translations, synthesis of versions, expert revision, and pilot testing. Some instruments were slightly modified to meet CAMHI survey purposes.

RESULTS

A cross-culturally adapted version in Greek was made available for the following instruments: Pediatric Symptoms Checklist (PSC); Deliberate Self Harm Inventory (DSH) (modified); Child and Adolescent Trauma Screen-2 (CATS-2); ABCD Screen Use (modified); Swanson, Nolan, and Pelham-IV (SNAP-IV); Parent Behavior Inventory (PBI); Mental Health Literacy Scale (MHLS)-(modified); Australian Mental Health Vignettes; Reported and Intended Behavior Scale (RIBS); Barriers to Access to Care (BACE) (modified); Experience of Service Questionnaire (ESQ) (modified); and Multitheoretical List of Therapeutic Interventions (MULTI-30) (modified).

CONCLUSION

A collection of these widely-used assessment tools is now adapted for the local context and freely accessible at [ https://osf.io/crz6h/ ]. Researchers and health professionals in Greece can utilize this resource to screen, evaluate, and monitor various constructs related to mental health in accordance with the most effective practices.

Development and reliability testing of a risk factor and risk outcome assessment scale for nurses in "internet + nursing services" for the elderly

BACKGROUND

China is experiencing an aging population, leading to a significant demand for "Internet + nursing services" tailored for elderly individuals. However, there are many risk problems in the process of nurse service, which hinder the development of the service, and a scale is needed to assess the risk problems faced by nurses in "Internet + nursing services" for the elderly.

OBJECTIVE

The purpose of this study is to develop an assessment scale for risk factors and outcomes related to nurses' involvement in the "Internet + Nursing Service" for the elderly and to assess its reliability and validity.

METHODS

Based on literature analysis, focus group, the Delphi method, and a presurvey, we designed an initial scale. The initial scale comprised two sections: risk factors and risk outcomes for nurses. In January and February of 2023, nurses engaged in "Internet + nursing services" for the elderly in Shanxi Province were chosen through a convenience sampling technique for a questionnaire survey. Subsequently, item analysis and exploratory factor analysis were employed to refine and develop a test version of the scale further. A follow-up questionnaire survey was carried out in March and April 2023 using a similar approach. The reliability and validity of the scale were assessed through confirmatory factor analysis, culminating in the formation of the final scale.

RESULTS

The initial survey yielded 244 valid responses. The cumulative variance contributions of the two segments from the exploratory factor analysis were 84.584% and 90.089%, respectively. A subsequent survey garnered 220 valid responses. The confirmatory factor analysis results indicated: χ2/df = 2.086, comparative fit index (CFI) = 0.918, normative fit index (NLI) = 0.855, root mean square of residuals (RMR) = 0.045, and root mean square of error of approximation (RMSEA) = 0.070. These results demonstrate good structural, convergent, and discriminant validity. The content validity index at the item level (I-CVI) ranged between 0.875 and 1.000, while the content validity index at the scale level (S-CVI/Ave) was 0.941. Cronbach's alpha coefficient for the entire scale stood at 0.970. Moreover, the scale exhibited a split-half reliability of 0.876 and a retest reliability of 0.980 (p < 0.01).

CONCLUSION

The risk factors and risk outcomes associated with nurses involved in "Internet + nursing services" for elderly individuals, as developed in this study, demonstrate strong reliability and validity. They are well suited to the Chinese national context.

Prognostic value of scales for aneurysmal subarachnoid hemorrhage: Report of a reference center in Peru

INTRODUCTION

Multiple scales have been designed to stratify the severity and predict the prognosis in the initial evaluation of patients with aneurysmal subarachnoid hemorrhage (aSAH). Our study aimed to validate the most commonly used prognostic scales for aSAH in our population: Hunt-Hess, modified Hunt-Hess, World Federation of Neurosurgical Societies (WFNS), Prognosis on Admission of Aneurysmal Subarachnoid Hemorrhage (PAASH), and Barrow Aneurysm Institute (BAI) scales.

METHODS

This study includes all aSAH cases treated at our institution between June 2019 and December 2020. We developed a retrospective cohort by reviewing medical records and radiologic images performed during hospitalization. The outcome was evaluated using the modified Rankin scale (mRS). It was defined as a poor outcome (mRS 4-5) and mortality (mRS 6). The ROC curves and the area under the curve (AUC) of each of the prognostic scales were calculated to evaluate their prognostic prediction capacity.

RESULTS

A total of 142 patients were diagnosed with aSAH. A poor outcome occurred in 52.1% of the patients, whereas mortality was 27.5%. The AUC of the scales studied was similar and no significant difference was found between them for predicting a poor outcome (P = .709) or mortality (P = .715).

CONCLUSION

We determined that the prognostic scales for aSAH had a similar predictive value for poor clinical outcomes and mortality in our institution, with no significant difference. Thus, we recommend the most simple and well-known scale used institutionally.

[By any Other Name …-Soviet Construction of Schizophrenia in the 1970-1980s and its Integration into the International Classification of Diseases]

The article reconstructs attempts to create scientifically coherent, internationally agreed-upon diagnostics for mild forms of schizophrenia throughout the 20th century. A particular focus here lies on what became known as bland-or sluggish-schizophrenia, a particular term coined in the USSR, which became known for its frequent use in internationally contested diagnoses of human rights activists. The argument follows the diagnosis of sluggish schizophrenia from its inception in a highly productive and equally international psychiatric community of the early 20th century pioneered by prominent Soviet scholar Andrey Snezhnevsky and through its epistemic detachment and content-related transformation in the highly isolated Soviet psychiatric community since the interwar period. This transformation is analyzed with help of the case study on the International Classification of Diseases (ICD). Released by the World Health Organization, the ICD-and in particular its ninth revision-played a crucial role in the attempt to legitimize sluggish schizophrenia. The comparative study of four presumably identical ICD-passages from three languages helps reconstructing how internationally accorded terms would become adapted to the Soviet societal and political realities. The ultimate aim of the attempted adaptation, the article claims, was to provide the elsewhere contested diagnostic term "sluggish" schizophrenia with additional legitimacy per authority of the WHO and, thus, much needed credibility for domestic, and often political, use.

The 68 symptoms of the clinical high risk for psychosis: Low similarity among fourteen screening questionnaires

The Clinical High Risk for psychosis (CHR) is a heterogeneous condition with multiple symptoms. CHR screening is challenging in routine care, as a wide variety of questionnaires exists. We propose to explore the extent to which these questionnaires differ or overlap in item content. We performed a systematic and quantitative analysis of item content in a set of widely-used CHR screening questionnaires. Items were extracted from questionnaires and reworded according to the Structured Interview for Psychosis-Risk Syndromes (SIPS). Then, symptoms were generated from individual items. The Jaccard Index was calculated to assess content overlap. The 14 analysed questionnaires were composed of 347 items, from which 198 symptoms were generated and, in turn, collapsed into 68 distinct symptoms. Positive symptoms were the most commonly represented. The overall overlap across questionnaires showed weak similarity (Jaccard = 0.19±0.50). CHR screening questionnaires might evaluate the same broad clinical construct, but have different scopes within that construct, and may be more or less comprehensive than one another. Clinicians and researchers should be mindful of the specific features of each instrument for optimal CHR screening.

Scales of non-avian reptiles and their derivatives contain corneous beta proteins coded from genes localized in the Epidermal Differentiation Complex

The evolution of modern reptiles from basic reptilian ancestors gave rise to scaled vertebrates. Scales are of different types, and their corneous layer can shed frequently during the year in lepidosaurians (lizards, snakes), 1-2 times per year in the tuatara and in some freshwater turtle, irregularly in different parts of the body in crocodilians, or simply wore superficially in marine and terrestrial turtles. Lepidosaurians possess tuberculate, non-overlapped or variably overlapped scales with inter-scale (hinge) regions. The latter are hidden underneath the outer scale surface or may be more exposed in specific body areas. Hinge regions allow stretching during growth and movement so that the skin remains mechanically functional. Crocodilian and turtles feature flat and shield scales (scutes) with narrow inter-scale regions for stretching and growth. The epidermis of non-avian reptilian hinge regions is much thinner than the exposed outer surface of scales and is less cornified. Despite the thickness of the epidermis, scales are mainly composed of variably amount of Corneous Beta Proteins (CBPs) that are coded in a gene cluster known as EDC (Epidermal Differentiation Complex). These are small proteins, 100-200 amino acid long of 8-25 kDa, rich in glycine and cysteine but also in serine, proline and valine that participate to the formation of beta-sheets in the internal part of the protein, the beta-region. This region determines the further polymerization of CBPs in filamentous proteins that, together a network of Intermediate Filament Keratins (IFKs) and other minor epidermal proteins from the EDC make the variable pliable or inflexible corneous material of reptilian scales, claws and of turtle beak. The acquisition of scales and skin derivatives with different mechanical and material properties, mainly due to the evolution of reptile CBPs, is essential for the life and different adaptations of these vertebrates.

Long-term stress induced cortisol downregulation, growth reduction and cardiac remodeling in Atlantic salmon

Stress and elevated plasma cortisol in salmonids have been linked with pathological remodeling of the heart and deterioration of fitness and welfare. However, these associations were based on biomarkers that fail to provide a retrospective view of stress. This study is the first whereby the association of long-term stress, using scale cortisol as a chronic stress biomarker, with cardiac morphology and growth performance of wild Atlantic salmon (Salmo salar) is made. Growth, heart morphology, plasma and scale cortisol levels, and expression of genes involved in cortisol regulation of the hypothalamic-pituitary-interrenal axis of undisturbed fish (control) were compared with those of fish exposed daily to stress for 8 weeks. Though scale cortisol levels showed a time-dependent accumulation in both groups, plasma and scale cortisol levels of stress group fish were 29.1% and 25.0% lower than those of control fish, respectively. These results correlated with the overall upregulation of stress-axis genes involved in the systemic negative feedback of cortisol, and local feedback via 11β-hydroxysteroid dehydrogenases, glucocorticoid and mineralocorticoid receptors in the stress treatment at the hypothalamus and pituitary level. These lower cortisol levels were, however, counterintuitive in terms of the growth performance as stress group fish grew 33.7% slower than control fish, which probably influenced the 8.4% increase in relative ventricle mass in the stress group. Though compact myocardium area between the treatments was comparable, these parameters showed significant linear correlations with scale cortisol levels, indicating the involvement of chronic stress in cardiac remodeling. These findings underscore the importance of scale cortisol as biomarker when associating chronic stress with long-term processes including cardiac remodeling.

Instruments and scales for the evaluation of acute radiation dermatitis: A systematic review

Various assessment instruments have been proposed to document and evaluate radiation dermatitis. In this systematic review, we identified nineteen instruments or scales for the evaluation of radiation dermatitis and performed a critical review of the signs and symptoms included in each of them. Of those scales, only two have been validated. There is a need to revise the currently used instruments so to improve their capability to measure all relevant aspects of radiation dermatitis and their severity. In addition, it would be important to add the patients' view of their conditions and how they affect their lives. Finally, in order to be useful in clinical and research settings, instruments for evaluation of radiation dermatitis should be submitted to the validation process that is currently prescribed in the field of outcome measures development.

Identification of appropriate tools to gauge brain functions in a clinical setup of a developing country: A pilot study

Objective

To identify the most appropriate tools to measure functions of the brain that can be utilized in the clinical setups of developing countries.

Methods

This qualitative research with a three-step approach was carried out from January 2022 to May 2022 at the Institute of Basic Medical Sciences, Khyber Medical University, Pakistan. Firstly, literature was searched to identify main brain faculties, then interviews were conducted with regional field experts to identify appropriate scales for the selected functions. Lastly a rubric was filled using interview transcripts and literature.

Results

The identified functions were vision, hearing, cognition, motor and emotions. Based on the rubric the best tests were visual fields (17/24), pure tone audiometry (16/24), Mini-Mental State Exam (20/24), Trait Emotional Intelligence Questionnaire (18/24), Romberg's test (19/24) and Manual Muscle Testing (18/24).

Conclusion

The clinicians in developing countries can utilize the visual fields, pure tone audiometry, Mini-Mental State Exam, Trait Emotional Intelligence Questionnaire, Romberg's test and Manual Muscle Testing for most efficient, feasible, accurate and cost-effective measurement of brain functions.

A declaration on the value of experiential measures of food and water insecurity to improve science and policies in Latin America and the Caribbean

BACKGROUND

Water security is necessary for good health, nutrition, and wellbeing, but experiences with water have not typically been measured. Given that measurement of experiences with food access, use, acceptability, and reliability (stability) has greatly expanded our ability to promote food security, there is an urgent need to similarly improve the measurement of water security. The Water InSecurity Experiences (WISE) Scales show promise in doing so because they capture user-side experiences with water in a more holistic and precise way than traditional supply- side indicators. Early use of the WISE Scales in Latin American & the Caribbean (LAC) has revealed great promise, although representative data are lacking for most of the region. Concurrent measurement of experiential food and water insecurity has the potential to inform the development of better-targeted interventions that can advance human and planetary health.

MAIN TEXT

On April 20-21, 2023, policymakers, community organizers, and researchers convened at Universidad Iberoamericana in Mexico City to discuss lessons learned from using experiential measures of food and water insecurity in LAC. At the meeting's close, organizers read a Declaration that incorporated key meeting messages. The Declaration recognizes the magnitude and severity of the water crisis in the region as well as globally. It acknowledges that traditional measurement tools do not capture many salient water access, use, and reliability challenges. It recognizes that the WISE Scales have the potential to assess the magnitude of water insecurity more comprehensively and accurately at community, state, and national levels, as well as its (inequitable) relationship with poverty, poor health. As such, WISE data can play an important role in ensuring more accountability and strengthening water systems governance through improved public policies and programs. Declaration signatories express their willingness to promote the widespread use of the WISE Scales to understand the prevalence of water insecurity, guide investment decisions, measure the impacts of interventions and natural shocks, and improve public health.

CONCLUSIONS

Fifty-three attendees endorsed the Declaration - available in English, Spanish and Portuguese- as an important step to making progress towards Sustainable Development Goal 6, "Clean Water and Sanitation for All", and towards the realization of the human right to water.

Translation and validation of the Swedish version of the Birth Satisfaction Scale-Revised (BSS-R)

BACKGROUND

Optimizing women's childbirth experience is essential for development of quality mother infant relationships. The Birth Satisfaction Scale-Revised (BSS-R) can be used to measure birth satisfaction.

AIM

The current investigation sought to translate and validate a Swedish version of the BSS-R.

METHOD

Following translation, a comprehensive psychometric validation of the Swedish-BSS-R (SW-BSS-R) was carried out using a multi-model, cross-sectional, between- and within-subjects design.

PARTICIPANTS

A total of 619 Swedish-speaking women participated, from which 591 completed SW-BSS-R and were eligible for analysis.

DATA ANALYSIS

Discriminant, convergent, divergent and predictive validity, internal consistency, test-retest reliability, and factor structure were evaluated.

RESULTS

The SW-BSS-R was found to have excellent psychometric properties and hence is a valid translation of the original UK(English)-BSS-R. Important insights into relationships between mode of birth, post-traumatic stress disorder (PTSD), and postnatal depression (PND) were observed.

CONCLUSIONS AND IMPLICATIONS FOR PRACTICE

The SW-BSS-R is a psychometrically valid translation of the original BSS-R and is suitable for use in a Swedish-speaking population of women. The study has also highlighted important dynamics between birth satisfaction and areas of significant clinical concern (i.e., mode of birth, PTSD and PND) in Sweden.

Consequences of survey modification in a program evaluation: An exploratory research on evaluation study

The purpose of this exploratory research on evaluation study was to examine how modified and unmodified scales of critical thinking and interest in science careers would affect the evaluation conclusions. Surveys measuring various outcomes that are used in program evaluation are frequently modified from their original versions in response to the unique context of programs. Modifying existing published surveys by removing or adding items can affect the psychometric properties of the original scale and may produce differing results. The results of the comparisons found that unmodified and modified surveys had similar reliabilities; however, one of the scales produced contradictory evaluation findings. Lessons learned from this study suggest that scales can be modified in evaluation, but great care is needed to address the potential strengths and limitations of the modified scale and balance the technical needs with responsiveness to program context.

Scales and Interventions for Resilience among Treatment-Seeking Patients with Depression: A Systematic Review

Introduction

Resilience is an ability of an individual to effectively adjust and thrive in adverse stressful conditions. Resilience has protective and compensatory effects against depression. Evaluating resilience clinically and modifying it among patients with depression hugely impacts their prognosis. We aimed to explore different clinical scales for measuring resilience as well as interventions used with an intent to improve resilience among patients with depression.

Methods

A systematic literature review was conducted by searching PubMed central, Biomed central, and google scholar, using relevant MeSH keywords. The population of interest were the patients who were clinically diagnosed with Bipolar or Unipolar Depression and the population were not restricted to any country. Clinical scales for evaluation and interventions for resilience among patients with depression were set as an outcome of the study. Randomized controlled trials (RCTs), Quasi-experimental studies, observational studies, and narrative reviews were considered relevant research designs for extraction.

Results

A total of 8689 articles were identified and 13 articles were included in the final review, which yielded five scales that have been identified and have been used to evaluate resilience among the patients who are clinically diagnosed with depression and six different interventions for building resilience among patients with depression.

Conclusion

Resilience-building interventions will not only act as a preventive measure against depression but also help in promoting recovery and sustaining remission after a depressive episode. Clinical evaluation of resilience and management will significantly support boosting emotional experience.

A mixed-design study on the development of birth unit assessment scale

INTRODUCTION

This is a mixed design study planned to determine the views of women, midwives, and physicians about the ideal birth unit and to develop a to develop a valid and reliable measurement tool for postpartum women's evaluation of the effect of birth units in terms of physical, emotional, and social aspects on their satisfaction with the birth environment.

METHODS

The exploratory sequential design, which is accepted as a mixed design, was used in the study. In the qualitative phase of the study, a content analysis was conducted by interviewing a total of 20 participants including 5 pregnant women, 5 postpartum women, 5 midwives and 5 obstetricians. In the quantitative phase, the Draft Birth Unit Satisfaction Assessment scale, which was developed in line with the data obtained as a result of the qualitative study, a literature review, and expert opinions, was used to evaluate postpartum women's (n = 435) satisfaction with the birth environment. Content validity, exploratory factor analysis, and confirmatory factor analysis were used for the validity analyses of the scale, and item analysis, internal consistency, and time-dependent invariance were evaluated for reliability.

RESULTS

In the qualitative phase of the study, the themes were grouped under 5 categories (physical features of the hospital, features of the birth room, privacy, aesthetics and support) according to the qualitative data on the factors that showed participants' views on the ideal birth unit. In the quantitative stage, the Birth Unit Satisfaction Assessment Scale, which consisted of 30 items and 5 sub-dimensions (communication and care, physical characteristics of the birth room, comfort, opportunities supporting birth, and decoration and aesthetics), was developed.

DISCUSSION

In conclusion, it was determined that the scale developed in this study was a valid and reliable measurement tool that could be used to evaluate postpartum women's satisfaction with the birth environment.

Are suicide risk scales sensitive to change? A scoping review

INTRODUCTION

Clinician- or self-administered scales are frequently used to assist in detecting risk of death by suicide and to determine the effectiveness of interventions. No recent review studies have examined whether these scales are sensitive to change. We conducted a scoping review to identify suicide risk scales that are sensitive to change.

MATERIAL AND METHODS

We searched Medline and Excerpta Medica Database from inception through March 17, 2022, to identify randomized trials, pooled analysis, quasi-experimental studies, and cohort studies reporting on sensitivity to change of suicide risk scales. We assessed sensitivity to change by examining internal and external responsiveness. Internal responsiveness evaluates whether the scale measures changes in suicide-related symptoms in response to an intervention while external responsiveness assess whether changes in the scale correspond to changes in risk of suicide. We summarized findings across studies using descriptive analysis.

RESULTS

Among 38 eligible scales, we identified 27 scales that included items that were modifiable to change. However, only 7 scales had been studied to determine their sensitivity to change based on internal or external responsiveness. While the results of studies suggested that 6 scales have internal responsiveness, none of the included studies confirmed that scales have external responsiveness.

DISCUSSION

A few suicide risk scales are internally responsive and may be useful in a clinical or research setting. It is unclear, however, whether changes in scores correspond to an actual change in suicide risk. Future research should confirm the external responsiveness of scales using robust metrics including suicide mortality.

Comparison between FRAIL Scale and Clinical Frailty Scale in predicting hospitalization in hemodialysis patients

BACKGROUND

To assess the prevalence of frailty by the Clinical Frailty Scale (CFS) and the 5-item FRAIL scale and their association with hospitalization in hemodialysis (HD) patients.

METHODS

This was a prospective observational study. We included patients of both genders ≥ 18 years old in HD treatment for at least 3 months. Demographic, clinical, and routine laboratory data were retrieved from the medical charts. Two different frailty assessment tools were used, the CFS and the FRAIL scale. Participants were followed up for 9 months and hospitalizations for all causes were evaluated. A Venn diagram was constructed to show the overlap of possible frailty and pre-frailty. Cox regression was used to identify the association between frailty and hospitalization. The significance level was 5%.

RESULTS

A total of 137 subjects were included in the analysis. The median age was 61 (52-67) years and 60% were male. The hospitalization rate and mortality in 9 months were 22.6% and 7.29%, respectively. Regarding frailty, the overall prevalence was 13.8% assessed by CFS and 36.5% according to the FRAIL scale. In the Cox regression, frailty by FRAIL scale was associated with a 2.8-fold increase in the risk of hospitalization (OR = 2.880; 95% CI = 1.361-6.096; p = 0.006), but frailty assessed by the CFS was not associated with the need for hospitalization.

CONCLUSION

In HD patients, the FRAIL scale proved to be an easy-to-apply tool, identifying a high prevalence of frailty and being a predictor of hospital admission.

Reliability and Validity of the Korean Version of the Ask Suicide-Screening Questions (ASQ)

BACKGROUND

The Ask Suicide-Screening Questions (ASQ) tool is a simple suicide screening tool developed to screen patient suicide risk (SR). The purpose of this study was to verify the reliability and validity of the ASQ tool in hospitalized patients.

METHODS

The internal consistency and test-retest reliability of the South Korean version of the ASQ tool were verified in 99 hospitalized patients admitted to a tertiary medical institution in Seoul. To verify the correlations and validity of each convergence with other scales, the Mini-International Neuropsychiatric Interview (MINI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Satisfaction with Life Scale (SWLS) were also conducted to determine convergent and discriminant validity. Then, the receiver operating characteristic (ROC) curve diagnosis values for suicide and depression levels with the highest correlations were analyzed.

RESULTS

As a result, Cronbach's alpha was 0.826, and when each item was removed sequentially, Cronbach's alpha ranged from 0.736-0.840, showing stable internal consistency. Most of the corrected item-total correlation were over 0.500; however, a relatively low correlation was shown for the fourth and fifth questions, which had values of 0.429 and 0.410, respectively. The test-retest reliability was 0.830, and the MINI and PHQ-9 showed high values of 0.872 and 0.672, respectively. The area under the curve (AUC) according to the ASQ diagnosis value was also the highest for the MINI (0.936).

CONCLUSION

The validity and reliability of the South Korean version of the ASQ tool were demonstrated. Through this validation, the ASQ tool can be used for simple suicide risk screening (SRS) in hospitalized patients.

Chronic stress causes cortisol, cortisone and DHEA elevations in scales but not serum in rainbow trout

Fish scales have been reported to incorporate cortisol over long periods of time and thus provide a promising means of assessing long-term stress in many species of teleost fish. However, the quantification of other stress related hormones has only been accomplished in our previous study conducted in goldfish (Carassius auratus). DHEA is a precursory androgen with anti-stress effects used alongside cortisol to diagnose chronic stress via the cortisol:DHEA ratio in mammals. Included in DHEA's anti-stress mechanisms are changes in the metabolism of cortisol to its inactive metabolite cortisone suggesting the relationships between cortisol, DHEA and cortisone may be additionally informative in the assessment of long-term stress. Therefore, to further explore these concepts in a native fish species and generate more comprehensive comparisons between scale and serum hormone concentrations than was possible in our previous study we implemented a 14-day stress protocol in adult rainbow trout (Oncorhynchus mykiss) and quantified resulting scale and serum cortisol, cortisone and DHEA concentrations. As predicted, elevations in scale concentrations of all hormones were observed in stressed trout compared to controls but were not reflected in serum samples. Significant differences in the cortisol:DHEA and cortisone:cortisol ratios were also found between control and stressed group scales but not serum. These results suggest not only that scales provide a superior medium for the assessment of long-term stress but also that the addition of scale cortisone and DHEA may provide additional relevant information for such assessments.

Clinical validation of the infant-driven feeding scales© in Turkey

BACKGROUND

Supporting the development of feeding skills among preterm infants is an important component of neonatal care. The selection of appropriate and supportive feeding interventions begins with a comprehensive assessment of the infant's skills.

PURPOSE

This study aimed to adapt the Infant-Driven Feeding Scales© (IDFS) to the Turkish language.

METHODS

This was a methodological, observational, single-center cross-sectional study. The study included 80 infants born at a gestational age ≥ 32 weeks, consecutively admitted to a tertiary Neonatal Intensive Care Unit (NICU). Research data were collected using a premature infant descriptive information form (IDIF), IDFS, and LATCH Score for Breastfeeding Assessment. For the Turkish validity-reliability of the IDF, the translate-back translate method was used with the content validity index (CVI) assessed.

RESULTS

The scale had CVI values between 0.90 and 1.00 with a mean CVI = 0.96. For measures 1 and 2, there were significant positive and high-level correlations between IFDS-R and IFDS-Q correlation values (r = 0.553-0.958; p = 0.001) and significant negative, low-level correlations between IFDS-R and IFDS-Q with the LATCH scale (r = 0.439-0.532; p = 0.001). According to inter-observer compatibility analyses, the kappa value was 0.94-1.00 for the first measure and 0.96-1.00 for the second measure (p = 0.001). There were negative significant correlations between IDFS-R points with gestational age and postmenstrual age (PMA) (p = 0.001), and gestational age and PMA were explanatory factors for 13.8% of IDFS-R points (F = 7.30, p = 0.001).

CONCLUSIONS

The IDFS is recommended for use as a valid and reliable tool to ease the safe and successful development of oral feeding skills in preterm infants and to plan evidence-based interventions.

IMPLICATIONS FOR PRACTICE

The IDFS appears to be a beneficial measurement device for use in assessing the state of readiness of preterm infants for oral feeding and for early determination of risks that may occur due to delayed feeding independence of infants.

Evaluation of the HEFESTOS scale to predict outcomes in emergency department acute heart failure patients

The HEFESTOS scale was developed in 14 Spanish primary care centres and validated in 9 primary care centres of other European countries. It showed good performance to predict death/hospitalisation during the first 30 days after an episode of acute heart failure (AHF), with c-statistics of 0.807/0.730 in the derivation/validation cohorts. We evaluated this scale in the emergency department (ED) setting, comparing it to the EHMRG and MEESSI scales in the ED and the EFFECT and GWTG scales in hospitalised patients, to predict 30-day outcomes, including death and hospitalisation. Consecutive AHF patients were enrolled in 34 Spanish EDs in January-February 2016, 2018, and 2019 with variables needed to calculate outcome scores. Thirty-day hospitalisation/death (together and separately) and post-discharge combined adverse event (ED revisit or hospitalisation for AHF or all-cause death) were determined for patients discharged home after ED care. Predictive capacity was assessed by c-statistic with 95% confidence intervals. Of 10,869 patients, 4,044 were included (median age: 83 years, 54% women). The performance of HEFESTOS was modest for 30-day hospitalisation/death, c-statistic=0.656 (0.637-0.675), hospitalisation, 0.650 (0.631-0.669), and death, 0.610 (0.576-0.644). Of 1,034 patients with scores for the 5 scales, HEFESTOS had the numerically highest c-statistic for hospitalisation/death at 30 days, 0.666 (0.627-0.704), vs. MEESSI= 0.650 (0.612-0.687, p=0.51), EFFECT=0.633 (0.595-0.672, p=0.21), GWTG=0.618 (0.578-0.657, p=0.06) and EHMRG=0.617 (0.577-0.704, p=0.07). Similar modest performances were observed for predicting hospitalisation [ranging from HEFESTOS=0.656 (0.618-0.695) to GWTG=0.603 (0.564-0.643)]. Conversely, prediction of 30-day death was good with the MEESSI=0.787 (0.728-845), EFFECT=0.754 (0.691-0.818) and GWTG=0.749 (0.689-0.809) scales, and modest with EHMRG=0.649 (0.581-0.717) and HEFESTOS=0.610 (0.538-0.683). Although the HEFESTOS scale was numerically better for predicting 30-day hospitalisation/death in ED AHF patients, its modest performance precludes routine use. Only 30-day mortality was adequately predicted by some scales, with the MEESSI achieving the best results.

Recommendations of the Spanish Society of Neurology's Headache Study Group

INTRODUCTION

Headache is the most common neurological complaint at the different levels of the healthcare system, and clinical history and physical examination are essential in the diagnosis and treatment of these patients. With the objective of unifying the care given to patients with headache, the Spanish Society of Neurology's Headache Study Group (GECSEN) has decided to establish a series of consensus recommendations to improve and guarantee adequate care in primary care, emergency services, and neurology departments.

METHODS

With the aim of creating a practical document, the recommendations follow the dynamics of a medical consultation: clinical history, physical examination, and scales quantifying headache impact and disability. In addition, we provide recommendations for follow-up and managing patients' expectations of the treatment.

CONCLUSIONS

With this tool, we aim to improve the care given to patients with headache in order to guarantee adequate, homogeneous care across Spain.

[Progress in the application of evaluation criteria for clinical efficacy of acupuncture in the treatment of knee osteoarthritis]

Knee osteoarthritis is a chronic joint disease characterized by degeneration of knee cartilage and secondary osteoproliferation, pain and dysfunction, with a high morbidity.Clinical evaluation of efficacy was mainly based on scales, including pain scales, knee function scales, quality of life scales. In order to fully present comprehensive evaluation criteria of acupuncture effect of knee osteoarthritis, this paper reviewed the scales, contrasted their characteristics and scope of application, analyzed the existing problems, and offered proposals to develop and choose efficacy evaluation criteria. Expecting to provide refe-rence frame to evaluate the clinical efficacy of acupuncture in treating knee osteoarthritis in the future.

Content agreement of depressive symptomatology in children and adolescents: a review of eighteen self-report questionnaires

Identifying major depression in children and adolescents is more challenging than in adults. Questionnaires are often used for screening or guiding clinical assessment. Several instruments of different lengths are used as equivalent measures in diagnostic decisions. In this paper, we explore to what extent 18 commonly used depression scales for children and adolescents explore depression clinical symptoms as established by standard DSM-5 diagnosis criteria. We analyzed scale content adequacy by examining the overlap between scale contents and consensus clinical symptoms, the diagnostic time frame for active symptom assessment, and readability for the target age group. The 18 scales encompassed 52 distinct symptoms. These scales included just 50% of clinical symptoms required for diagnosis. The content overlap was low; on average, 29% of symptoms coincide across scales. Half of the scales did not use the standard period for active symptom appraisal, and some did not include a period for assessment. The reading levels on six scales were inappropriate for the scale's target population age group. The substantial heterogeneity in defining the depressive syndrome, the low overlap among scales, different periods of a positive diagnosis, and mismatch of reading competence for detecting may lead to heterogeneity in clinical diagnoses when using different scales. Improving the content of self-report in terms of homogeneity of diagnostic criteria would lead to better diagnostic decisions and patient management.

Apathy for psychiatrists - In a Nutshell!

In this paper, authors try to briefly bring together current knowledge regarding apathy as a transdiagnostic construct, from conceptual insights to measurement, neurobiology, and treatment.

Measurement Informed Care in Attention-Deficit/Hyperactivity Disorder (ADHD)

Measurement-informed care is a cornerstone of evidence-based practice and shared decision-making. A structured diagnostic interview specific to ADHD provides a globally agreed-on standard of evaluation. These interviews are accessible in the public domain in multiple languages and are helpful to clinicians new to the diagnosis of ADHD. Broad-based rating scales looking at multiple domains of psychopathology are critical to assuring recognition of comorbid diagnoses, which might otherwise be missed, differential diagnoses, and identification of the most prominent or treatable diagnosis. Recent innovations in computerized adaptive testing have improved the efficiency and accuracy of diagnostic screening. Rating scales specific to ADHD and disruptive behavior disorders establish the severity of the disorder and response to intervention. Age- and gender-normed symptom rating scales for ADHD capture clinically salient differences between what is normative in different demographic groups. An evaluation of functional impairment in ADHD has been critical to understanding the patient's perspective of the presenting problem. Best practice care for ADHD treatment goes beyond improvement to well-defined standards for both symptom and functional remission. Studies of executive function, emotional regulation, mind-wandering, and sluggish cognitive tempo have led to a richer understanding of the breadth and depth of associated deficits commonly experienced by ADHD patients. Psychometrically validated tools are available to complement every aspect of ADHD care and provide global standards for research.

Urban health challenges: Lessons from COVID-19 responses

The COVID-19 pandemic has forced a re-examination of our societies and in particular urban health. We argue that urban health needs to address three inter-related challenge areas - the unequal impacts of climate change, changing patterns of urbanization, and the changing role of the local government - across multiple spatial scales: from individual, households to neighbourhoods, cities, and urban hinterlands. Urban health calls for nimble institutions to provide a range of responses while adapting to crisis situations, and which operate beyond any one spatial scale. We illustrate our argument by drawing on South and Southeast Asian examples where responses to the pandemic have confronted these challenges across scales. A multiscalar definition of urban health offers an opportunity to challenge dominant approaches to urban health in research, policy, and practice.

Measuring the Quality of Life for Individuals With Prolonged Social Withdrawal (Hikikomori)

OBJECTIVE

This study aimed to develop a quality of life scale for hikikomori (QOL-H), measuring the subjective quality of life (QOL) of individuals with hikikomori, and confirming its reliability and validity.

METHODS

The characteristics of the scale were examined using item response theory. Data were collected from 99 people with hikikomori, 100 people who had experienced hikikomori in the past, and 198 people who had not experienced hikikomori, to develop the scale, examine its reliability, validity, and characteristics. For convergent validity, the correlation coefficients between QOL-H and social interaction behaviors, hikikomori characteristics, depressive symptoms, subjective happiness, and difficulty in social participation were calculated.

RESULTS

Good internal consistency, test-retest reliability, and convergent validity were confirmed for the QOL-H. Furthermore, significant differences in scores among all groups confirmed adequate criterion-related validity. Total information function indicated a high measurement accuracy when QOL was average or slightly high.

CONCLUSION

This study suggests that QOL-H can be an appropriate measure of QOL for individuals with hikikomori.

Assessing suicide ideation among older adults: a systematic review of screening and measurement tools

OBJECTIVES

Rates of suicide in older adults may be higher than reported due to poor understandings of presentation of suicide ideation in this group. The objectives of this paper were to (i) review current measurement tools designed for older adults to detect suicide ideation and (ii) assess their psychometric properties.

DESIGN

We used a systematic review approach to identify measurement tools developed specifically for older adults without cognitive decline or impairment.

RESULTS

Ten articles that reported on a total of seven different measurement tools were identified. These included tools that focused on resiliency to suicide and those that measured risk of suicide behavior. There was wide variation across the articles: some were adaptations of existing scales to suit older populations, others were developed by authors; they varied in length from four to 69 items; a range of settings was used, and there was a mix of self-report and clinician-administered measures. Most displayed good psychometric properties, with both approaches showing similar quality. Limitations in terms of samples, settings, and measurement design are discussed.

CONCLUSION

The case for specific measures for older adults is clear from this review. There appear to be unique factors that should be considered in understanding suicide ideation and behavior among older adults that may not be directly assessed in non-specific measurements. However, there is a need to expand the diversity of individuals included in measurement development to ensure they are appropriate across gender, culture and minority status, and for the views of professionals to be considered.

[Review of the validity of fall risk assessment scales in hospitalised patients]

Falls in the hospital setting are a major health problem due to their high prevalence and their physical, functional, psychological or economic consequences. Since 1990s, different fall risk assessment scales have been developed to detect high-risk patients, which are also applied in the hospital setting. The aim of this review is to analyse the validity of different scales for assessing fall risk in adults in the hospital setting, especially in elderly patients. Following a literature search in April 2021, 36 primary studies were found that analysed the validity of the Downton, Morse, HendrichII, Stratify and Tinetti scales. Meta-analyses of sensitivity and specificity showed a high heterogeneity that does not allow recommending a specific tool that can be considered as standard in acute inpatients.

Proteome dataset of sea bass (Dicentrarchus labrax) skin-scales exposed to fluoxetine and estradiol

Contamination of aquatic ecosystems with anthropogenic pollutants, including pharmaceutical drugs, is a major concern worldwide. Aquatic organisms such as fish are particularly at risk of exposure to pollutants. The surface of fish is the first point of contact with pollutants, but few studies have considered the impact of pollutants on the skin-scale barrier. The present proteome data are the basis of the findings discussed in the associated research article “Proteomics of sea bass skin-scales exposed to the emerging pollutant fluoxetine compared to estradiol” [1]. Juvenile sea bass were exposed by intraperitoneal injections to: a) the antidepressant fluoxetine (FLX), a widely prescribed psychotropic drug and an emerging pollutant; b) the natural estrogen 17β-estradiol (E2) and c) the vehicle, coconut oil (control). The scale proteome of fish exposed to these compounds for 5 days was analysed using quantitative label-free proteomics technology SWATH-MS (sequential windowed data-independent acquisition of the total high-resolution-mass spectra). The proteome data generated was submitted to the ProteomeXchange Consortium via the PRIDE partner repository with the dataset identifier PXD020983. LC-MS data from pooled protein extracts from the scales of all experimental groups was acquired using information-dependent acquisition (IDA) and 1,254 proteins were identified by searching against the sea bass genome database. 715 proteins were quantified by SWATH acquisition, and 213 proteins had modified levels (p < 0.05) between the E2- or FLX-exposed fish compared to the control. The main biological processes and KEGG pathways affected by E2 or FLX treatments were identified using Cytoscape/ClueGO enrichment analyses.

Developing an International Standard Set of Patient-Reported Outcome Measures for Psychotic Disorders

OBJECTIVE

The objective of this project was to develop a set of patient-reported outcome measures for adolescents and adults who meet criteria for a psychotic disorder.

METHODS

A research team and an international consensus working group, including service users, clinicians, and researchers, worked together in an iterative process by using a modified Delphi consensus technique that included videoconferencing calls, online surveys, and focus groups. The research team conducted systematic literature searches to identify outcomes, outcome measures, and risk adjustment factors. After identifying outcomes important to service users, the consensus working group selected outcome measures, risk adjustment factors, and the final set of outcome measures. International stakeholder groups consisting of >100 professionals and service users reviewed and commented on the final set.

RESULTS

The consensus working group identified four outcome domains: symptoms, recovery, functioning, and treatment. The domains encompassed 14 outcomes of importance to service users. The research team identified 131 measures from the literature. The consensus working group selected nine measures in an outcome set that takes approximately 35 minutes to complete.

CONCLUSIONS

A set of patient-reported outcome measures for use in routine clinical practice was identified. The set is free to service users, is available in at least two languages, and reflects outcomes important to users. Clinicians can use the set to improve clinical decision making, and administrators and researchers can use it to learn from comparing program outcomes.

Testing the sensitivity of two dementia knowledge instruments in dementia workforce education

BACKGROUND

The importance of dementia education in improving the care and support that people living with dementia is well established. Previous research has shown ceiling effects in pre and post educational intervention measures of dementia knowledge using Knowledge in Dementia Scale (KIDE) on post-registered health and social care staff in Scotland. The aim was to test the sensitivity of two dementia knowledge instruments, namely the (KIDE) and the Dementia Knowledge Assessment Scale (DKAS).

DESIGN

A pre and post evaluation comparison of two dementia knowledge scales.

SETTING

The tenth cohort of Scotland's National Dementia Champions Education Programme, September 2019-March 2020.

PARTICIPANTS

Post-registered Health and Social Care staff (n = 117).

METHODS

Both the DKAS and KIDE scales were administered pre and post programme delivery. Wilcoxon signed-rank tests were performed to examine T1 - T2 differences in dementia knowledge for both validated measures.

RESULTS

Ceiling effects continued to be present for the KIDE scale at T1 and T2. The DKAS responses showed a different score distribution than that achieved by the KIDE. Ceiling effects noted for KIDE at T1 were not present for the DKAS. Further, at T2, only 6% of respondents scored the maximum on the DKAS.

CONCLUSIONS

The DKAS appears to be a more useful instrument for measuring knowledge in post-registered health and social care staff; however, there was some evidence of ceiling effects post-intervention. There is a need for both scales to be tested in more educationally diverse populations, so educators and researchers can make informed decisions about the instrument's target range. Additionally, further research is needed to develop new sets of dementia knowledge items suitable for use in trained health and social care staff.

European clinical guidelines for Tourette syndrome and other tic disorders-version 2.0. Part I: assessment

In 2011 a working group of the European Society for the Study of Tourette Syndrome (ESSTS) has developed the first European assessment guidelines for Tourette syndrome (TS). Now, we present an updated version 2.0 of these European clinical guidelines for Tourette syndrome and other tic disorders, part I: assessment. Therefore, the available literature has been thoroughly screened, supplemented with national guidelines across countries and discussions among ESSTS experts. Diagnostic changes between DSM-IV and DSM-5 classifications were taken into account and new information has been added regarding differential diagnoses, with an emphasis on functional movement disorders in both children and adults. Further, recommendations regarding rating scales to evaluate tics, comorbidities, and neuropsychological status are provided. Finally, results from a recently performed survey among ESSTS members on assessment in TS are described. We acknowledge that the Yale Global Tic Severity Scale (YGTSS) is still the gold standard for assessing tics. Recommendations are provided for scales for the assessment of tics and psychiatric comorbidities in patients with TS not only in routine clinical practice, but also in the context of clinical research. Furthermore, assessments supporting the differential diagnosis process are given as well as tests to analyse cognitive abilities, emotional functions and motor skills.

Comparison of different scales for the evaluation of anxiety and compliance with anesthetic induction in children undergoing scheduled major outpatient surgery

INTRODUCTION

Anxiety in children triggered by a scheduled surgical intervention is a major issue due to its frequency and consequences. Preoperative anxiety is associated with increased patient fear and agitation on anesthetic induction. The aim of this study is to compare three preoperative anxiety scales for children undergoing elective outpatient surgery, and to correlate each of these tools with the degree of patient compliance on induction, as assessed by the Induction Compliance Checklist (ICC).

METHODS

An observational prospective study was performed on a cohort of children with ages between 2 and 16 years old, scheduled for outpatient surgery. Anxiety was assessed upon arrival to the hospital (M0), during transfer to the surgical unit (M1), and in the operating room during anesthetic induction (M2). Anxiety in the parents (measured with the State-Trait Anxiety Inventory, STAI) and in the children (measured with the Spence Anxiety Scale-Pediatric, SCAS-P, the State-Trait Anxiety Inventory Children, STAIC, and Modified Yale Preoperative Anxiety Scale, m-YPAS) was assessed. Compliance with anesthetic induction was assessed with ICC.

RESULTS

The study included 76 patients (72.4% male, median age 7.9 years). Anxiety scores (m-YPAS) increased as the moment of surgery approached, being greater at the entrance to the surgical unit (M0 = 26.1 ± 9.5; M1 = 31.8 ± 18.1; M2 = 33.5 ± 21.1). A strong correlation was found between ICC scale and m-YPAS at M1 (0.738) and M2 timepoints (0.794), but not with the rest of scales at M0.

CONCLUSIONS

Standard anxiety assessment scales do not predict the quality of anesthetic induction. m-YPAS scale can detect increasing anxiety in children as they approach the surgical procedure and this correlates strongly with a worse anesthetic induction, defined by higher score on ICC scale.

Mathematization of nature: how it is done

Natural phenomena can be quantitatively described by means of mathematics, which is actually the only way of doing so. Physics is a convincing example of the mathematization of nature. This paper gives an answer to the question of how mathematization of nature is done and illustrates the answer. Here nature is to be taken in a wide sense, being a substantial object of study in, among others, large domains of biology, such as epidemiology and neurobiology, chemistry, and physics, the most outspoken example. It is argued that mathematization of natural phenomena needs appropriate core concepts that are intimately connected with the phenomena one wants to describe and explain mathematically. Second, there is a scale on and not beyond which a specific description holds. Different scales allow for different conceptual and mathematical descriptions. This is the scaling hypothesis, which has meanwhile been confirmed on many occasions. Furthermore, a mathematical description can, as in physics, but need not be universally valid, as in biology. Finally, the history of science shows that only an intensive gauging of theory, i.e., mathematical description, by experiment leads to progress. That is, appropriate core concepts and appropriate scales are a necessary condition for mathematizing nature, and so is its verification by experiment.

A systematic review of questionnaires assessing the psychological impact of COVID-19

The COVID-19 pandemic has led to a number of complications in everyday life, greatly affecting public health. Estimating its impact on mental health constitutes a priority issue. The current study aims to summarize the scales that have been specifically developed for this reason and are not adaptations of already existing scales. A comprehensive search was conducted by two reviewers during the period 28/09/2020-30/09-2020 in the following databases: PubMed, ScienceDirect, ScieLo, Mendeley, Google Scholar. A quality appraisal of the identified scales was made by three reviewers using the COSMIN checklist for methodological issues and the Terwee criteria for measurement properties. Our search strategy yielded a total of 855 results. Of these, 832 articles were excluded according to exclusion criteria, 23 were assessed for eligibility and 10 were finally included. These are presented in the text with additional useful information found separately. The identified scales tended to be quite short and examine stress, anxiety or fear. All studies were cross-sectional and the majority was conducted online. Most of them had a good Cronbach value (> 0.80) and adequate fit indices. It is however noted that the evaluation of their quality may be untimely due to relevant lack of data.

Phylogenetic position and morphology of Raphidiophrys elongata sp. nov. (Haptista: Centroplasthelida) with notes on cyst wall structure and evolution

The majority of centrohelids bear external coverings consisting of organic spicules or siliceous scales. Cyst coverings are usually reinforced with additional layers of modified scales. The cyst wall of Raphidiophrys heterophryoidea has an unusual and complex structure. It consists of three different types of scales and includes the mosaic scale layer not known in other centrohelids. During excystment, the cyst wall fragments along the sutures of the mosaic layer. For other Raphidiophrys species, cyst coverings are not studied. The present paper describes a new Raphidiophrys species, R. elongata, belonging to the NC7 environmental clade. Trophozoites bore thin plate scales with reduced upper plate. Under starvation, cysts emerged in clonal cultures. Cyst coverings of R. elongata and R. heterophryoidea were studied in comparison with the use of FIB-SEM. Cyst wall of R. elongata was significantly thinner than in R. heterophryoidea and was formed with 3-5 layers of uniform overlapping scales. No mosaic scale layer was present. During excystment, trophozoite exited cyst shell through random fissure. Possible evolutionary events and driving forces behind the complication of cyst wall within Raphidiophrys were discussed.

Multidimensional scale of perceived social support: evidence of validity and reliability in a Chilean adaptation for older adults

Background

Given the relevance of social support on the mental health of older adults, having an instrument to evaluate this variable is essential for research in the area. However, mainly, having instruments with suitable evidence of their psychometric properties is critical. For this reason, this study sought to evaluate the factorial and reliability structure of the Multidimensional Scale of Perceived Social Support within autonomous older adults from the Province of Concepción, Chile.

Methods

We surveyed 399 older adults using quote sampling. They answered a Spanish version of the Multidimensional Scale of Perceived Social Support, plus a sociodemographic questionnaire. We performed confirmatory factor analysis using Weighted Least Squares Means and Variances adjusted estimation (WLSMV) to compare the factor models proposes by previous studies. To evaluate reliability, we calculated Cronbach’s alpha and McDonald’s omega.

Results

The Confirmatory factor analysis found that the 3-factors models showed the best fist index between the models with CFI = 0.991, TLI = 0.989, and SRMR = 0.035, even though RMSEA were over the cutoff point. The factors presented reliabilities from α = 0.858 to α = 0.941, and from ω = 0.937 to ω = 0.972.

Conclusions

The results support the existence of three factors for the Multidimensional Scale of Perceived Social Support (MSPSS), differentiating the support perceived from Family, Friends, and significant others. All factors present good or excellent reliability. This solution is theoretically consistent and coherent with the literature, and it presents evidence in favor of the use of MSPSS as a measurement to distinguish the support perceived source.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02404-6.

The costs of scaling up HIV and syphilis testing in low- and middle-income countries: a systematic review

Around two-thirds of all new HIV infections and 90% of syphilis cases occur in low- and middle-income countries (LMICs). Testing is a key strategy for the prevention and treatment of HIV and syphilis. Decision-makers in LMICs face considerable uncertainties about the costs of scaling up HIV and syphilis testing. This paper synthesizes economic evidence on the costs of scaling up HIV and syphilis testing interventions in LMICs and evidence on how costs change with the scale of delivery. We systematically searched multiple databases (Medline, Econlit, Embase, EMCARE, CINAHL, Global Health and the NHS Economic Evaluation Database) for peer-reviewed studies examining the costs of scaling up HIV and syphilis testing in LMICs. Thirty-five eligible studies were identified from 4869 unique citations. Most studies were conducted in Sub-Saharan Africa (N = 17) and most explored the costs of rapid HIV in facilities targeted the general population (N = 19). Only two studies focused on syphilis testing. Seventeen studies were cost analyses, 17 were cost-effectiveness analyses and 1 was cost-benefit analysis of HIV or syphilis testing. Most studies took a modelling approach (N = 25) and assumed costs increased linearly with scale. Ten studies examined cost efficiencies associated with scale, most reporting short-run economies of scale. Important drivers of the costs of scaling up included testing uptake and the price of test kits. The 'true' cost of scaling up testing is likely to be masked by the use of short-term decision frameworks, linear unit-cost projections (i.e. multiplying an average cost by a factor reflecting activity at a larger scale) and availability of health system capacity and infrastructure to supervise and support scale up. Cost data need to be routinely collected alongside other monitoring indicators as HIV and syphilis testing continues to be scaled up in LMICs.

Retrospective Evaluation of Thoracolumbar Injury Classification System and Thoracolumbar AO Spine Injury Scores for the Decision Treatment of Thoracolumbar Traumatic Fractures in 458 Consecutive Patients

BACKGROUND

Thoracolumbar Injury Classification System (TLICS) score and Thoracolumbar AO Spine Injury Score (TLAOSIS) are the scores preferred to classify and treat thoracolumbar fractures. Our study evaluates the reliability of both as guidelines for treatment.

METHODS

Single-center and retrospective case series of 458 patients. Clinical variables, radiology, and treatment were analyzed. We classified fractures according to the AO Spine Thoracolumbar System and retrospectively applied both scales in 2 groups (surgical and conservative). A concordance analysis and statistical measures comparing both were performed.

RESULTS

The patients were divided as follows: 257 patients (56.1%) in the conservative group and 201 patients (43.9%) in the surgical group. The concordance analysis between both scales was 89.7% (95% confidence interval, 86.5%-92.3%), and the Cohen kappa coefficient was 0.68 (95% confidence interval, 59%-76%). TLAOSIS had a higher tendency to classify patients in the gray zone (10.3% vs. 2.8%, P < 0.001), whereas TLICS had a more conservative nature (85.2% vs. 78.4%, P = 0.01). In the surgical group, the matching decision ratio was 29.9% for TLICS and 42.8% for TLAOSIS, but differences were found in TLICS being more conservative (70.1% vs. 57.2%, P = 0.01). In the conservative group, the matching decision ratio was 98.1% for both scales, being the main difference in the gray zone for TLAOSIS.

CONCLUSIONS

Both scales have a good concordance in general, with TLICS being more conservative overall. They had rather low coincidence when predicting surgery. Because TLAOSIS placed more patients in the gray zone, we think it might be slightly better for giving surgeons more license to decide a surgical approach on certain controversial types of fractures.

Thyroid hormone regulates abrupt skin morphogenesis during zebrafish postembryonic development

Thyroid hormone is a key regulator of post-embryonic vertebrate development. Skin is a biomedically important thyroid hormone target organ, but the cellular and molecular mechanisms underlying skin pathologies associated with thyroid dysfunction remain obscure. The transparent skin of zebrafish is an accessible model system for studying vertebrate skin development. During post-embryonic development of the zebrafish, scales emerge in the skin from a hexagonally patterned array of dermal papillae, like other vertebrate skin appendages such as feathers and hair follicles. We show here that thyroid hormone regulates the rate of post-embryonic dermal development through interaction with nuclear hormone receptors. This couples skin development with body growth to generate a well ordered array of correctly proportioned scales. This work extends our knowledge of thyroid hormone actions on skin by providing in-vivo evidence that thyroid hormone regulates multiple aspects of dermal development.

Validation of the McIntyre And Rosenblat Rapid Response Scale (MARRRS) in Adults with Treatment-Resistant Depression Receiving Intravenous Ketamine Treatment

BACKGROUND

Depression severity and efficacy measurement scales employed for rapid-acting treatments (e.g., ketamine) were initially validated in adults receiving conventional monoamine-based antidepressants. The emergence of rapid-acting antidepressants in psychiatry provides the impetus for outcome measures that have been validated as sensitive to change with rapid-acting treatments. Herein, we provide results validating the McIntyre and Rosenblat Rapid Response Scale (MARRRS).

METHODS

Adults with treatment-resistant depression (TRD) receiving intravenous (IV) ketamine had depressive symptoms measured with the 16-Item Quick Inventory Depressive Symptoms Self-Report (QIDS-SR-16) and MARRRS at baseline and as a repeated measure across an acute course of four infusions. The MARRRS is a self-report measure assessing depressive symptoms during the past 72 hours.

RESULTS

Sixty-four patients (M_age = 45.4 ± 13.5) were included. The MARRRS had a high internal consistency across acute infusions as determined by Cronbach's alpha (0.84 to 0.94). There was significant convergent validity between the QIDS-SR-16 and MARRRS total scores across infusions (rs(292) = .87, p < .001); the MARRRS was also sensitive to change (rs(49) = .70, p < .001). Exploratory factor analysis revealed that MARRRS items loaded onto two factors (i.e., dysphoria and psychic anxiety) accounting for 63.4% of the total variance.

LIMITATIONS

Heterogenous sample of adults with TRD receiving open-label treatment without placebo comparison.

CONCLUSION

The MARRRS is a brief validated self-report metric of depression symptom severity that is sensitive to change with the rapid-acting antidepressant ketamine. Measuring outcomes with the MARRRS informs treatment progress and facilitates treatment decisions in persons receiving the rapid-acting antidepressant ketamine. Studies of other rapid-acting antidepressants should incorporate outcome measures that are validated as sensitive to change with rapid-acting antidepressants.

Development and Validation of the Oral Mucositis Risk Assessment Scale in Hematology Patients

OBJECTIVES

This study was conducted as a methodological study to develop a valid and reliable scale to evaluate the risk of developing oral mucositis in hematology patients.

DATA SOURCES

The universe and sample were comprised of one hundred eighty-seven in-patients who were taken to receive chemotherapy in the hematology clinics over a six-month period. The data were collected through the Patient Diagnosis Form, the World Health Organization's Mucositis Evaluation Form and Oral Mucositis Risk Assessment Scale in Hematology Patients developed. Risk of "taking high-dose chemotherapy regimen", "neutropenia", "dry mouth", "pain", "leukopenia", "parenteral feeding", "previous history of oral mucositis" and "chemotherapy or radiotherapy in the past" were found as an oral mucositis risk factor. We have added "using high-risk chemotherapeutic agents", "bone marrow transplant", " head-neck or mouth cancer" which we consider clinically important. The scale consists of 11 items. The sensitivity value is 0.941 and the selectivity value is 0.724.

CONCLUSION

We recommend that use the Oral Mucositis Risk Assessment Scale in Hematology Patients. Similar studies should be performed in oncology clinics and especially in patients receiving head and neck, oral radiotherapy.

IMPLICATIONS FOR NURSING PRACTICE

Oral mucositis is an important problem for hematology patients. nurses' risk assessment and early intervention to oral mucositis prevent the formation and complications of oral mucositis.

The Multidimensional Cough Index: A Practical Scale to Measure Cough and Sputum

BACKGROUND

There currently is a lack of easy-to-use instruments with which to assess cough. The aim of the present study was to develop a scale for measuring the characteristics of cough and sputum.

METHODS

The authors developed a scale for assessing cough, including aspects such as intensity, frequency, physical impact, psychosocial impacts and sputum characteristics. The first four components were scored using a Cough Index, with a range of 0 to 20. Sputum information included volume, appearance, and hemoptysis. The scale was administered to 105 patients and re-administered to 51 about two weeks later. The patients also reported cough frequency and intensity using a 100-mm visual analogue scale (VAS) and answered the Leicester Cough Questionnaire (LCQ). Additionally, 12 patients with acute exacerbation (AE) of chronic airways disease were interviewed upon admission to and discharge from the hospital.

RESULTS

Analysis identified only one factor for the Cough Index, and Cronbach's alpha value was 0.819. Cough Index was significantly correlated with VAS_frequency (r = 0.651, p < 0.0001), VAS_intensity (r = 0.543, p<0.0001), and LCQ (r = -0.824, p < 0.0001). The intraclass correlation coefficient of test-retest scores was 0.779. The median Cough Index significantly decreased after AE treatment, as did the number of patients reporting increased sputum production and greenish and dark sputum. A Cough Index ≥ 4 distinguished respiratory patients from healthy subjects, with a sensitivity of 80% and a specificity of 85%.

CONCLUSION

The Multidimensional Cough Index condenses complex aspects related to cough and sputum production into a single instrument, with satisfactory validation.

Zebrafish twist2/dermo1 regulates scale shape and scale organization during skin development and regeneration

Scales are skin appendages in fishes that evolutionarily predate feathers in birds and hair in mammals. Zebrafish scales are dermal in origin and develop during metamorphosis. Understanding regulation of scale development in zebrafish offers an exciting possibility of unraveling how the mechanisms of skin appendage formation evolved in lower vertebrates and whether these mechanisms remained conserved in birds and mammals. Here we have investigated the expression and function of twist 2/dermo1 gene - known for its function in feather and hair formation - in scale development and regeneration. We show that of the four zebrafish twist paralogues, twist2/dermo1 and twist3 are expressed in the scale forming cells during scale development. Their expression is also upregulated during scale regeneration. Our knockout analysis reveals that twist2/dermo1 gene functions in the maintenance of the scale shape and organization during development as well as regeneration. We further show that the expression of twist2/dermo1 and twist3 is regulated by Wnt signaling. Our results demonstrate that the function of twist2/dermo1 in skin appendage formation, presumably under regulation of Wnt signaling, originated during evolution of basal vertebrates.