bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship of Dyadic Coping With Emotional Functioning and Quality of the Relationship in Couples Facing Cancer—A Meta-Analysis
Authors: Ştefǎnuţ Adelina Mihaela , Vintilǎ Mona , Tudorel Otilia Ioana
Published: January 2021

Objective: This study is a meta-analysis that considers the association between dyadic coping and emotional functioning, and between dyadic coping and the quality of the relationship as perceived by cancer patients and their life partners.

Methods: A systematic search was conducted in the electronic databases PsycINFO, PubMed, ScienceDirect and those peer-reviewed cross-sectional and longitudinal studies published up until April 2020 that investigated these relationships were selected.

Results: A total of 1,168 studies were identified, of which 10 met the inclusion criteria (N = 1,727 couples). These evidenced statistically significant positive relationships between common dyadic coping and emotional functioning and between common dyadic coping and the quality of the relationship as perceived by patients and their partners. There was also a statistically significant positive association between stress communication (by oneself), supportive dyadic coping (by oneself and by partner), and the quality of the relationship. In addition, a statistically significant negative association was found between negative dyadic coping (by oneself and by partner) and the quality of the relationship as perceived by patients' partners and also between negative dyadic coping (by oneself) and the quality of the relationship as perceived by patients.

Conclusions: The results suggest the existence of a significant association between dyadic coping and emotional functioning and between dyadic coping and the quality of the relationship as perceived by members of couples facing cancer. However, these results must be interpreted with caution due to the small number of studies included in the analysis. Clinically, an understanding of the existence of such relationships is helpful for the implementation, and study of the effectiveness of, interventions aimed at improving dyadic coping in order to improve both quality of life and quality of relationship in couples where there is an oncological diagnosis.
Visual, Verbal and Everyday Memory 2 Years After Bariatric Surgery: Poorer Memory Performance at 1-Year Follow-Up
Authors: Walø-Syversen Gro , Kvalem Ingela L. , Kristinsson Jon , Eribe Inger L. , Rø Øyvind , Brunborg Cathrine , Dahlgren Camilla Lindvall
Published: January 2021

Severe obesity has been associated with reduced performance on tests of verbal memory in bariatric surgery candidates. There is also some evidence that bariatric surgery leads to improved verbal memory, yet these findings need further elucidation. Little is known regarding postoperative memory changes in the visual domain and how patients subjectively experience their everyday memory after surgery. The aim of the current study was to repeat and extend prior findings on postoperative memory by investigating visual, verbal, and self-reported everyday memory following surgery, and to examine whether weight loss and somatic comorbidity predict memory performance. The study was a prospective, observational study in which participants (n= 48) underwent cognitive testing at baseline, 1 and 2 years after bariatric surgery. Repeated measures analyses of variance revealed significantly poorer visual and verbal memory performance at the 1-year follow-up, with performance subsequently returning to baseline levels after 2 years. Verbal learning and self-reported everyday memory did not show significant postoperative changes. Memory performance at 1 year was not significantly predicted by weight loss, changes in C-reactive protein levels or postoperative somatic comorbidity (Type 2 diabetes, sleep apnea, and hypertension). The study demonstrated poorer visual and verbal memory performance at 1-year follow-up that returned to baseline levels after 2 years. These findings are in contrast to most previous studies and require further replication, however, the results indicate that postoperative memory improvements following bariatric surgery are not universal. Findings suggest that treatment providers should also be aware of patients potentially having poorer memory at 1 year following surgery.
Transgender Identity Is Associated With Bullying Involvement Among Finnish Adolescents
Authors: Heino Elias , Ellonen Noora , Kaltiala Riittakerttu
Published: January 2021

Background

During adolescence, bullying often has a sexual content. Involvement in bullying as a bully, victim or both has been associated with a range of negative health outcomes. Transgender youth appear to face elevated rates of bullying in comparison to their mainstream peers. However, the involvement of transgender youth as perpetrators of bullying remains unclear in the recent literature.

Objective

The aim of this study was to compare involvement in bullying between transgender and mainstream youth and among middle and late adolescents in a general population sample.

Methods

Our study included 139,829 students in total, divided between a comprehensive school and an upper secondary education sample. Associations between gender identity and involvement in bullying were first studied using cross-tabulations with chi-square statistics. Logistic regression was used to study multivariate associations. Gender identity was used as the independent variable, with cisgender as the reference category. Subjection to and perpetration of bullying were entered each in turn as the dependent variable. Demographic factors, family characteristics, internalizing symptoms, externalizing behaviors, and involvement in bullying in the other role were added as confounding factors. Odds ratios (OR) with 95% confidence intervals (95% CI) are given. The limit for statistical significance was set at p < 0.001.

Results

Both experiences of being bullied and perpetrating bullying were more commonly reported by transgender youth than by cisgender youth. Among transgender youth, all involvement in bullying was more commonly reported by non-binary youth than those identifying with the opposite sex. Logistic regression revealed that non-binary identity was most strongly associated with involvement in bullying, followed by opposite sex identity and cisgender identity. Transgender identities were also more strongly associated with perpetration of bullying than subjection to bullying.

Conclusion

Transgender identity, especially non-binary identity, is associated with both being bullied and perpetrating bullying even when a range of variables including internal stress and involvement in bullying in the opposite role are taken into account. This suggests that bullying during adolescence may serve as a mechanism of maintaining heteronormativity.
Student Moods Before and After Body Expression and Dance Assessments. Gender Perspective
Authors: Mateu Mercè , Garcías Silvia , Spadafora Luciana , Andrés Ana , Febrer Eulàlia
Published: January 2021

Body expression and dance are activities that contribute to the integral well-being of people. In an educational context, the process of evaluating our students implies variations in their moods. This study tackles the states of mind that students perceive before and after the evaluation of a practice in the subject ofBody expression and dance, developed through choreographies, that were, previously rehearsed, and later presented to the rest of the class in a specific session. Our main interest was the obtention of information on the states of mind of the students prior to the evaluation of their choreographies (cooperative task), and again once they had been performed. The study design consisted of two phases: two different choreographies separated by an interval of 2 months. The students were asked about their moods before and after performing their choreographies, which were evaluated. The participants, 167 in total, 35 women (20.5%) and 132 men (79.5%), aged 18 to 22 years old, filled out a POMS (Profile of Mood States) questionnaire, before and after the evaluation of each occasion. Differences were found in the stress-anxiety, vigor-activity, fatigue-immobility scales and the total mood score (PGMS). In all of them, except for the fatigue-immobility scale, we found a decrease in scores after the performance, compared to scores before. For the Stress-Anxiety factor, lower values were observed in the post-tests in comparison to the pre-tests, and also lower values in the pre- and post-test scores regarding the second choreography. We conclude that the practical evaluation of the subject through choreography modifies the mood states of the students, favoring their well-being after its execution, which is why evaluation through practice is considered a positive element in the educational process.
Self-Oriented Empathy and Compassion Fatigue: The Serial Mediation of Dispositional Mindfulness and Counselor’s Self-Efficacy
Authors: Zhang Lin , Ren Zhihong , Jiang Guangrong , Hazer-Rau Dilana , Zhao Chunxiao , Shi Congrong , Lai Lizu , Yan Yifei
Published: January 2021

This study aimed to explore the association between self-oriented empathy and compassion fatigue, and examine the potential mediating roles of dispositional mindfulness and the counselor’s self-efficacy. A total of 712 hotline psychological counselors were recruited from the Mental Health Service Platform at Central China Normal University, Ministry of Education during the outbreak of Corona Virus Disease 2019, then were asked to complete the questionnaires measuring self-oriented empathy, compassion fatigue, dispositional mindfulness, and counselor’s self-efficacy. Structural equation modeling was utilized to analyze the possible associations and explore potential mediations. In addition to reporting confidence intervals (CI), we employed a new method named model-based constrained optimization procedure to test hypotheses of indirect effects. Results showed that self-oriented empathy was positively associated with compassion fatigue. Dispositional mindfulness and counselor’s self-efficacy independently and serially mediated the associations between self-oriented empathy and compassion fatigue. The findings of this study confirmed and complemented the etiological and the multi-factor model of compassion fatigue. Moreover, the results indicate that it is useful and necessary to add some training for increasing counselor’s self-efficacy in mindfulness-based interventions in order to decrease compassion fatigue.
Healthcare Workers Who Work With COVID-19 Patients Are More Physically Exhausted and Have More Sleep Problems
Authors: van Roekel Henrico , van der Fels Irene M. J. , Bakker Arnold B. , Tummers Lars G.
Published: January 2021

In this survey study of 7,208 Dutch healthcare workers, we investigate whether healthcare workers dealing with COVID-19 patients experience lower general health, more physical and mental exhaustion and more sleep problems than other healthcare workers. Additionally, we study whether there are differences in well-being within the group of healthcare workers working with COVID-19 patients, based on personal and work characteristics. We find healthcare workers who are in direct contact with COVID-19 patients report more sleep problems and are more physically exhausted than those who are not in direct contact with COVID-19 patients. Mental exhaustion and general health do not significantly differ between healthcare workers who are in direct contact with COVID-19 patients and those who are not. Among healthcare workers in direct contact with COVID-19 patients, lower well-being on one or more indicators is reported by those who are female, living alone, without leadership role, or without sufficient protective equipment. Regarding age, physical exhaustion is more prevalent under healthcare workers older than 55 years, whereas mental exhaustion is more prevalent under healthcare workers younger than 36 years. These results stress the need of mental and physical support of healthcare workers during a pandemic, catered to the needs of healthcare workers themselves.
Case Report: Paliperidone Palmitate in the Management of Bipolar I Disorder With Non-compliance
Authors: Li Kanglai , Liao Yingtao , Yang Zhihua , Yang Caishuang , Chen Minhua , Wu Xiuhua , Gan Zhaoyu
Published: January 2021

Background: Medication non-adherence is prevalent in patients with bipolar disorder (BD). Long-acting injectable antipsychotics (LAIAs) are widely used to improve compliance with treatment. This study aimed to illustrate the effectiveness, compliance, and safety profile of once-monthly paliperidone palmitate (PP1M), a novel therapeutic LAIA, in the management of bipolar I disorder (BDI).

Method: A prospective follow-up was arranged to 11 BDI patients who were prescribed PP1M as monotherapy or adjunctive treatment. Severity of symptoms, disturbing behavior, status of employment, 17-item Hamilton Depression Rating Scale (HAMD-17), and Young Mania Rating Scale (YMRS) were evaluated at the baseline and the endpoint of follow-up. Clinical Global Impression—Bipolar Disorder—Severity of Illness Scale (CGI-BP) and Treatment Emergent Symptom Scale (TESS) were measured at each injection of PP1M. Compliance, relapse or switch, and new hospitalization were monitored through the period of follow-up.

Results: The median duration of treatment was 14 months, ranging from 5 to 22 months. The scores (mean ± standard deviation) of HAMD-17, YMRS, and CGI-BP generally decreased from the baseline (16.1 ± 10.3, 30.9 ± 12.6, 5.3 ± 0.7) to the endpoint (7.4 ± 5.7, 3.7 ± 3.2, 2.3 ± 0.7). No disturbing behavior was detected at the endpoint. Neither new hospitalization nor manic/mixed episode occurred during treatment, whereas mild to moderate depressive episodes were reported in three cases. The status of employment of 10 participants (90.9%) was improved, and no new safety concern was detected.

Conclusion: PP1M might offer a new valid treatment option in the long-term management of BDI, especially for those with poor compliance with oral medication. However, more studies are needed to further justify such role.
Premature Birth and Developmental Programming: Mechanisms of Resilience and Vulnerability
Authors: Lammertink Femke , Vinkers Christiaan H. , Tataranno Maria L. , Benders Manon J. N. L.
Published: January 2021

The third trimester of pregnancy represents a sensitive phase for infant brain plasticity when a series of fast-developing cellular events (synaptogenesis, neuronal migration, and myelination) regulates the development of neural circuits. Throughout this dynamic period of growth and development, the human brain is susceptible to stress. Preterm infants are born with an immature brain and are, while admitted to the neonatal intensive care unit, precociously exposed to stressful procedures. Postnatal stress may contribute to altered programming of the brain, including key systems such as the hypothalamic–pituitary–adrenal axis and the autonomic nervous system. These neurobiological systems are promising markers for the etiology of several affective and social psychopathologies. As preterm birth interferes with early development of stress-regulatory systems, early interventions might strengthen resilience factors and might help reduce the detrimental effects of chronic stress exposure. Here we will review the impact of stress following premature birth on the programming of neurobiological systems and discuss possible stress-related neural circuits and pathways involved in resilience and vulnerability. Finally, we discuss opportunities for early intervention and future studies.
From Emotional Intelligence to Self-Injuries: A Path Analysis in Adolescents With Conduct Disorder
Authors: Halicka-Masłowska Joanna , Szewczuk-Bogusławska Monika , Rymaszewska Joanna , Adamska Agnieszka , Misiak Błażej
Published: January 2021

Objective: Self-harm acts are highly prevalent among adolescents with conduct disorder. It has been shown that low level of emotional intelligence (EI) might be related to a higher risk of self-injuries. However, the exact mechanisms underlying this association are still unclear. The purpose of this study was to explore whether psychopathological symptoms and selected psychological processes mediate the association between EI and self-harm risk in adolescents with conduct disorders.

Method: Out of 162 adolescents with conduct disorder approached for participation, 136 individuals (aged 14.8 ± 1.2 years, 56.6% females) were enrolled and completed the questionnaires evaluating the level of EI, depression, anxiety, impulsiveness, empathy, venturesomeness, self-esteem, and disgust.

Results: Individuals with a lifetime history of self-injuries had significantly higher levels of depression, anxiety and impulsivity as well as significantly lower levels of EI and self-esteem. Higher levels of EI were associated with significantly higher levels of self-esteem, venturesomeness and empathy as well as significantly lower levels of depression, anxiety and impulsivity. Further analysis revealed that trait and state anxiety as well as self-esteem were complete mediators of the association between EI and self-harm risk.

Conclusions: Our findings indicate that anxiety and self-esteem might mediate the association between EI and a risk of self-injuries in adolescents with conduct disorder. However, a cross-sectional design of this study limits conclusions on the direction of causality. Longitudinal studies are needed to test validity of our model.
Frequency-Specific Changes in the Fractional Amplitude of the Low-Frequency Fluctuations in the Default Mode Network in Medication-Free Patients With Bipolar II Depression: A Longitudinal Functional MRI Study
Authors: Zhou Jun , Ma Xiaoqian , Li Chunwang , Liao Aijun , Yang Zihao , Ren Honghong , Tang Jinsong , Li Jinguang , Li Zongchang , He Ying , Chen Xiaogang
Published: January 2021

Objective: This study aimed to examine the treatment-related changes of the fractional amplitude of low-frequency fluctuations (fALFF) in the default mode network (DMN) across different bands after the medication-free patients with bipolar II depression received a 16-week treatment of escitalopram and lithium.

Methods: A total of 23 medication-free patients with bipolar II depression and 29 healthy controls (HCs) were recruited. We evaluated the fALFF values of slow 4 (0.027–0.073 Hz) band and slow 5 (0.01–0.027 Hz) band of the patients and compared the results with those of the 29 HCs at baseline. After 16-week treatment of escitalopram with lithium, the slow 4 and slow 5 fALFF values of the patients were assessed and compared with the baselines of patients and HCs. The depressive symptoms of bipolar II depression in patients were assessed with a 17-item Hamilton Depression Rating Scale (HDRS) before and after treatment.

Results: Treatment-related effects showed increased slow 5 fALFF in cluster D (bilateral medial superior frontal gyrus, bilateral superior frontal gyrus, right middle frontal gyrus, and bilateral anterior cingulate), cluster E (bilateral precuneus/posterior cingulate, left cuneus), and cluster F (left angular, left middle temporal gyrus, left superior temporal gyrus, and left supramarginal gyrus) in comparison with the baseline of the patients. Moreover, a positive association was found between the increase in slow 5 fALFF values (follow-up value minus the baseline values) in cluster D and the decrease in HDRS scores (baseline HDRS scores minus follow-up HDRS scores) at follow-up, and the same association between the increase in slow 5 fALFF values and the decrease in HDRS scores was found in cluster E.

Conclusions: The study reveals that the hypoactivity of slow 5 fALFF in the DMN is related to depression symptoms and might be corrected by the administration of escitalopram with lithium, implying that slow 5 fALFF of the DMN plays a key role in bipolar depression.
@myTabu—A Placebo Controlled Randomized Trial of a Guided Web-Based Intervention for Individuals Who Sexually Abused Children and Individuals Who Consumed Child Sexual Exploitation Material: A Clinical Study Protocol
Authors: Fromberger Peter , Schröder Sonja , Bauer Louisa , Siegel Bruno , Tozdan Safiye , Briken Peer , Buntrock Claudia , Etzler Sonja , Rettenberger Martin , Leha Andreas , Müller Jürgen L.
Published: January 2021

Background: There is a high demand for evidence-based and cost-effective treatment concepts for convicted individuals who sexually abused children (ISAC) and individuals who consumed child sexual exploitation material (ICCSEM) under community supervision (CS). The @myTabu-consortium developed a guided web-based intervention for convicted ISAC and ICCSEM under CS consisting of six online modules targeting psychological meaningful risk factors. The study aims to evaluate the effectiveness of this guided web-based intervention in reducing dynamic risk factors and the risk to re-offend compared to a placebo condition. Furthermore, these dynamic risk factors are measured before and after every module to evaluate their individual effectiveness to reduce the respective risk factor as well as risk to re-offend. This clinical trial protocol describes the planned methods as well as the intervention concept.

Methods: The methodological design is a placebo controlled randomized add-on trial (N = 582) with follow-ups at 8 points in time. The placebo condition controls for attention and expectation effects and comprises the same amount of modules with a comparable temporal effort as the experimental intervention. The trial is conducted as an add-on to community supervision as usually done. Primary outcomes are dynamic risk factors assessed by self-report risk assessment tools and officially recorded re-offenses.

Discussion: To the best of our knowledge, the study is the first to compare the (cost-) effectiveness of a guided web-based intervention for convicted ISAC and ICCSEM under community supervision against a placebo condition. Methodological limitations (e.g., potential ceiling- or volunteers-effects) are discussed.

Clinical Trial Registration: German Clinical Trial Register (DRKS 00021256). Prospectively registered: 24.04.2020.
Psychiatry Trainees' Attitudes, Knowledge, and Training in Addiction Psychiatry—A European Survey
Authors: Orsolini Laura , Rojnić Palavra Irena , Papanti Gabriele Duccio , Potočan Matej , Quattrone Diego , Martens Matis , Sklenářová Sandra , Levola Jonna , Grichy Leslie , Naughton Sean , Grinevičiene Indre Kotryna , Kuiters Jelly Petra , Gondek Tomasz M. , Panfil Anca-Livia , Borovcanin Milica M. , San Roman Uria Alberto , Biskup Ewelina , Sönmez Güngör Ekin , Casanova Dias Marisa , Tomori Sonila , Banjac Visnja , Marinova-Djambazova Petra , Pinto da Costa Mariana
Published: January 2021

Background: Although psychoactive substance use disorders (PSUDs) are a domain of mental health, addiction psychiatry is only formally recognized as a subspecialty in a few European countries, and there is no standardized training curriculum.

Methods: A 76-item questionnaire was developed and disseminated through an online anonymous data-collecting system and hand-to-hand amongst psychiatric trainees from the 47 European countries of the Council of Europe plus Israel and Belarus.

Results: 1,049/1,118 psychiatric trainees from 30 European countries completed the questionnaire. Fifty-nine-point nine percent of trainees stated to have training in addictions. Amongst the trainees who described having training in addictions, 43% documented a not well-structured training and 37% an unsatisfactory training, mainly due to poor acquired knowledge. Overall, 97% of trainees stated that addiction represents a core curriculum for their training. Overall, general adult psychiatric trainees reported a better knowledge in addictions, compared to trainees in child and adolescent psychiatry.

Conclusion: Despite a growing spread of PSUDs in European countries, addiction psychiatry is a relatively poorly trained field within psychiatry training programs. Further research should investigate reasons for poor training and timings of the educational activities to optimize experiential education training in addiction psychiatry.
Emotion Dysregulation Moderates the Association Between Stress and Problematic Cannabis Use
Authors: Cavalli Jessica M. , Cservenka Anita
Published: January 2021

Background: Research suggests emotion dysregulation is a transdiagnostic risk factor for substance use and addiction and that stress may lead to problematic cannabis use. Thus, the current study examines how emotion dysregulation moderates the associations between stress (stressful life events and perceived stress) and problematic cannabis use.

Methods: Eight hundred and fifty-two adults reporting any lifetime cannabis use completed an anonymous online survey. Participants completed a brief demographic questionnaire and were asked to report their past 30-day use of cannabis, alcohol, nicotine, and illicit substances. Problematic cannabis use (via the Marijuana Problem Scale), emotion dysregulation (via the Difficulties in Emotion Regulation Scale), perceived stress (via the Perceived Stress Scale), and stressful life events (via the Holmes-Rahe Life Stress Inventory) were assessed. Hierarchical multiple linear regressions were conducted.

Results: Findings indicate that when examining the moderating role of emotion dysregulation, more stressful life events and less perceived stress were associated with more severe problematic cannabis use, and these associations were stronger at higher levels of emotion dysregulation.

Conclusions: These results demonstrate a strong step toward understanding how emotion dysregulation moderates the relationship between stress and problematic cannabis use; however, longitudinal studies are needed to determine directionality of effects. Overall, these results suggest the importance of examining emotion dysregulation as a moderator of both stressful life events and stress perception as they relate to problematic cannabis use.
Cognitive Functioning and Schizotypy: A Four-Years Study
Authors: Karamaouna Penny , Zouraraki Chrysoula , Giakoumaki Stella G.
Published: January 2021

Although there is ample evidence from cross-sectional studies indicating cognitive deficits in high schizotypal individuals that resemble the cognitive profile of schizophrenia-spectrum patients, there is still lack of evidence by longitudinal/follow-up studies. The present study included assessments of schizotypal traits and a wide range of cognitive functions at two time points (baseline and 4-years assessments) in order to examine (a) their stability over time, (b) the predictive value of baseline schizotypy on cognition at follow-up and (c) differences in cognition between the two time points in high negative schizotypal and control individuals. Only high negative schizotypal individuals were compared with controls due to the limited number of participants falling in the other schizotypal groups at follow-up. Seventy participants (mean age: 36.17; 70% females) were assessed at baseline and follow-up. Schizotypal traits were evaluated with the Schizotypal Personality Questionnaire. We found that schizotypal traits decreased over time, except in a sub-group of participants (“schizotypy congruent”) that includes individuals who consistently meet normative criteria of inclusion in either a schizotypal or control group. In these individuals, negative schizotypy and aspects of cognitive-perceptual and disorganized schizotypy remained stable. The stability of cognitive functioning also varied over time: response inhibition, aspects of cued attention switching, set-shifting and phonemic/semantic verbal fluency improved at follow-up. High negative schizotypy at baseline predicted poorer response inhibition and semantic switching at follow-up while high disorganized schizotypy predicted poorer semantic processing and complex processing speed/set-shifting. The between-group analyses revealed that response inhibition, set-shifting and complex processing speed/set-shifting were poorer in negative schizotypals compared with controls at both time points, while maintaining set and semantic switching were poorer only at follow-up. Taken together, the findings show differential stability of the schizotypal traits over time and indicate that different aspects of schizotypy predict a different pattern of neuropsychological task performance during a 4-years time window. These results are of significant use in the formulation of targeted early-intervention strategies for high-risk populations.
Transdiagnostic Dimensions of Psychiatric Comorbidity in Individuals at Clinical High Risk for Psychosis: A Preliminary Study Informed by HiTOP
Authors: Cowan Henry R. , Mittal Vijay A.
Published: January 2021

Background: Although psychiatric comorbidity is the norm among individuals at clinical high risk for psychotic disorders (CHR), research has yet to examine transdiagnostic dimensional models of comorbidity in this critical population.

Methods: This study analyzed quantitative measures of eleven psychiatric syndromes in a group at CHR (n = 71) and a matched healthy comparison group (n = 73) to determine these syndromes' dimensional structure and relationships to cognition, functioning, and risk of conversion to psychotic disorders.

Results: Relative to the comparison group, the CHR group was elevated on all eleven psychiatric syndromes. Exploratory factor analysis found three psychopathology dimensions: internalizing, negative symptoms, and positive symptoms. Depression cross-loaded onto the internalizing and negative symptom dimensions. Hypomania loaded positively on positive symptoms but negatively on negative symptoms. The negative symptom factor was associated with poorer cognition and functioning and a higher risk of conversion to psychosis.

Conclusions: These dimensions align with internalizing, detachment, and thought disorder, three of the five spectra in higher-order models such as the Hierarchical Taxonomy of Psychopathology (HiTOP). In the CHR state, detachment appears to be particularly insidious and predictive of psychosis. Further research is required to distinguish depression and hypomania from attenuated psychotic symptoms in this population.
Physical Activity in Relation to Wellbeing Among Newly Arrived Refugees in Sweden: A Quantitative Study
Authors: Sjögren Forss Katarina , Mangrio Elisabeth , Leijon Matti , Grahn Mathias , Zdravkovic Slobodan
Published: January 2021

Background: Little is known about physical activity among newly arrived refugees and what impact physical activity might have on their health, as measured by mental wellbeing, vitality, stress and sleep quality. Thus, this study sought to investigate the relationship between physical activity and wellbeing among refugees who were newly arrived in Sweden.

Methods: The present study was based on the results from a survey, conducted in 2015–2016 among newly arrived adult refugees who spoke Arabic, Pashto, Somali or Dari, participated in a mandatory public integration support programme in the Scania region of Sweden and agreed to participate in the survey. Ultimately 681 participants completed the survey (a response rate of 39.5%).

Results: We found a significant association between physical activity and mental wellbeing, vitality, stress and sleep quality among newly arrived refugees.

Conclusions: Newly arrived refugees need to be informed about the importance of prioritizing physical activity for their health and wellbeing, regardless of their external circumstances, and supported in their attempts to do so.
What Are Good Situations for Running? A Machine Learning Study Using Mobile and Geographical Data
Authors: Wang Shihan , Scheider Simon , Sporrel Karlijn , Deutekom Marije , Timmer Joris , Kröse Ben
Published: January 2021

Running is a popular form of physical activity. Personal, social, and environmental determinants influence the engagement of the individual. To get insight in the relation between running behavior and external situations for different types of users, we carried out an extensive data mining study on large-scale datasets. We combined 4 years of historical running data (collected by a mobile exercise application from over 10K participants) with weather, topographical and demographical datasets. We introduce weighted frequent item mining for the analysis of the data. In this way, we capture temporal and environmental situations that frequently associate with different running performances. The results show that specific temporal and environmental situations (hour in a day, day in a week, temperature, distance to residential areas, and population density) influence the running performance of users more than other situational features. Hierarchical agglomerative clustering on the running data is used to split runners in two clusters (with sustained and less sustained running behavior). We compared the two groups of runners and found that runners with less sustained behavior are more sensitive to the environmental situations (especially several weather and location related features, such as temperature, weather type, distance to the nearest park) than regular runners. Further analysis focused on the situational features for the less sustained runners. Results show that specific feature values correspond to a better or worse running distance. Not only the influence of individual features was examined but also the interplay between features. Our findings provide important empirical evidence that the role of external situations in the running behavior of individuals can be derived from analysis of the combined historical datasets. This opens up a large potential to take those situations specifically into consideration when supporting individuals which show less sustained behavior.
Collision of Fundamental Human Rights and the Right to Health Access During the Novel Coronavirus Pandemic
Authors: dos Santos José Luiz Gondim , Stein Messetti Paulo André , Adami Fernando , Bezerra Italla Maria Pinheiro , Maia Paula Christianne G. G. Souto , Tristan-Cheever Elisa , Abreu Luiz Carlos de
Published: January 2021

Introduction:COVID-19 requires governmental measures to protect healthcare system access for people. In this process, the collision of fundamental rights emerges as a crucial challenge for decision-making.

Policy Options and Implications:This policy review analyzes selected articles by the PubMed searcher about extreme measures taken in several countries during precedent pandemics and the current pandemic, and selects hard decisions relating to the exceptional measures taken by judicial departments in Brazil, connecting them to the “collision of fundamental rights and law principles.” The collision of rights and principles imposed on decision makers a duty to provide balanced rights, and to adopt the enforcement of some rights prioritization. Ethical concerns were also verified in this field involving rights limitations. During a pandemic, the importance of extreme measures to protect health rights and healthcare systems is instrumental for focused, fast, and correct decision making to avoid loss of life and the collapse of healthcare systems. The main goals of this research are to discuss the implications and guidelines for public health decision making, the indispensable ethical and legal aspects for safeguarding health systems and the lives of people, and the respect of the Justice principle and of fundamental health and dignity rights. We conclude that COVID-19 justifies the prioritization of collective and individual health access rights. Acceptable standards of fundamental rights restrictions are established at the constitutional and international levels and must be enforced by rules and governmental action, to ensure fast and accurate decision making during a pandemic. Freedom rights exercises must be linked to solidarity for the realization of social welfare, for the health rights of all individuals and for health systems to function well during a pandemic.

Actionable Recommendations:All individuals are free and equal, therefore social exclusion is prohibited. Institutions must consider social inequalities when discussing public health measures and be guided by ethical standards, by law principles, and rules recognized by constitutional and international law for the benefit of all during a health pandemic.

Conclusions:Collective and individual health rights prevail over the collision of rights when facing pandemic occurrences, case by case, in health systems protection, based on the literature, on precedent pandemics and on legitimate Public Health efforts.
Hospital Preparedness, Resilience, and Psychological Burden Among Clinical Nurses in Addressing the COVID-19 Crisis in Riyadh, Saudi Arabia
Authors: Balay-odao Ejercito Mangawa , Alquwez Nahed , Inocian Ergie Pepito , Alotaibi Raid Salman
Published: January 2021

In the continuous effort to minimize the devastating effects of coronavirus disease (COVID-19) and to curb the spread of the disease, hospital preparedness and resilience play significant roles in the psychological well-being of clinical nurses given that their work demands immediate action to adapt and adjust to stressors. Thus, this study investigates the hospital preparedness, psychological burden, and resilience of clinical nurses in addressing COVID-19 in Riyadh, Saudi Arabia. A total of 281 clinical nurses participated in the survey from April 2020 to June 2020. Results show that clinical nurses perceived a high self-assessed COVID-19 hospital preparedness (49.65, SD = 2.30); high self-assessed nurses' resilience (4.03, SD = 0.36); and most have normal levels of depression, anxiety, and stress. The variables were predicted to be statistically significant (F18,262 = 4.14, p = 0.001) and accounted for 16.8% of the variance in the nurses' perception of hospital preparedness (R2 = 0.221; adjusted R2 = 0.168). The regression analysis was statistically significant (F30,250 = 6.71, p = 0.001) and accounted for 38% of the variance in nurses' resilience (R2 = 0.446, Adjusted R2 = 0.380). The predictors of depression, anxiety, and stress show that the overall relationship was statistically significant at (F23,257 = 6.71, p < 0.001), (F23,257 = 6.675, p 0.000), and (F23,257 = 6.692, p 0.000) with 31.9% of the variance (R2 = 0.375, Adjusted R2 = 0.319), 31.8% of the variance (R2 = 0.374, Adjusted R2 = 0.318), and 31.9 % of the variance (R2 = 0.375, Adjusted R2 = 0.319), respectively. The findings of this study helps in improving the continuing education program, psychological support, and mental health program to ensure that the needs of clinical nurses are addressed during the outbreak of a disease.
Quo Vadis HTA for Medical Devices in Central and Eastern Europe? Recommendations to Address Methodological Challenges
Authors: Daubner-Bendes Rita , Kovács Sándor , Niewada Maciej , Huic Mirjana , Drummond Michael , Ciani Oriana , Blankart Carl Rudolf , Mandrik Olena , Torbica Aleksandra , Yfantopoulos John , Petrova Guenka , Holownia-Voloskova Malwina , Taylor Rod S. , Al Maiwenn , Piniazhko Oresta , Lorenzovici László , Tarricone Rosanna , Zemplényi Antal , Kaló Zoltán
Published: January 2021

Objectives: Methodological challenges in the evaluation of medical devices (MDs) may be different for early and late technology adopter countries, as well as the potential health technology assessment (HTA) solutions to tackle them. This study aims to provide guidance to Central and Eastern European (CEE) countries on how to address key challenges of HTA for MDs with special focus on the transferability of scientific evidence.

Methods: As part of the COMED Horizon 2020 project, a comprehensive list of issues related to MD HTA were identified based on a targeted literature review. Health technology assessment issues which pose a greater challenge or require different solutions in late technology adopter countries were selected. Draught recommendations to address these issues were developed and discussed in a focus group. The recommendations were then validated with a wider group of experts, including HTA and reimbursement decision makers from CEE countries in May and June 2020.

Results: A consolidated list of 11 recommendations were developed in 3 major areas: (1) clinical value assessment, focusing on the use of joint EU work, relying on real-world evidence, use of coverage with evidence development schemes, transferring evidence from foreign countries and addressing the challenges of learning curve and centre effect; (2) economic value assessment, covering cost calculation of complex medical devices and transferability of economic evaluations of MDs; (3) HTA processes, related to the frequent product modifications and various indications of MDs.

Conclusions: Central and Eastern European countries with limited resources for conducting HTA, can benefit from HTA methods and evidence generated in early technology adopter countries. Considering the appropriate reuse of international HTA materials, late technology adopter countries can still implement HTA, even for MDs, which have a more limited evidence base compared with pharmaceuticals.
Adequate Utilization of Emergency Services in Germany: Is There a Differential by Migration Background?
Authors: Sauzet Odile , David Matthias , Naghavi Baharan , Borde Theda , Sehouli Jalid , Razum Oliver
Published: January 2021

Background: The role of emergency services (ES) is to provide round-the-clock acute care. In recent years, inadequate use of ES has been internationally thematised because of overcrowding and the associated cost. Evidence shows that migrant populations tend to use more ES than non-migrant but it remains to show if there is a differential in inadequacy.

Method: Quantitative data from consecutive patients visiting three ES in Berlin (hospital-based outpatient clinics for internal medicine or gynecology) from July 2017 to July 2018 were obtained. Utilization was defined as adequate if the patient was admitted to hospital and/or if all of the three following criteria were fulfilled: reported to have been sent by medical staff; reported strong pain; and reported a high urgency (both ≥7, scale from 0 to 10). Differences between migrants (1st generation), their offspring (2nd generation), and non-migrants were evaluated using logistic regression.

Results: Of the 2,327 patients included, 901 had a migration background. Adjusting for gender, age, gynecological hospital-based outpatient clinic, and the number of chronic diseases, 1st generation migrant patients (n = 633) had significantly lower odds than non-migrants to have an adequate utilization of services [OR 0.78, 95% confidence interval (0.62, 0.99), p-value 0.046]. For 2nd generation patients (n = 268), no statistically significant difference was found [OR 0.80, 95% confidence interval (0.56, 1.15), p-value 0.231]. Only adjusting for gynecological hospital-based outpatient clinic did weaken the association between migration status on adequacy but interactions between type of hospital-based outpatient clinic and migration were not significant.

Discussion: First generation migrants show lower odds of adequate ES use compared to non-migrants. Only visiting a gynecological hospital-based outpatient clinic as opposed to internal medicine could partly explain the lower odds of adequate use among immigrants. This indicates a need for structural changes in the healthcare system: The threshold of access to general practices needs to be lowered, considering the needs of diverse subgroups of migrant patients.
Yuck! Plural Valuation of Constructed Wetland Maintenance for Decentralized Wastewater Treatment in Rural India
Authors: Friedrichsen Claire N. , Monroe Martha C. , Daroub Samira H. , Wani Suhas P.
Published: January 2021

In 2012, an estimated 50% of rural households in India had a system of drainage for moving wastewater away from their homes, but 0.0% have access to safe, reuseable, treated wastewater. Constructed wetlands can provide decentralized wastewater treatment for rural villages and lead to multiple benefits, such as reusable water, reduced disease, and decreased environmental pollution. However, the maintenance of decentralized wastewater technologies is poorly understood. We used a case study design across four communities and six constructed wetlands to understand the social and cultural variables impacting the maintenance of constructed wetlands for decentralized wastewater treatment to provide agricultural irrigation water. Semi-structured interviews (n= 39) and focus groups (n= 4) were conducted with people from Telangana and Karnataka, India. Interviewees were classed into four groups: (1) Scientists, (2) Farmers, (3) Privileged Community Members, and (4) Socially Disadvantaged Community members. Inductive, constant comparison qualitative data analysis was used to develop a model for explaining the existing practice of wetland maintenance. Three themes emerged from the data: mental models of constructed wetland maintenance show plural valuation of ecosystem services, yuck as a leverage point for decreasing social cohesion in the community, and recommendations for improving maintenance through human-centered design. Based on the results, we propose a model for understanding how to incorporate the plural valuation of ecosystem services provided by constructed wetlands and human-centered design to support long-term adoption and maintenance of decentralized wastewater treatment technologies.
The Strategy of Boosting the Immune System Under the COVID-19 Pandemic
Authors: Alagawany Mahmoud , Attia Youssef A. , Farag Mayada R. , Elnesr Shaaban S. , Nagadi Sameer A. , Shafi Manal E. , Khafaga Asmaa F. , Ohran Husein , Alaqil Abdulaziz A. , Abd El-Hack Mohamed E.
Published: January 2021

The novel coronavirus (SARS-CoV-2) infection (COVID-19) has raised considerable concern on the entire planet. On March 11, 2020, COVID-19 was categorized by the World Health Organization (WHO) as a pandemic infection, and by March 18, 2020, it has spread to 146 countries. The first internal defense line against numerous diseases is personalized immunity. Although it cannot be claimed that personalized nutrition will have an immediate impact on a global pandemic, as the nutritional interventions required a long time to induce beneficial outcomes on immunity development, nutritional strategies are still able to clarify and have a beneficial influence on the interplay between physiology and diet, which could make a positive contribution to the condition in the next period. As such, a specific goal for every practitioner is to evaluate different tests to perceive the status of the patient, such as markers of inflammation, insulin regulation, and nutrient status, and to detect possible imbalances or deficiencies. During the process of disease development, the supplementation and addition of different nutrients and nutraceuticals can influence not only the viral replication but also the cellular mechanisms. It is essential to understand that every patient has its individual needs. Even though many nutrients, nutraceuticals, and drugs have beneficial effects on the immune response and can prevent or ameliorate viral infections, it is essential to detect at what stage in COVID-19 progression the patient is at the moment and decide what kind of nutrition intervention is necessary. Furthermore, understanding the pathogenesis of coronavirus infection is critical to make proper recommendations.