bluuebunny/crossref_metadata_2025 huggingface dataset:
Photosystem I Inhibition, Protection and Signalling: Knowns and Unknowns
Authors: Lima-Melo Yugo , Kılıç Mehmet , Aro Eva-Mari , Gollan Peter J.
Published: December 2021

Photosynthesis is the process that harnesses, converts and stores light energy in the form of chemical energy in bonds of organic compounds. Oxygenic photosynthetic organisms (i.e., plants, algae and cyanobacteria) employ an efficient apparatus to split water and transport electrons to high-energy electron acceptors. The photosynthetic system must be finely balanced between energy harvesting and energy utilisation, in order to limit generation of dangerous compounds that can damage the integrity of cells. Insight into how the photosynthetic components are protected, regulated, damaged, and repaired during changing environmental conditions is crucial for improving photosynthetic efficiency in crop species. Photosystem I (PSI) is an integral component of the photosynthetic system located at the juncture between energy-harnessing and energy consumption through metabolism. Although the main site of photoinhibition is the photosystem II (PSII), PSI is also known to be inactivated by photosynthetic energy imbalance, with slower reactivation compared to PSII; however, several outstanding questions remain about the mechanisms of damage and repair, and about the impact of PSI photoinhibition on signalling and metabolism. In this review, we address the knowns and unknowns about PSI activity, inhibition, protection, and repair in plants. We also discuss the role of PSI in retrograde signalling pathways and highlight putative signals triggered by the functional status of the PSI pool.
Persistence Conditions of Institutional Entities: Investigating Copredication Through a Forced-Choice Experiment
Authors: Murphy Elliot
Published: December 2021

The conditions under which certain complex polysemous nominals can sustain coherent sense relations (informally, can “survive”) is investigated through a two-alternative forced choice experiment. Written scenarios were constructed which permitted copredication, through which multiple, semantically different sense types are associated with a single nominal. Participants were presented with two scenarios involving a polysemous nominal (e.g.,bank,city) and had to select which scenario (and, hence, which combination of predicates) appeared to be the most prototypical, faithful realization of the nominal. In order to achieve this, an additional manipulation was added, such that the number of senses hosted by each forced choice was either equal (2 senses choice vs. 2 senses choice) or unequal (1 sense choice vs. 2/3 senses choice). In order to address certain concerns in the literature about prototypicality, a core question addressed was whether the institutional sense of the nominals strongly determined the option chosen by participants, or whether the number of senses more strongly predicted this. It was found that the best predictor of sense “survival” was not sense frequency, but rather sense complexity or approximation to the institutional sense.
Social Innovation Toward a Meaningful Everyday Life for Nursing Home Residents: An Ethnographic Study
Authors: Slettebø Åshild , Skaar Ragnhild , Brodtkorb Kari
Published: December 2021

Background: The literature shows that innovation, which includes culture change, may be important to create a meaningful everyday life for nursing home residents. However, there is a gap in how social innovation practices may contribute to this. The theoretical discourse for the study is person-centered care.

Aim: The main aim was to explore phenomena within social innovation that can contribute to improving nursing home residents’ everyday lives.

Design and Method: This study uses an ethnographic design with observations and interviews in two nursing homes in Southern Norway.

Findings: The main theme was that social innovation within working practices in nursing homes includes phenomena that contribute to a meaningful everyday life for the residents. This main theme includes five subthemes: (1) opening the nursing home to the surroundings; (2) expanding and strengthening the community of practice; (3) facilitating customized activities; (4) ensuring sufficient nutrition and facilitating enjoyable mealtimes; and (5) preventing unrest and disturbing behavior.

Conclusion: The study reveals that innovation practices grounded in person-centered care in nursing homes may contribute to opening the nursing home to the community and establishing a common community practice for all members of the nursing home. This enables residents to experience meaningful everyday life through customized activities, sufficient nutrition, and a pleasant milieu during mealtimes. Disturbing behavior is also prevented, making it possible to promote meaningful lives in nursing homes.
Structural, Psychological and Contextual Predictors of Car Use
Authors: Semenescu Alin , Gavreliuc Alin
Published: December 2021

Besides its undeniable advantages, personal car use generates a wide array of problems, among which its contribution to global warming is probably the most severe. To implement sound policies that are effective in reducing private car use, it is essential to first understand its important antecedents. Structural, psychological and contextual predictors were extensively studied independently, yet integrative approaches that investigate all these factors in a single theoretical model are lacking. The present study contributes to a more comprehensive understanding of car use behavior by proposing a model that includes structural, psychological and contextual determinants and tests this model on an international sample of drivers (N = 414). Responses were analyzed using a structural equation modeling approach. Results show that car use habits, perceived behavioral control, policy measures, fuel cost, infrastructure, temperature and level of precipitations significantly influence car use behavior. Such results support the inclusion of both structural (i.e., hard) and psychological (i.e., soft) factors in the design of policy interventions, while also considering contextual situations. Implications for policy and practice are discussed.
How Morphological Computation Shapes Integrated Information in Embodied Agents
Authors: Langer Carlotta , Ay Nihat
Published: December 2021

The Integrated Information Theory provides a quantitative approach to consciousness and can be applied to neural networks. An embodied agent controlled by such a network influences and is being influenced by its environment. This involves, on the one hand, morphological computation within goal directed action and, on the other hand, integrated information within the controller, the agent's brain. In this article, we combine different methods in order to examine the information flows among and within the body, the brain and the environment of an agent. This allows us to relate various information flows to each other. We test this framework in a simple experimental setup. There, we calculate the optimal policy for goal-directed behavior based on the “planning as inference” method, in which the information-geometric em-algorithm is used to optimize the likelihood of the goal. Morphological computation and integrated information are then calculated with respect to the optimal policies. Comparing the dynamics of these measures under changing morphological circumstances highlights the antagonistic relationship between these two concepts. The more morphological computation is involved, the less information integration within the brain is required. In order to determine the influence of the brain on the behavior of the agent it is necessary to additionally measure the information flow to and from the brain.
SENNA Inventory for the Assessment of Social and Emotional Skills in Public School Students in Brazil: Measuring Both Identity and Self-Efficacy
Authors: Primi Ricardo , Santos Daniel , John Oliver P. , De Fruyt Filip
Published: December 2021

Responding to the need for school-based, broadly applicable, low-cost, and brief assessments of socio-emotional skills, we describe the conceptual background and empirical development of the SENNA inventory and provide new psychometric information on its internal structure. Data were obtained through a computerized survey from 50,000 Brazilian students enrolled in public school grades 6 to 12, spread across the entire State of São Paulo. The SENNA inventory was designed to assess 18 particular skills (e.g., empathy, responsibility, tolerance of frustration, and social initiative), each operationalized by nine items that represent three types of items: three positively keyed trait-identity items, three negatively keyed identity items, and three (always positively keyed) self-efficacy items, totaling a set of 162 items. Results show that the 18 skill constructs empirically defined a higher-order structure that we interpret as the social-emotional Big Five, labeled as Engaging with Others, Amity, Self-Management, Emotional Regulation, and Open-Mindedness. The same five factors emerged whether we assessed the 18 skills with items representing (a) a trait-identity approach that emphasizes lived skills (what do I typically do?) or (b) a self-efficacy approach that emphasizes capability (how well can I do that?). Given that its target youth group is as young as 11 years old (grade 6), a population particularly prone to the response bias of acquiescence, SENNA is also equipped to correct for individual differences in acquiescence, which are shown to systematically bias results when not corrected.
Childhood Emotional Maltreatment and Romantic Relationships: The Role of Compassionate Goals
Authors: Sun Lining , Canevello Amy , Lewis Kathrine A. , Li Jiqiang , Crocker Jennifer
Published: December 2021

Past research indicates that childhood emotional maltreatment (CEM) undermines the quality of adult romantic relationships by fostering negative characteristics in survivors. Two longitudinal studies investigated the hypothesis that decreased compassionate goals toward partners over time explain the association between CEM and declining relationship quality. In Study 1, CEM predicted decreased compassionate goals over time, which in turn predicted decreased relationship quality in individuals in romantic relationships. Study 2 replicated this effect in romantically involved couples and showed that partners’ high compassionate goals attenuated the decline in compassionate goals associated with reported CEM. These results point to the importance of examining how CEM may affect positive relationship processes and the protective roles of partners’ compassionate goals.
Internal-Control Willingness and Managerial Overconfidence
Authors: Liu Bin , Li Lin
Published: December 2021

Internal control is a branch of accounting subject, and accounting control and risk management are the core of enterprise internal control. Previous studies have shown that high-quality internal control inhibits or regulates managerial overconfidence (MOC). However, it is believed that the influential factors of internal-control quality (ICQ) are normally objective factors, such as corporate characteristics, financial status, and governance structure. Corresponding to another type of constituent element, that is, the subjective factor, which we called internal-control willingness, has not been explored. In this study, we defined internal-control willingness as the degrees of the subjective initiative of the internal-control construction and execution activities of enterprises. In addition, we proposed a method to measure internal-control willingness based on text analysis and principal component analysis using Python, and then, we tested its impact on ICQ and MOC. Our findings are as follows: (A) internal-control willingness has a positive impact on ICQ, and (B) internal-control willingness lowers MOC. Our study introduces subjective initiative factors into the field of internal control and also extends the understanding of internal-control theory. Based on empirical conclusions, we suggested that regulatory authorities and corporate boards improve incentive mechanisms to jointly strengthen the internal-control willingness of all employees, so as to help enterprise managers operate rationally.
Cognitively Engaging Physical Activity for Targeting Motor, Cognitive, Social, and Emotional Skills in the Preschool Classroom: The Move for Thought preK-K Program
Authors: Vazou Spyridoula , Mavilidi Myrto F.
Published: December 2021

Despite the growing body of research indicating that integrated physical activity with learning benefits children both physically and cognitively, preschool curricula with integrated physical activities are scarce. The “Move for Thought (M4T) preK-K” program provides activities on fundamental motor skills that are integrated with academic concepts, executive function, and social-emotional skills in the preschool environment. The aim of this study was to evaluate the feasibility, usability, and effectiveness of the M4T preK-K program over an eight-week period in 16 preschool centers (N=273; Mage=4.22 SD=0.61) that were randomly assigned to the intervention (8 M4T; n=138; Mage=4.31 SD=0.61) and the control (8 traditional; n=135; Mage=4.13 SD=0.60) group. In both groups, teacher ratings of children’s attention, behavioral control, and social skills (i.e., cooperation, assertion, and self-control) in the classroom, as well as children’s perceived motor skill competence and executive functions, were collected before and after the intervention. A daily teacher log measured intervention fidelity and perceived experiences with the program. Results showed a significant improvement on attention scores for children in the M4T preK-K group, compared to the control group. No significant differences emerged for behavioral control, social skills, executive functions, and perceived motor competence among groups. A significant time effect was evident for executive functions, with both groups improving over time. Further, the program was well-received, easy to implement in the preschool classroom and with high rates of satisfaction for both children and teachers. The M4T preK-K program is promising in helping teachers prepare preschool children for future educational success.
Gaming Motivation and Negative Psychosocial Outcomes in Male Adolescents: An Individual-Centered 1-Year Longitudinal Study
Authors: Wang Ling , Li Jialan , Chen Yuzhou , Chai Xuemei , Zhang Yuman , Wang Zihan , Tan Hong , Gao Xumei
Published: December 2021

“Gaming motivation” is a useful concept to draw upon when considering inconsistencies in the effects of online gaming on psychosocial wellbeing. However, most prior studies that utilize it are cross-sectional and do not allow that individuals can be driven by multiple motives. The present study uses an individual-centered method to classify gaming motivation styles of male adolescents and longitudinally observes the relationship between gaming motivations and psychosocial outcomes. A total of 929 healthy, male, adolescent gamers were recruited in October 2019 and classified into “recreational” “achiever,” and “escaper” categories according to their baseline gaming motivations and self-esteem levels. Then, 1-year incidence rates of players and relative risks (RRs) of social withdrawal problems, anxiety/depression syndrome, and self-destructive/identity problems were assessed. Recreational players were found to have the lowest incidence of all the three psychosocial problems among the three categories, achievers only had a moderate risk of social withdrawal, compared to recreational players, while escapers showed a strong risk for social withdrawal, anxiety/depression, and self-destructive/identity problems, relative to recreational gamers. Overall, the different motivation subgroups were associated with different psychosocial problems. Both achievers and escapers were found to be maladaptive, but their psychosocial outcomes were different, a finding that provides further insight into the psychological mechanisms underlying these subgroups.
Entrepreneurship Education and Founding Passion: The Moderating Role of Entrepreneurial Family Background
Authors: Lee Younggeun , Cortes Andres Felipe , Joo Minjoo
Published: December 2021

In this paper, we examine the relationship between entrepreneurship education and entrepreneurial passion. Despite the advancement of entrepreneurship education literature and the increasing focus on entrepreneurship education in business schools, we lack empirical exploration on how entrepreneurship education can impact students’ passion for founding new organizations. We hypothesize that students who take entrepreneurship classes would develop high levels of founding passion due to a great perception of skills and abilities that increase positive emotions and decrease negative emotions about the entrepreneurship process. Moreover, we draw on the literature on role models to suggest that students’ entrepreneurial family background (students whose immediate family members are entrepreneurs) strengthens the influence of entrepreneurship education on entrepreneurial passion. Utilizing survey data collected from 160 university students, we found that entrepreneurship education positively influences students’ founding passion and that this relationship is strengthened when students have entrepreneurs in their immediate family.
Over-Specification of Small Cardinalities in Referential Communication
Authors: Zevakhina Natalia , Pasalskaya Lena , Chinkova Alisa
Published: December 2021

The paper presents experimental evidence for the over-specification of small cardinalities in referential communication. The first experiment shows that when presented with a small set (2, 3, or 4) of unique objects, the speaker includes a numeral denoting a small cardinality into the description of given objects, although it is over-informative for the hearer (e.g., “three stars”). On the contrary, when presented with a large set of unique objects, the speaker does not include a numeral denoting a large cardinality into their description, so she produces a bare plural (e.g., “stars”). The effect of small cardinalities resembles the effect of over-specifying color in referential communication, which has been extensively studied in recent years (cf. Tarenskeen et al., 2015; Rubio-Fernández, 2016, among many others). This suggests that, like color, small cardinalities are absolute and salient. The second experiment demonstrates that when presented with an identical small set of monochrome objects, the speaker over-specifies a small cardinality to a much greater extent than a color. This suggests that small cardinalities are even more salient than color. The third experiment reveals that when slides are flashed on the screen one by one, highlighted objects of small cardinalities are still over-specified. We argue that a plausible explanation for the salience of small cardinalities is a subitizing effect, which is the human capacity to instantaneously grasp small cardinalities.
The Mixed Effect of Role Overload on Extra-Role Performance: The Mediation Role of Behavioral Inhibition System/Behavioral Activation System Responses
Authors: Huang Bo , Ma Lina , Xia Wei
Published: December 2021

The findings of existing studies of how role overload affects employees’ performance in organizations have been mixed and controversial. We draw on the hindrance–challenge framework to suggest that role overload contains both hindrance and challenge stressor components. We integrate this theory with the behavioral inhibition and behavioral activation systems (BIS and BAS) perspective to develop hypotheses about the effects of role overload on employees’ extra-role performance (voice). We suggest that although role overload is positively associated with withdrawal (a prototypical response of the BIS system) and ultimately negatively influences extra-role performance, it can also trigger job crafting (a prototypical response of the BAS system) and is, consequently, positively associated with extra-role performance. We further posit that the strength of these indirect effects is moderated by the quality of leader–member exchange (LMX). To support these hypotheses, we conducted a time-lagged study of 450 full-time pre-school teachers from various Chinese kindergartens. As hypothesized, we found that withdrawal and job crafting mediated the relationship between role overload and extra-role performance. Further, LMX strengthens the positive relationship between role overload and job crafting. Taken together, our results suggest that role overload can be a mixed stressor that activates both negative and positive behaviors, thus ultimately having an impact on extra-role performance.
Underdog or Top Dog Brand Story? The Role of Self-Construal and Need of Uniqueness
Authors: Li Yalin , Zhao Min
Published: December 2021

The design of an effective brand story has become a key issue in marketing strategies. This study aims to explore what kinds of brand stories (underdog or top dog) individuals prefer from the perspective of the level of self-construal and the need for uniqueness. In this study, a questionnaire survey was used to collect data from China. One-way analysis of variance and bootstrapping via the Process plug-in were adopted to test the hypotheses. This study confirms that individuals with independent self-construal have a higher need for uniqueness and prefer underdog brand stories, while individuals with interdependent self-construal have a lower need for uniqueness and prefer the top dog brand story. This paper promotes theoretical research in the fields of self-construal, the need for uniqueness, and brand stories, and provides rich theoretical support for enterprises in designing and adjusting brand stories. Implications, limitations and future studies are discussed.
Why Do Some Users Become Enticed to Cheating in Competitive Online Games? An Empirical Study of Cheating Focused on Competitive Motivation, Self-Esteem, and Aggression
Authors: Lee Sung Je , Jeong Eui Jun , Lee Dae Young , Kim Gyoung Mo
Published: December 2021

Cheating, the act of winning in a competition based on unfair advantages over one’s opponents, often occurs in online games (e.g., illegal money exchange, account hacking, and exploiting a bug). With the recent flourishing of competitive tournament games online, such as League of Legends (LoL) and Overwatch, cheating has emerged as a serious problem since it not only promotes the de-socialization of gamers but also adversely affects game brands. However, there has little research on this issue in studies on competitive online games. Focused on three psychological factors (i.e., competitive motivation, self-esteem, and aggression), which has been reported to be primarily related to cheating in sports, this paper presents a study that empirically examined the associations between the factors and cheating in competitive online game environments. From survey data of 329 LoL gamers in South Korea, a structural equation model was analyzed. The results showed that gamers with a high degree of competitive motivation are more inclined to cheat in the game. Aggression increased cheating behavior and had a significant relationship with competitive motivation. Self-esteem decreased the degree of cheating but did not affect competitive motivation. Notably, gaming time negatively influenced cheating. The practical implications of these study results were discussed.
Embodied Irrationality? Knowledge Avoidance, Willful Ignorance, and the Paradox of Autonomy
Authors: Arfini Selene , Magnani Lorenzo
Published: December 2021

In the current philosophical and psychological literature, knowledge avoidance and willful ignorance seem to be almost identical conditions involved in irrational patterns of reasoning. In this paper, we will argue that not only these two phenomena should be distinguished, but that they also fall into different parts of the epistemic rationality-irrationality spectrum. We will adopt an epistemological and embodied perspective to propose a definition for both terms. Then, we will maintain that, while willful ignorance is involved in irrational patterns of reasoning and beliefs, knowledge avoidance should be considered epistemically rational under particular circumstances. We will begin our analysis by considering which of the two phenomena is involved in patterns of reasoning that are still amply recognized as irrational—as wishful thinking, self-deception, and akrasia. We will then discuss the impact of epistemic feelings—which are emotional events that depend on epistemic states—on agents' decision-making. Then, we will consider the impact of willful ignorance and knowledge avoidance on agents' autonomy. By considering these issues, we will argue that when agents are aware that they are avoiding certain information (and aware of what kind of feelings acquiring the information would trigger), knowledge avoidance should be considered a rational, autonomy-increasing, hope-depended selection of information.
Review of the Internal Structure, Psychometric Properties, and Measurement Invariance of the Work-Related Rumination Scale – Spanish Version
Authors: Rosario-Hernández Ernesto , Rovira-Millán Lillian V. , Merino-Soto César
Published: December 2021

Background: The aim of the current study was to examine the internal structure and assess the psychometric properties of the Work-Related Rumination Scale (WRRS) – Spanish version in a Puerto Rican sample of workers. This instrument is a 15-item questionnaire, which has three factors, affective rumination, problem-solving pondering, and detachment. This measure is used in the occupational health psychology context; however, there is little evidence of its psychometric properties.

Materials and Methods: A total sample of 4,100 from five different study samples was used in this cross-sectional study design in which the WRRS was used. We conducted confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) to examine the internal structure of the Work-Related Rumination Scale. Measurement invariance across sex and age was examined.

Results: The three-factor model was supported; however, four items were eliminated due to their cross-loadings and factorial complexity. This 11-item Spanish version of the WRRS was invariant across sex and age. Reliability of the three-factors of WRRS were within the range of 0.74 to 0.87 using Cronbach’s alpha and McDonald’s omega. Correlations between the three factors were as expected as well as with other established measures.

Conclusion: The results suggest that the WRRS-Spanish version appears to be a reliable and valid instrument to measure work-related rumination using its three factors. Comparison across sex and age appear to be useful in occupational health psychology research setting since results suggest that the WRRS is invariant regarding those variables.
Immune and Epigenetic Pathways Linking Childhood Adversity and Health Across the Lifespan
Authors: Chen Michelle A. , LeRoy Angie S. , Majd Marzieh , Chen Jonathan Y. , Brown Ryan L. , Christian Lisa M. , Fagundes Christopher P.
Published: December 2021

Childhood adversity is associated with a host of mental and physical health problems across the lifespan. Individuals who have experienced childhood adversity (e.g., child abuse and neglect, family conflict, poor parent/child relationships, low socioeconomic status or extreme poverty) are at a greater risk for morbidity and premature mortality than those not exposed to childhood adversity. Several mechanisms likely contribute to the relationship between childhood adversity and health across the lifespan (e.g., health behaviors, cardiovascular reactivity). In this paper, we review a large body of research within the field of psychoneuroimmunology, demonstrating the relationship between early life stress and alterations of the immune system. We first review the literature demonstrating that childhood adversity is associated with immune dysregulation across different indices, including proinflammatory cytokine production (and its impact on telomere length), illness and infection susceptibility, latent herpesvirus reactivation, and immune response to a tumor. We then summarize the growing literature on how childhood adversity may alter epigenetic processes. Finally, we propose future directions related to this work that have basic and applied implications.
Salesperson Self-Regulated Learning and Online Customers’ Patronage: An Ambidexterity Perspective
Authors: Han Bing , Fan Hua
Published: December 2021

Although the roles of exploratory and exploitative learning as alternative sales skills have been documented, there is not yet a clear consensus, and empirical evidence in the online sales context is lacking. In addition, existing studies have tended to examine the two activities in parallel, without looking into the dyadic situation of balanced or imbalanced exploratory-exploitative learning. Grounded in the WeChat business context, this study explores how online sales agents’ balanced and imbalanced ambidextrous learning influence customers’ e-loyalty and, in turn, their patronage intention and behavior. Polynomial regression and response surface analysis are performed on 226 dyads, and the results support the hypothesized balance effect. Further, asymmetrical imbalance effects are identified, with customers exhibiting higher e-loyalty and better patronage outcomes when online sales agents adopt more exploitative learning than exploratory learning. This study helps improve understanding of the efficiency of personal selling in a virtual context.
Exploring the Interaction Effects of Gender Contentedness and Pubertal Timing on Adolescent Longitudinal Psychological and Behavioral Health Outcomes
Authors: Kuo Jen-Hao , Albaladejo Carrera Raúl , Cendra Mulyani Lidya , Strong Carol , Lin Yi-Ching , Hsieh Yi-Ping , Tsai Meng-Che , Lin Chung-Ying
Published: December 2021

Background: Off-time pubertal timing (PT) and non-conforming gender identity have been reported to predict adverse health and well-being in adolescents. However, the joint effects of these two factors are less addressed. We aimed to investigate the main and interaction effects of gender identity, proxied by perceived gender contentedness (GC), and PT on longitudinal adolescent psychological and behavioral outcomes.

Methods: Data (N = 1806, Mage = 13.3 ± 0.5 years) come from the Taiwan Youth Project, which prospectively followed a longitudinal cohort of Taiwanese junior high school students from 2000 (wave 1) to 2009 (wave 9). GC was self-reported at waves 1 and 9 in a binary response, and thus 4 GC trajectories were created. PT was defined using the Pubertal Developmental Scale, which mainly measured physical changes in puberty. Multiple linear regression analyses with gender stratification were applied to examine the effects of the GC trajectory and its interaction with PT on the outcomes.

Results: A total of 1,562 subjects (86.5%) remained consistently satisfied with their gender, while the GC of 226 subjects (12.6%) changed at some point. Regression analyses found that males with gender dissatisfaction at wave 9 were likely to engage in delinquent behavior, and females in this group were more likely to have lower self-esteem, as compared to those with consistent GC. The interaction effect between the GC trajectory and PT appeared to be associated with smoking and drinking only at wave 1.

Conclusions: These findings indicate that healthcare professionals should concentrate on gender non-conforming individuals at early adolescence, navigating them toward a healthy adulthood.
Coping Styles Among High School Graduates Aiming to Study Medicine in Dealing With Depressive and Anxious Symptoms
Authors: Erschens Rebecca , Loda Teresa , Stuber Felicitas , Herrmann-Werner Anne , Nikendei Christoph , Gashi Kaltrina , Zipfel Stephan , Junne Florian
Published: December 2021

Background: Psychological distress, its associated stressors and resilience factors, and the implications derived for the education and training of medical students and physicians have long been the subject of international studies. The study presented here investigated affective symptoms in association with coping styles in the earliest phase of University medical education: high school graduates aiming to study medicine.

Materials and Methods: We conducted a self-report survey at a medical school in Germany among high school graduates who indicated being interested in studying medicine at the university's on-campus recruitment day. The questionnaire included validated instruments for the self-assessment of symptoms of depression (i.e., Patient Health Questionnaire; PHQ-9) and anxiety (i.e., Generalized Anxiety Disorder 7 (GAD-7), and participants were also asked to rate functional and dysfunctional behavior-based coping styles for symptoms of depression and anxiety. Additional variables addressed were gender, motivation, interest in studying medicine, and parental employment in medicine.

Results: Of 400 high school graduates, 346 (87%) completed the survey. More than 40 (12.5%) and nearly 30 (8.4%) reported relevant symptoms of depression (PHQ-9 sum score ≥10) and anxiety (GAD-7 sum score ≥10), respectively. Among the graduates, young women had higher values for symptoms of depression than young men, and one's interested exclusively in studying human medicine tended to have marginally higher levels of symptoms of depression than ones who were also interested in other subjects. Relevant functional coping styles included seeking social support, relaxing, engaging in sports, listening to or making music, and reading books, whereas relevant dysfunctional coping styles included consuming alcohol, abusing drugs, restrictive eating, watching TV, surfing the Internet, and withdrawing and ruminating.

Conclusion: The results clarify the burden and associated resilience factors of premedical high school graduates at the earliest phase of their University education. As such, they reveal ways to address educational and supportive services and support the need for further investigation into factors of success in studying human medicine.
Estimates of Prevalence Rates of Cancer Patients With Children and Well-Being in Affected Children: A Systematic Review on Population-Based Findings
Authors: Inhestern Laura , Bultmann Johanna Christine , Johannsen Lene Marie , Beierlein Volker , Möller Birgit , Romer Georg , Koch Uwe , Bergelt Corinna
Published: December 2021

This review assessed population-based estimate rates of cancer patients with minor and young adult children (≤ 25 years), children and young adults having a parent with cancer as well as the psychosocial situation and well-being of children and young adults affected by parental cancer. Eighteen publications on population-based studies were included. Studies varied in the age ranges of both cancer patients and children. The prevalence rates of cancer patients having children ranged from 14 to 24.7% depending on the sample structure (e.g., age, gender). Studies reported that between 1.6 and 8.4% of children resp. young adult children have a parent with a history of cancer. Seven publications reported on the psychosocial situation or well-being in children and young adults affected by parental cancer. Estimate rates of psychosocial problems, psychiatric diagnoses or distress ranged between 2.5 and 34% of children depending on the method of measurement and outcome. The differences in the sample structure between the studies impeded the comparison of prevalence rates. However, the findings help to determine the need for specific support services and health care planning. The results emphazise the importance to routinely include issues on the parental role of patients and questions on the well-being and coping of children into psychooncological care. If necessary, support should be provided to families living with a cancer diagnosis.
Suppression May Improve Adaptation to Worry When Facing Uncertainty: Studying COVID-19 Pandemic
Authors: Khatibi Ali , Sharpe Louise , Dehghani Mohsen , Ghalibaf Erfan , Hosseinchi Parham , Mazidi Mahdi , Ranjbar Seyran , Deldar Zoha , Gevers-Montoro Carlos , Alizadeh Pouyan , Alidoust Shaghayegh , Babaei Arghavan , Telkabadi Fattaneh , Ghadiri Tahereh
Published: December 2021

The COVID-19 pandemic has been associated with increased uncertainty, fear and worry in everyone's life. The effect of changes in daily life has been studied widely, but we do not know how emotion-regulation strategies influence adaptation to a new situation to help them overcome worry in the face of uncertainty. Here, 1,064 self-selected Farsi speaking participants completed an online battery of questionnaires that measured fear of virus and illness, worry, intolerance of uncertainty, and emotion regulation (two subscales: reappraisal, suppression). We also documented the number of daily COVID-19 cases and deaths due to COVID-19 on the day in which participants completed the questionnaire. Our findings suggest a correlation between contamination fear and the number of daily-confirmed cases (r = 0.11), and the number of reported deaths due to COVID-19 (r = 0.09). Worry mediated the relationship between intolerance of uncertainty and fear of virus and illness (b = 0.16, 0.1141 < CI < 0.2113). In addition, suppression moderated the relationship between intolerance of uncertainty and worry (p < 0.01). Our results suggest that suppression (at least in the short term) can be an adaptive response to the worry associated with uncertainty. Suppression can reduce worry, which in turn can decrease fear of contamination and improve adaptation to social distancing requirements. Although, the observed correlations were significant, but considering the sample size, they are not strong, and they should be interpreted cautiously.
Nutritional Ketosis as a Potential Treatment for Alcohol Use Disorder
Authors: Mahajan Vikrant R. , Elvig Sophie K. , Vendruscolo Leandro F. , Koob George F. , Darcey Valerie L. , King M. Todd , Kranzler Henry R. , Volkow Nora D. , Wiers Corinde E.
Published: December 2021

Alcohol use disorder (AUD) is a chronic, relapsing brain disorder, characterized by compulsive alcohol seeking and disrupted brain function. In individuals with AUD, abstinence from alcohol often precipitates withdrawal symptoms than can be life threatening. Here, we review evidence for nutritional ketosis as a potential means to reduce withdrawal and alcohol craving. We also review the underlying mechanisms of action of ketosis. Several findings suggest that during alcohol intoxication there is a shift from glucose to acetate metabolism that is enhanced in individuals with AUD. During withdrawal, there is a decline in acetate levels that can result in an energy deficit and could contribute to neurotoxicity. A ketogenic diet or ingestion of a ketone ester elevates ketone bodies (acetoacetate, β-hydroxybutyrate and acetone) in plasma and brain, resulting in nutritional ketosis. These effects have been shown to reduce alcohol withdrawal symptoms, alcohol craving, and alcohol consumption in both preclinical and clinical studies. Thus, nutritional ketosis may represent a unique treatment option for AUD: namely, a nutritional intervention that could be used alone or to augment the effects of medications.
Abnormal Cortical Activation Patterns Among Chinese-Speaking Schizophrenia Patients During Category and Letter Verbal Fluency Tasks Revealed by Multi-Channel Functional Near-Infrared Spectroscopy
Authors: Li Juan , Mu Junlin , Shen Chenyu , Yao Guanqun , Feng Kun , Zhang Xiaoqian , Liu Pozi
Published: December 2021

Background: Functional near-infrared spectroscopy (fNIRS) has many advantages over other neuroimaging modalities for routine measurement of task-dependent cortical activation, but most fNIRS studies of schizophrenia have used letter fluency tasks (LFTs). Further, performances on category fluency tasks (CFTs) and LFTs may be distinct in Chinese patients due to the unique semantic features of Chinese written characters. To identify unique disease biomarkers measurable by fNIRS in Chinese schizophrenia patients, this study compared cortical oxygenated hemoglobin changes ([oxy-Hb]) during a Chinese LFT and CFT between patients and healthy controls.

Methods: Inpatients of the Second Affiliated Hospital of Xinxiang Medical University were recruited from Match 2020 to July 2021. The Positive and Negative Symptom Scale (PANSS) was used to evaluate psychiatric symptoms. Dynamic changes in [oxy-Hb], an indicator of neural activity, were measured during CFT and LFT performance by 52-channel fNIRS.

Results: Forty-seven schizophrenia inpatients and 29 healthy controls completed all tests. Schizophrenia patients showed significant cortical activation at 15 channels covering the left hemisphere and 17 channels over the right hemisphere during the CFT. During the LFT, activity was significantly increased at only six channels, all over the left hemisphere (FDR P < 0.05). In healthy controls, significant [oxy-Hb] increases were found at 24 channels over the left hemisphere and 19 channels over the right hemisphere during CFT. While during the LFT, the significant increases were found at 7 channels all over the left hemisphere (FDR P < 0.05). When years of education was included as a covariate, the schizophrenia group demonstrated no significant hypoactivation relative to healthy controls at any channel after FDR correction (FDR P < 0.05) during CFT while demonstrated significant hypoactivation at channel 11 during LFT (FDR P < 0.05). There were no significant associations between PANSS scores and [oxy-Hb] changes after FDR correction (FDR P < 0.05).

Conclusions: Left lateralization during CFT was reduced among schizophrenia patients and may be related to the semantic deficit. The Chinese-CFT could be a more sensitive indicator of frontal-temporal dysfunction in schizophrenia.
Patterns of Suicide in the Context of COVID-19: Evidence From Three Australian States
Authors: Clapperton Angela , Spittal Matthew John , Dwyer Jeremy , Garrett Andrew , Kõlves Kairi , Leske Stuart , Millar Ciara , Edwards Bronwen , Stojcevski Victor , Crompton David Robert , Pirkis Jane
Published: December 2021

Aims: We aimed to determine whether there has been a change in the number of suicides occurring in three Australian states overall, and in age and sex subgroups, since the COVID-19 pandemic began, and to see if certain risk factors for suicide have become more prominent as likely underlying contributing factors for suicide.

Method: Using real-time data from three state-based suicide registers, we ran multiple unadjusted and adjusted interrupted time series analyses to see if trends in monthly suicide counts changed after the pandemic began and whether there had been an increase in suicides where relationship breakdown, financial stressors, unemployment and homelessness were recorded.

Results: Compared with the period before COVID-19, during the COVID-19 period there was no change in the number of suicides overall, or in any stratum-specific estimates except one. The exception was an increase in the number of young males who died by suicide in the COVID-19 period (adjusted RR 1.89 [95% CI 1.11–3.23]).

The unadjusted analysis showed significant differences in suicide in the context of unemployment and relationship breakdown during the COVID-19 compared to the pre-COVID-19 period. Analysis showed an increase in the number of suicides occurring in the context of unemployment in the COVID-19 period (unadjusted RR 1.53 [95% CI 1.18–1.96]). In contrast, there was a decrease in the number of suicides occurring in the context of relationship breakdown in the COVID-19 period (unadjusted RR 0.82 [95% CI 0.67–0.99]). However, no significant changes were identified when the models were adjusted for possible over-dispersion, seasonality and non-linear trend.

Conclusion: Although our analysis found no evidence of an overall increase in suicides after the pandemic began, the picture is complex. The identified increase in suicide in young men indicates that the impact of the pandemic is likely unevenly distributed across populations. The increase in suicides in the context of unemployment reinforces the vital need for mitigation measures during COVID-19, and for ongoing monitoring of suicide as the pandemic continues.
Prediction of PCOS and Mental Health Using Fuzzy Inference and SVM
Authors: Kodipalli Ashwini , Devi Susheela
Published: December 2021

Polycystic ovarian syndrome (PCOS) is a hormonal disorder found in women of reproductive age. There are different methods used for the detection of PCOS, but these methods limitedly support the integration of PCOS and mental health issues. To address these issues, in this paper we present an automated early detection and prediction model which can accurately estimate the likelihood of having PCOS and associated mental health issues. In real-life applications, we often see that people are prompted to answer in linguistic terminologies to express their well-being in response to questions asked by the clinician. To model the inherent linguistic nature of the mapping between symptoms and diagnosis of PCOS a fuzzy approach is used. Therefore, in the present study, the Fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method is evaluated for its performance. Using the local yet specific dataset collected on a spectrum of women, the Fuzzy TOPSIS is compared with the widely used support vector machines (SVM) algorithm. Both the methods are evaluated on the same dataset. An accuracy of 98.20% using the Fuzzy TOPSIS method and 94.01% using SVM was obtained. Along with the improvement in the performance and methodological contribution, the early detection and treatment of PCOS and mental health issues can together aid in taking preventive measures in advance. The psychological well-being of the women was also objectively evaluated and can be brought into the PCOS treatment protocol.
Evolution of Public Health Expenditure Financed by the Romanian Social Health Insurance Scheme From 1999 to 2019
Authors: Radu Ciprian-Paul , Pana Bogdan Cristian , Pele Daniel Traian , Costea Radu Virgil
Published: December 2021

The Romanian health system is mainly public financed (80.45%) through the following sources: Social Health Insurance (65%), State and Local Authorities Budget (15.45%), while the private sources (voluntary health insurance and out of pocket) adds an additional 19.55% to the public funds. The shares of the types of expenditure reflect the importance of each sector in the overall health system, and trends in expenditure show the impact of financing on the health sector's structural changes. We analyzed the 20-year trend of the Social Health Insurance budget, from 1999 to 2019. The influences of the different allocations, subcategories, and new budget categories appearing over time were adjusted to reveal relevant trends. Of the 14 medical service categories and the stand-alone Administrative expenditure category, six expenditure categories including Hospital services, Total drugs, and Primary care showed stationary 20-year trends; five including Medical devices, Dialysis, and Homecare services showed ascendant trends; and four including Dentistry and Emergency services showed descendant trends. Stationary trends imply no structural changes in the health sector of relevant magnitude to impact the financing shares of major categories: hospitals, drugs, or primary care. Emerging trends related to the impact of different reforms were revealed only in the low share of expenditures categories. The allocation methodology and statistical analysis of the trends reveal a new perspective on the evolution of health sector in Romania.