bluuebunny/crossref_metadata_2025 huggingface dataset:
How Can We Improve Teacher’s Work Engagement? Based on Chinese Experiences
Authors: Zhang Danhui , He Jingwen , Fu Dingmeng
Published: December 2021

Drawing on Self-Determination Theory, the current study analysed the relationship between teachers’ perceived autonomy support and work engagement while it also explored the mediating effect of basic psychological need satisfaction and intrinsic motivation. The study investigated 520 elementary teachers in Beijing, and we found the following: (1) teachers in different groups reported diverse senses of perceived autonomy support, in that teachers with less teaching experience as well as those with a master’s degree have a higher score regarding the perceptions of teacher autonomy; and (2) teacher autonomy can affect work engagement not only in terms of the satisfaction of basic psychological needs but also by the chain of satisfaction of basic psychological needs and intrinsic motivation. Teachers with more autonomy support will have higher basic psychological need satisfaction and stronger teaching motivation, which will further enhance their work engagement.
Live Music Performance: The Relationship Between Flow and Music Performance Anxiety
Authors: Spahn Claudia , Krampe Franziska , Nusseck Manfred
Published: December 2021

Most studies exploring the relation between flow and Music Performance Anxiety (MPA) have focused on the disposition of generally experiencing flow and the occurrence of MPA. Little is known about the connection between experiencing flow and MPA as it relates to a specific performance. In this study, flow and MPA have been investigated in 363 orchestral musicians in relation to a particular live music performance. The musicians were asked to fill out a questionnaire immediately after a concert. Flow experience during the performance was measured using the Flow Short Scale. The Performance-specific Questionnaire on MPA (PQM) was used for MPA. The PQM addresses particular aspects of MPA and refers retrospectively to the time before and during the performance as well as to the moment of filling out the questionnaire after the performance. Using three scales, the functional coping, the perceived symptoms of MPA and self-efficacy were determined for each time point of the performance. The results showed that experiencing flow was on average higher among orchestral musicians compared to a sample of the general population. However, there were differences between the professional and non-professional musicians. All PQM scales showed significant correlations with the global flow scale. Regression analysis on the global flow score found that regarding the time before the performance the PQM scale symptoms of MPA were diametrically connected with the flow experience. The PQM scale functional coping was shown to be positively related to the flow during the performance. Moreover, high self-efficacy was found to be closely related with stronger flow experience. Furthermore, flow seems to have positive effects on functionally coping with MPA and the self-efficacy after the performance. These findings confirm the negative relationship between flow and symptoms of MPA, offering further approaches in understanding the relationship especially for live music performances.
Emotional Intelligence and Perceived Health Related to Expressed Compassion Fatigue: A Study in Health Sector at Regional Level
Authors: Ruiz Fernández María Dolores , Lirola María-Jesús , Ramos-Pichardo Juan Diego , Ortíz-Amo Rocío , Ibáñez-Masero Olivia , Rodríguez Gómez Susana , Ortega-Galán Ángela María
Published: December 2021

Background: The work of health professionals often involves physical as well as psychological strain. They constantly deal with traumatic situations of pain and suffering, which destabilize the sense of well-being. Compassion fatigue is a feeling that appears in these cases and is related to other variables such as burnout or emotional drain.

Aims: The principal aim of this project was to deepen the analysis of compassion fatigue and how it could be explained through the relationship with other constructs such as emotional intelligence and perceived health.

Methods: This work followed the STROBE checklist for cross-sectional studies. In this study 1,521 nurses (Mage = 47.32; SD = 8.44) participated. The responses reported by the nurses were analyzed by classifying them as high or low compassion fatigue and the differences of both groups were analyzed for the variables of emotional intelligence, perceived health and quality of professional life.

Results: It was obtained significant differences for all factors except for emotional intelligence factor. A linear regression analysis showed both emotional intelligence and perceived health helped to explain (12%) compassion fatigue.

Conclusion: This study provides light on comprehending the conception of compassion fatigue. It highlights the importance of intervention programs that improve the quality of professional life.
Early Numeracy and Literacy Skills Among Monolingual and Bilingual Kindergarten Children
Authors: Bar Liat , Shaul Shelley
Published: December 2021

Early numeracy and literacy skills are all the knowledge that children acquire spontaneously and independently before entering school and beginning formal learning. This knowledge is essential and forms the basis for the acquisition of reading and arithmetic in school. A bilingual child is a child who is fluent in two languages, as opposed to a monolingual child who is exposed to only one language. Bilingualism has been found to affect verbal and mathematical abilities in children, but only a few studies have focused on the early numeracy and literacy skills of preschoolers. This study examined the connection between early numeracy and literacy skills and among monolingual children as compared to bilingual children in preschool. Three hundred and two children aged 5–6years old were recruited from 74 kindergartens. Participants were divided into two groups: 151 monolingual children who spoke and were exposed to only one language (Hebrew) and 151 bilingual children who spoke and were exposed to two languages (the bilingual children spoke different languages). Monolingual children performed better than the bilingual children in most of the literacy tasks, except for phonological awareness, in which no differences were found between the groups. In addition, in the early numeracy tasks, a difference was found only in the task, which included linguistic knowledge, number knowledge, and counting tasks, in which the monolingual children performed better. Furthermore, stronger correlations were found between the early numeracy and literacy skills among the monolingual group compared to the bilingual group. The study findings stress the importance of strengthening linguistic abilities, such as vocabulary expansion in kindergarten among populations in which more than one language is spoken. Supporting these abilities can reduce the gap between bilingual children and their monolingual classmates before entering school.
Effect of Cognitive Control on Age-Related Positivity Effects in Attentional Processing – Evidence From an Event-Related Brain Potential Study
Authors: Liu Haining , Liu Yanli , Dong Xianling , Liu Haihong , Han Buxin
Published: December 2021

Studies investigating age-related positivity effects during facial emotion processing have yielded contradictory results. The present study aimed to elucidate the mechanisms of cognitive control during attentional processing of emotional faces among older adults. We used go/no-go detection tasks combined with event-related potentials and source localization to examine the effects of response inhibition on age-related positivity effects. Data were obtained from 23 older and 23 younger healthy participants. Behavioral results showed that the discriminability index (d') of older adults on fear trials was significantly greater than that of younger adults [t(44)=2.37, p=0.024, Cohen’s d=0.70], whereas an opposite pattern was found in happy trials [t(44)=2.56, p=0.014, Cohen’s d=0.75]. The electroencephalography results on the amplitude of the N170 at the left electrode positions showed that the fear-neutral face pairs were larger than the happy-neutral ones for the younger adults [t(22)=2.32, p=0.030, Cohen’s d=0.48]; the older group’s right hemisphere presented similar tendency, although the results were not statistically significant [t(22)=1.97, p=0.061, Cohen’s d=0.41]. Further, the brain activity of the two hemispheres in older adults showed asymmetrical decrement. Our study demonstrated that the age-related “positivity effect” was not observed owing to the depletion of available cognitive resources at the early attentional stage. Moreover, bilateral activation of the two hemispheres may be important signals of normal aging.
Stress and Burnout in Teachers During Times of Pandemic
Authors: Vargas Rubilar Natalia , Oros Laura Beatriz
Published: December 2021

In Argentina, once mandatory isolation was declared due to the COVID-19 pandemic, teachers of all educational levels and modalities had to substantially modify their way of working. The aim of this study was to identify the work situations that education professionals perceived as threats under the modality of non-face-to-face teaching, and to describe the level of perceived stress and its possible effect on psychophysical symptoms. Likewise, it sought to examine possible differences in the manifestations of burnout depending on the level of perceived stress and associated symptoms. An empirical study with a cross-sectional design was developed, in which 9,058 Argentine teachers, who had to complete self-report measures, participated. The sampling method was non-random, using an online procedure of reclusion of volunteers. Descriptive techniques and non-parametric tests were used for data analysis. More than 60% of the educators reported high and moderately high levels of stress. The predominant stressors were uncertainty about the consequences of the pandemic, work overload and inadequate working environment. The more stress they perceived, the higher the manifestation of unwanted psychophysical symptoms. Professional burnout was higher for teachers with a higher load of stress and with more psychophysical indicators of discomfort. These results reveal the psychological impact of the COVID-19 pandemic on the education staff, and encourage the development of intervention measures to preserve the health of professionals.
Pilot Study of Mindfulness Training on the Self-Awareness of Motor Symptoms in Parkinson’s Disease – A Randomized Controlled Trial
Authors: Buchwitz Timo Marcel , Maier Franziska , Greuel Andrea , Thieken Franziska , Steidel Kenan , Jakobs Viktoria , Eggers Carsten
Published: December 2021

Objective:This study aims to evaluate feasibility and effects of a newly developed mindfulness intervention tailored to specific needs of patients with Parkinson’s disease (PD).

Background:The phenomenon of impaired self-awareness of motor symptoms (ISAm) in PD might be reduced by increasing patients’ mindfulness. A PD-specific mindfulness intervention has been developed and evaluated as a potential treatment option: IPSUM (“Insight into Parkinson’s Disease Symptoms by using Mindfulness”).

Methods:IPSUM’s effectiveness is evaluated by comparing an intervention with a waitlist-control group. Applying a pre-post design, patients were assessed before, directly after and 8weeks after treatment. The primary outcome was the change in a quantitative ISAm score from baseline to post-assessment. Secondary outcome measures were PD-related affective changes and neuropsychological test performance. Feasibility was evaluatedviafeedback forms.

Results:In total, 30 non-depressed and non-demented PD patients were included (intervention:n=14, waitlist-control:n=16). ISAm score did not change significantly, but the training group showed greater performance in sustained attention and language tasks over time. Additional changes included greater mindfulness as well as less sleeping problems and anxiety. Cognitive disturbances, apathy, and sleeping problems worsened only in the waitlist-control group. Patients’ feedback regarding the training concept and material was excellent.

Conclusion:Insight into Parkinson’s Disease Symptoms by using Mindfulness has not been capable of reducing ISAm in PD patients but appears to be a feasible and effective concept to, among others, support mental health in the mid-term. It has to be noted though that the study was stopped beforehand because of the SARS CoV-2 pandemic. The lack of findings might therefore be caused by a lack of statistical power. The need for further research to better understand the mechanisms of ISAm and its connection to mindfulness in PD is highlighted.
University Students’ Basic Psychological Needs, Motivation, and Vitality Before and During COVID-19: A Self-Determination Theory Approach
Authors: Müller Florian H. , Thomas Almut E. , Carmignola Matteo , Dittrich Ann-Kathrin , Eckes Alexander , Großmann Nadine , Martinek Daniela , Wilde Matthias , Bieg Sonja
Published: December 2021

Self-determination theory assumes that the basic psychological needs for autonomy, competence, and relatedness are associated with motivational regulation. As these basic psychological needs may have been affected by the shift to distance learning, students’ motivational regulation and vitality may have suffered as well. The purpose of this study was to examine the motivational regulation, satisfaction, or frustration of the basic psychological needs and vitality of university students before and after the transition to forced distance learning during the COVID-19 pandemic: Two student samples from Austria and Germany were studied: One was surveyed before the conversion to distance learning (N=1,139) and the other at the beginning of forced distance learning (N=1,835). The instruments used were the Scales for the Measurement of Motivational Regulation for Learning in University Students (SMR-L), the German version of the Basic Psychological Needs Satisfaction and Frustration Scale, a scale developed by the authors to differentiate the assessment of social relatedness, and the German version of the Subjective Vitality Scale. The results show that the satisfaction of basic psychological needs was significantly lower and the frustration thereof substantially higher during the distance learning period than before the pandemic. Intrinsic motivation and identified regulation were significantly lower during the forced distance learning period, and more controlled forms of motivation were higher than before the pandemic. Structural equation models showed that 42% of the students’ vitality can be explained by motivational regulation and the satisfaction and frustration of their basic needs. Motivational regulation styles functioned (differentiated according to the degree of autonomy) as mediating variables between basic needs and vitality. In terms of theoretical implications, the distinction between approach and avoidance components of introjected regulation was shown to be adequate and necessary, as they explain the outcome vitality differently. The support and avoidance of frustration of basic psychological needs should be considered in distance learning to promote the quality of motivation and students’ vitality.
Most Chinese Preschool Teachers Value Guided Play Over Free Play: Latent Profiles and Associated Predictors
Authors: Lin Xunyi , Liao Yutong , Xue Manli , Colliver Yeshe
Published: December 2021

Longitudinal research suggests that optimal long-term outcomes are achieved when early childhood education and care (ECEC) balance free with guided play. A prerequisite for this achievement is that ECEC teachers value both equally. This study examines preschool teachers’ play beliefs profile and explores its association with teachers’ backgrounds (e.g., teaching experience, education level) in a sample of 674 Chinese teachers in Fujian, China. Participants completed an adapted form of the Parent Play Belief Scale, the Chinese Teacher Play Beliefs Scale (CTPBS), to report their beliefs regarding young children’s play and early academics. Latent profile analysis (LPA) revealed 91% of teachers exhibited highAcademics over Guided Play(AGP) and lowFree Play and Socio-Emotional Skills Support(FPSSS), whereas only 9% were high in both factors. Teachers with a decade or more teaching experience were more likely to belong to thehigh AGPand lowFPSESprofile. The findings indicate that the majority of Chinese ECEC teachers value guiding play to academic skills more than they do facilitating free play for socio-emotional skills. Professional development focused on balancing guided with free play may be necessary for the majority of Chinese ECEC teachers to catch up with the zeitgeist of contemporary international research and policy on intentional teaching in play.
Subgroups in Late Adulthood Are Associated With Cognition and Wellbeing Later in Life
Authors: Radhoe Tulsi A. , Agelink van Rentergem Joost A. , Kok Almar A. L. , Huisman Martijn , Geurts Hilde M.
Published: December 2021

Objectives: In this study, we aim to discover whether there are valid subgroups in aging that are defined by modifiable factors and are determinant of clinically relevant outcomes regarding healthy aging.

Method: Data from interviews were collected in the Longitudinal Aging Study Amsterdam at two measurement occasions with a 3-year interval. Input for the analyses were seven well-known vulnerability and protective factors of healthy aging. By means of community detection, we tested whether we could distinguish subgroups in a sample of 1478 participants (T1-sample, aged 61–101 years). We tested both the external validity (T1) and predictive validity (T2) for wellbeing and subjective cognitive decline. Moreover, replicability and long-term stability were determined in 1186 participants (T2-sample, aged 61–101 years).

Results: Three similar subgroups were identified at T1 and T2. Subgroup A was characterized by high levels of education with personal vulnerabilities, subgroup B by being physically active with low support and low levels of education, and subgroup C by high levels of support with low levels of education. Subgroup C showed the lowest wellbeing and memory profile, both at T1 and T2. On most measures of wellbeing and memory, subgroups A and B did not differ from each other. At T2, the same number of subgroups was identified and subgroup profiles at T1 and T2 were practically identical. Per T1 subgroup 47–62% retained their membership at T2.

Discussion: We identified valid subgroups that replicate over time and differ on external variables at current and later measurement occasions. Individual change in subgroup membership over time shows that transitions to subgroups with better outcomes are possible.
Foreign Language Enjoyment and Anxiety as the Correlates of the Ideal L2 Self in the English as a Foreign Language Context
Authors: Fathi Jalil , Mohammaddokht Farnoosh
Published: December 2021

Learners’ emotions in learning a foreign language are claimed to shape complicated dynamic associations contributing to their motivational and linguistic outcomes, as evidenced by recent research in this area. In order to advance this research area, this study sought to investigate the foreign language enjoyment (FLE) and foreign language classroom anxiety (FLCA) as the predictors of ideal L2 self in Iranian English as a Foreign Language (EFL) context. The total number of 195 English-major students from various universities completed an online survey containing the three scales in question. The measurement models were first verified using confirmatory factor analysis (CFA). Then, the structural model for the relations among the variables was tested employing structural equation modeling (SEM). The SEM results showed that although FLE and FLCA significantly predicted ideal L2 self, FLE was a stronger predictor of ideal L2 self than FLCA. This study provides significant pedagogical implications for EFL practitioners.
The Role of Oxidative Stress in Suicidal Behaviour Among Bipolar Patients: A Cross-Sectional Study in a Malaysian Sample
Authors: Loo Jiann Lin , Mohamad Kamal Nurul Ain , Goon Jo Aan , Ahmad Damanhuri Hanafi , Tan Jaclyn Ai Chin , Abdul Murad Nor Azian , Shah Shamsul Azhar , Sulaiman Siti Aishah , Fazry Shazrul , Sharip Shalisah , Mohamed Saini Suriati , Gunasekaran Geetha , Maniam Thambu , A. Jamal A. Rahman , Wan Ngah Wan Zurinah , Mohd Badli Shah Fatimatul Syahirah , Chan Lai Fong
Published: December 2021

Background: Oxidative stress markers are found to be linked with depression and suicide attempts in bipolar disorder (BD), although the role of DNA damage as a marker of suicidal ideation and attempt has yet to be determined. We aim to investigate the association between DNA damage and suicidal behaviour, i.e., suicidal ideation and suicide attempt, among suicidal ideators in BD patients while accounting for clinical and psychosocial risk factors.

Methods: A cross-sectional study was conducted in the Universiti Kebangsaan Malaysia Medical Centre on 62 consecutive BD patients diagnosed using the M.I.N.I. Neuropsychiatric Interview and 26 healthy control participants. Socio-demographic and clinical assessments were performed using the Columbia Suicide Severity Rating Scale (C-SSRS) for lifetime suicidal ideation and attempt, Quick Inventory of Depressive Symptomatology (QIDS) for depression severity, Clinical Global Impression for Bipolar Disorder (CGI-BD) for illness severity [both mania (CGI-Mania) and major depressive episode (CGI-MDE)], Social Readjustment Rating Scale (SRRS) for change in life events, and Barratt Impulsiveness Scale (BIS) for behavioural impulsivity. The degree of DNA damage in peripheral blood samples was determined using a standard protocol of comet assay.

Results: Multivariable logistic regression revealed higher scores of CGI-MDE as the sole significant factor for lifetime suicidal ideation (OR = 1.937, 95% CI = 1.799–2.076). Although initial bivariate analysis showed a significant association between DNA damage, malondialdehyde (MDA), catalase (CAT), and suicidal behaviour, the findings were not seen in multivariable logistic regression. Bivariate subgroup analysis showed that moderate and severe DNA damage (p = 0.032 and p = 0.047, respectively) was significantly associated with lifetime suicide attempts among lifetime suicidal ideators. The study is the first to look at the connexion between DNA damage and suicidal risk in bipolar patients. It is limited by the small sample size and lack of information on illicit substance use.

Conclusions: More severe DNA damage was significantly associated with lifetime suicide attempts among lifetime suicidal ideators in BD. However, the severity of depression was found to be independently associated with lifetime suicidal ideation per se rather than DNA damage in BD. Larger prospective studies are required to ascertain the potential of DNA damage as a biomarker for the transition from suicidal ideation to a suicide attempt.
Protective Factors Associated With Post-traumatic Outcomes in Individuals With Experiences of Psychosis
Authors: Campodonico Carolina , Berry Katherine , Haddock Gillian , Varese Filippo
Published: December 2021

Trauma and trauma-specific mental health difficulties (e.g., post-traumatic stress disorder) are highly prevalent in people with psychosis. However, not everyone develops post-traumatic symptoms, and some people even experience post-traumatic growth (PTG) following trauma. It is important to identify which protective factors are associated with less severe trauma symptoms and/or positive outcomes to inform the development and implementation of interventions fostering these variables. Eighty-five patients with experiences of psychosis took part in a cross-sectional study. They were administered questionnaires measuring exposure to traumatic events, symptoms of PTSD and complex PTSD and potential protective factors assumed to be associated with lower vulnerability for post-traumatic symptoms and higher post-traumatic growth (trait resilience, secure attachment, social support, adaptive coping, optimism, general self-efficacy). Multiple hierarchical regression showed that some of these protective factors, in particular optimism, were associated with lower post-traumatic symptoms, explaining 21% of the variance in complex PTSD symptoms and 16% of the variance in PTSD symptoms. However, the hypothesized protective factors, in particular resilience and adaptive coping, explained a considerably larger proportion of variance in PTG (44%). Our results suggest that whilst these variables provide only moderate protection from the vulnerability to experience post-traumatic stress, they may play an important role in allowing people to find meaning despite multiple traumas and subsequently lead more fulfilling lives. Therapies targeting the emotional and psychological consequences of trauma in people with psychosis might benefit from the integration of intervention strategies to enhance these additional psychological protective factors, which in turn may lead to positive treatment outcomes beyond the mere reduction of post-traumatic stress symptoms.
Age- and Sex-Related Cortical Gray Matter Volume Differences in Adolescent Cannabis Users: A Systematic Review and Meta-Analysis of Voxel-Based Morphometry Studies
Authors: Allick Aliyah , Park Grace , Kim Kwon , Vintimilla Michelle , Rathod Krutika , Lebo Rachael , Nanavati Julie , Hammond Christopher J.
Published: December 2021

Introduction: Adolescent-onset cannabis use is rising in the era of marijuana legalization. Recent imaging studies have identified neuroanatomical differences between adult cannabis users and controls that are more prominent in early-onset users. Other studies point to sex-dependent effects of cannabis.

Methods: A systematic review following PRISMA guidelines and subsequent effect-size seed-based d mapping (SDM) meta-analyses were conducted to investigate relationships between age (across the 12-to-21-year-old developmental window), sex, and gray matter volume (GMV) differences between cannabis using (CU) and typically developing (TD) youth.

Results: Our search identified 1,326 citations, 24 of which were included in a qualitative analysis. A total of 6 whole-brain voxel-based morphometry (VBM) studies comparing regional GMV between 357 CU [mean (SD) age = 16.68 (1.28); 71% male] and 404 TD [mean (SD) age = 16.77 (1.36); 63% male] youth were included in the SDM-meta-analysis. Meta-analysis of whole-brain VBM studies identified no regions showing significant GMV difference between CU and TD youth. Meta-regressions showed divergent effects of age and sex on cortical GMV differences in CU vs. TD youth. Age effects were seen in the superior temporal gyrus (STG), with older-aged CU youth showing decreased and younger-aged CU youth showing increased STG GMV compared to age-matched TD youth. Parallel findings in the STG were also observed in relation to duration of CU (years) in supplemental meta-regressions. Regarding sex effects, a higher proportion of females in studies was associated with increased GMV in the middle occipital gyrus in CU vs. TD youth.

Conclusions: These findings suggest that GMV differences between CU and TD youth, if present, are subtle, and may vary as a function of age, cumulative cannabis exposure, and sex in young people. Whether age- and sex-related GMV differences are attributable to common predispositional factors, cannabis-induced neuroadaptive changes, or both warrant further investigation.
A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden
Authors: Alexiou Eirini , Steingrimsson Steinn , Akerstrom Magnus , Jonsdottir Ingibjörg H. , Ahlstrom Linda , Finizia Caterina , Wijk Helle , Degl'Innocenti Alessio
Published: December 2021

Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures.

Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PHCWs at a university hospital in Sweden (n = 1,618) in September 2020. The response rate was 38% (566 of 1,507 eligible participants). Working environment survey responses collected in 2019 were used as pre-pandemic comparators. Statistical analyses were performed to assess overall impact over time on work demands, support, motivation, and recovery, stratified by professional role, and considering variables such as access to personal protective equipment.

Results: The percentage of individuals responding negatively to statements about working environment increased significantly for most items after the first wave. Similarly, the increase of five of the investigated factors indicated a more negative perception of recovery during the pandemic. Registered nurses reported a greater negative impact of the pandemic on perceived working conditions and ability to recover than other professional groups. PHCWs working with patients with COVID-19 (35%) who reported being worried about becoming infected (12%) or infecting others (17%), or lacking adequate personal protective equipment (22%) were more negatively impacted regarding work environment-related items than those who did not.

Conclusions: PHCWs' working environment and possibility for recovery were impacted by the first wave of the COVID-19 pandemic, nurses being most affected. Although psychiatric services do not directly care for patients with severe COVID-19 infection, the results from this study suggests that mental health services should also prepare for future pandemics.
Early Life Experiences Moderate the Relationship Between Genetic Risk of Autism and Current and Lifetime Mental Health
Authors: Shin Su Hyun , Wright Cheryl , Johnston Susan
Published: December 2021

Although individuals with autism are at greater risk of mental health challenges than others, we know little about the relationship between the mental health of older adults (50+) and autism because they are less likely to be diagnosed. Identifying the risk and protective factors that are associated with mental health can increase educational awareness, inform clinical practice, and provide information to help diagnose and treat older adults with autism. This study used longitudinal panel data of the 2008–2016 waves of the Health and Retirement Study. It estimated individual random-effect models by interacting a genetic propensity toward autism and early life experiences to test whether the latter has a moderating effect on the relationships between genetics and the Center for Epidemiologic Studies Depression (CES-D) score, self-reported depression, and history of psychiatric problems. Results suggest that individuals with a higher genetic propensity for autism are less likely to develop psychiatric problems if they report a positive maternal relationship early in life. Further, a combined effect of police encounters early in life and genetic risk for autism is associated with higher CES-D scores, increased odds of self-reported depression, and a history of psychiatric problems. Clinical applications of these findings include the need to establish and support high-quality relationships by addressing both child and caregiver needs. Further, these findings support the need to design and implement proactive interventions to teach police and autistic individuals how to successfully navigate these encounters.
Potential Transdiagnostic Lipid Mediators of Inflammatory Activity in Individuals With Serious Mental Illness
Authors: Hylén Ulrika , McGlinchey Aidan , Orešič Matej , Bejerot Susanne , Humble Mats B. , Särndahl Eva , Hyötyläinen Tuulia , Eklund Daniel
Published: December 2021

Mental disorders are heterogeneous and psychiatric comorbidities are common. Previous studies have suggested a link between inflammation and mental disorders. This link can manifest as increased levels of proinflammatory mediators in circulation and as signs of neuroinflammation. Furthermore, there is strong evidence that individuals suffering from psychiatric disorders have increased risk of developing metabolic comorbidities. Our group has previously shown that, in a cohort of low-functioning individuals with serious mental disorders, there is increased expression of genes associated with the NLRP3 inflammasome, a known sensor of metabolic perturbations, as well as increased levels of IL-1-family cytokines. In the current study, we set out to explore the interplay between disease-specific changes in lipid metabolism and known markers of inflammation. To this end, we performed mass spectrometry-based lipidomic analysis of plasma samples from low-functioning individuals with serious mental disorders (n = 39) and matched healthy controls (n = 39). By identifying non-spurious immune-lipid associations, we derived a partial correlation network of inflammatory markers and molecular lipids. We identified levels of lipids as being altered between individuals with serious mental disorders and controls, showing associations between lipids and inflammatory mediators, e.g., osteopontin and IL-1 receptor antagonist. These results indicate that, in low-functioning individuals with serious mental disorders, changes in specific lipids associate with immune mediators that are known to affect neuroinflammatory diseases.
Readability and Comprehension of Printed Patient Education Materials
Authors: Szabó Pálma , Bíró Éva , Kósa Karolina
Published: December 2021

Background: Health literacy, a recently determined construct plays an important role in how individuals are able to manage their health. A useful approach for the assessment of health literacy is to measure the comprehension of available patient education materials (PEMs).

Objective: We aimed at assessing the usefulness of PEMS available in Hungarian by testing comprehension of selected PEMs in different groups of users.

Methods: Comprehension of patient education materials in the domain of healthcare was tested by selecting PEMs and creating questions based on their text in 3 dimensions of health literacy: understand, process/appraise, apply/use. Twenty questions were created that could be answered without pre-existing knowledge by reading the appropriate text taken from PEMs. Comprehension was examined in four groups: laypersons, non-professional healthcare workers, 1st year healthcare students, and 5th year medical students. Readability indices were calculated for the same texts to which questions were created.

Results: Laypersons answered <50% of the PEMs-based questions correctly. Non-professional healthcare workers performed better with 57% of right answers but significantly worse than healthcare students or medical students. Those with at least high school qualification (maturity exam) showed significantly higher comprehension compared to those with lower educational attainment. Persons in good or very good health also had significantly better comprehension than those in less favorable health. All readability indices showed that comprehension of the tested PEMs required at least 10 years of schooling or more. Therefore, these PEMS are difficult to understand for persons with less than high school level of education.

Conclusion: Rephrasing of the investigated patient educational materials would be recommended so that they better fit the educational attainment of the Hungarian population. Evaluation of the readability and comprehensibility of other PEMs also seems warranted.
Telehealth to the Rescue During COVID-19: A Convergent Mixed Methods Study Investigating Patients' Perception
Authors: Al-Sharif Ghadah A. , Almulla Alia A. , AlMerashi Eman , Alqutami Reem , Almoosa Mohammad , Hegazi Mona Zakaria , Otaki Farah , Ho Samuel B.
Published: December 2021

Background: The onset of the pandemic necessitated abrupt transition to telehealth consultations. Although there is a few tools that gauge the patients' perception about their experiences, none of them are contextualized to an emergency in the Middle East and North Africa region. Accordingly, this study aims at developing and validating a tool to address this gap, and deploying it to assess the patients' perception of telehealth services during COVID-19 in Dubai, United Arab Emirates (UAE).

Methods: A convergent mixed methods design was adapted. A random selection of 100 patients from Dubai, UAE were invited to participate. Qualitative and quantitative datasets were collected using a tailor-made survey. The qualitative data, collected through open-ended questions, was analyzed using multi-staged thematic analysis. As for the quantitative data, it captured the patients' extent of satisfaction, and was assessed using SPSS (with a series of descriptive and inferential analyses). The qualitative and quantitative findings were then merged via joint display analysis.

Results: Out of the 100 patients that were randomly selected, 94 patients participated in this study. The reliability score of Cronbach's Alpha for the instrument was 98.9%. The percentage of the total average of satisfaction was 80.67%. The Principal Component Analysis showed that 88.1% of the variance can be explained by the instrument (p < 0.001). The qualitative data analysis expanded upon the quantitative findings enabling a better understanding of the patients' perception. Three themes, revolving around the quality of the patient telehealth experiences, surfaced: “Factors that worked to the benefit of the patients,” “Factors that the patients were not in favor of,” and “Opportunities for improvements as perceived by the patients.”

Discussion: This study introduced a novel patient satisfaction with telehealth consultation survey contextualized to the COVID-19 times in Dubai, UAE. The participants were quite satisfied with the quality of their experience, however they suggested areas for improvement. Regional healthcare decision-makers can leverage the identified advantages and opportunities for improvement of telehealth. This will enable making informed decisions regarding the continuity of telehealth irrespective of how matters unfold in relation to the pandemic. It will also better prepare the healthcare sector for potential resurgence(s) of COVID-19 and/or the occurrence of other similar emergencies.
SARS-CoV-2 Among Migrants Recently Arrived in Europe From Low- and Middle-Income Countries: Containment Strategies and Special Features of Management in Reception Centers
Authors: Fabris Silvia , d'Ettorre Gabriella , Spagnolello Ornella , Russo Alessandro , Lopalco Maurizio , D'Agostino Fausto , Vassalini Paolo , Celani Luigi , Aronica Raissa , Gabrielli Simona , d'Ettorre Gabriele , Angeletti Silvia , Mastroianni Claudio M. , Ciccozzi Massimo , Ceccarelli Giancarlo
Published: December 2021

Despite the “migrants and COVID-19” topic has been neglected since felt marginal concerning other aspects of the SARS-CoV-2 pandemic, it represents a relevant public health issue in the European countries. This report describes COVID-19 containment strategies adopted in a large Italian reception center hosting recently arrived asylum-seeker migrants. Risk assessment and prevention measures adopted were described. Geo-spatial epidemiological analysis of the outbreak was reported. Significant gaps in the knowledge of self-protection measures from contagious diseases and in the perception of the pandemic risk were observed in migrants; health promotion activities, targeted to remove cultural barriers and improve behaviors appropriate to individual protection, were able to fulfill this gap. In low-resource settings, especially in closed communities, the implementation of social distancing strategies, the systematic use of individual protection devices, and active syndromic surveillance are essential tools to limit the risk of outbreaks. In the event of an outbreak, it is relevant to rapidly activate containment procedures based on systematic screening, isolation, and quarantine, taking into consideration the limits of tracing contacts within a closed community. Not being able to trace certain contacts, the geo-spatial epidemiological analysis of cases distribution could be key in the management of the outbreak. Interestingly, positive cases identified in our facility were all clinically pauci-symptomatic or asymptomatic. Dedicated strategies are needed to minimize the chance of SARS-CoV-2 transmission in a limited space such as reception centers and a vulnerable population such as migrants.
Diabetes Prevention and Care Capacity at Urban Indian Health Organizations
Authors: Fort Meredith P. , Reid Margaret , Russell Jenn , Santos Cornelia J. , Running Bear Ursula , Begay Rene L. , Smith Savannah L. , Morrato Elaine H. , Manson Spero M.
Published: December 2021

American Indian and Alaska Native (AI/AN) people suffer a disproportionate burden of diabetes and cardiovascular disease. Urban Indian Health Organizations (UIHOs) are an important source of diabetes services for urban AI/AN people. Two evidence-based interventions—diabetes prevention (DP) and healthy heart (HH)–have been implemented and evaluated primarily in rural, reservation settings. This work examines the capacity, challenges and strengths of UIHOs in implementing diabetes programs.

Methods: We applied an original survey, supplemented with publicly-available data, to assess eight organizational capacity domains, strengths and challenges of UIHOs with respect to diabetes prevention and care. We summarized and compared (Fisher's and Kruskal-Wallis exact tests) items in each organizational capacity domain for DP and HH implementers vs. non-implementers and conducted a thematic analysis of strengths and challenges.

Results: Of the 33 UIHOs providing services in 2017, individuals from 30 sites (91% of UIHOs) replied to the survey. Eight UIHOs (27%) had participated in either DP (n = 6) or HH (n = 2). Implementers reported having more staff than non-implementers (117.0 vs. 53.5; p = 0.02). Implementers had larger budgets, ~$10 million of total revenue compared to $2.5 million for non-implementers (p = 0.01). UIHO strengths included: physical infrastructure, dedicated leadership and staff, and community relationships. Areas to strengthen included: staff training and retention, ensuring sufficient and consistent funding, and data infrastructure.

Conclusions: Strengthening UIHOs across organizational capacity domains will be important for implementing evidence-based diabetes interventions, increasing their uptake, and sustaining these interventions for AI/AN people living in urban areas of the U.S.
Reinforcing Collaboration and Harmonization to Unlock the Potentials of Advanced Therapy Medical Products: Future Efforts Are Awaited From Manufacturers and Decision-Makers
Authors: Qiu Tingting , Liang Shuyao , Wang Yitong , Dussart Claude , Borissov Borislav , Toumi Mondher
Published: December 2021

Some advanced therapy medicinal products (ATMPs) hold great promises for life-threatening diseases with high unmet needs. However, ATMPs are also associated with significant challenges in market access, which necessitates the joint efforts between all relevant stakeholders to navigate. In this review, we will elaborate on the importance of collaborations and harmonization across different stakeholders, to expedite the market access of promising ATMPs. Manufacturers of ATMPs should proactively establish collaborations with other stakeholders throughout the whole lifecycle of ATMPs, from early research to post-market activities. This covered engagements with (1) external developers (i.e., not-for-profit organizations and commercial players) to obtain complementary knowledge, technology, or infrastructures, (2) patient groups and healthcare providers to highlight their roles as active contributors, and (3) decision-makers, such as regulators, health technology assessment (HTA) agencies, and payers, to communicate the uncertainties in evidence package, where parallel consultation will be a powerful strategy. Harmonization between decision-makers is desired at (1) regulatory level, in terms of strengthening the international standardization of regulatory framework to minimize discrepancies in evidence requirements for market authorization, and (2) HTA level, in terms of enhancing alignments between regional and national HTA agencies to narrow inequity in patient access, and cross-border HTA cooperation to improve the quality and efficiency of HTA process. In conclusion, manufacturers and decision-makers shared the common goals to safeguard timely patient access to ATMPs. Collaboration and harmonization will be increasingly leveraged to enable the value delivery of ATMPs to all stakeholders.
A Framework of AI-Based Approaches to Improving eHealth Literacy and Combating Infodemic
Authors: Liu Tianming , Xiao Xiang
Published: December 2021

The global COVID-19 pandemic has put everyone in an urgent need of accessing and comprehending health information online. Meanwhile, there has been vast amount of information/misinformation/disinformation generated over the Internet, particularly social media platforms, resulting in an infodemic. This public health crisis of COVID-19 pandemic has put each individual and the entire society in a test: what is the level of eHealth literacy is needed to seek accurate health information from online resources and to combat infodemic during a pandemic? This article aims to summarize the significances and challenges of improving eHealth literacy in both communicable (e.g., COVID-19) and non-communicable diseases [e.g., cancer, Alzheimer's disease, and cardiovascular diseases (CVDs)]. Also, this article will make our recommendations of a general framework of AI-based approaches to improving eHealth literacy and combating infodemic, including AI-augmented lifelong learning, AI-assisted translation, simplification, and summarization, and AI-based content filtering. This general framework of AI-based approaches to improving eHealth literacy and combating infodemic has the general advantage of matching the right online health information to the right people.