Subjective evaluation of home environment and levels of self-reported depression in middle to old age: Results from the HCHS study.

OBJECTIVES: The immediate living environment might, like other lifestyle factors, be significantly related to mental well-being. The current study addresses the question whether five relevant subjective home environment variables (i.e., protection from disturbing nightlight, daylight entering the home, safety at home, quality of window views, and noise disturbance) are associated with levels of self-reported depression over and above well-known sociodemographic and common lifestyle variables. METHODS: Data from the Hamburg City Health Study (HCHS) were analyzed. In N = 8757 with available PHQ-9 depression data, multiple linear regression models were computed, with demographic data, lifestyle variables, and variables describing the subjective evaluation of the home environment. RESULTS: The model explained 15% of variance in depression levels, with ratings for the subjective evaluation of home environment accounting for 6%. Better protection from disturbing light at night, more daylight entering the home, feeling safer, and perceived quality of the window views, were all significantly associated with lower, while more annoyance by noise was associated with higher levels of self-reported depression. Results did not differ if examining a sample of the youngest (middle-aged participants: 46-50 years) versus oldest (70-78 years) participants within HCHS. CONCLUSION: Beyond studying the role of lifestyle factors related to self-reported depression, people's homes may be important for subclinical levels of depression in middle and older age, albeit the direction of effects or causality cannot be inferred from the present study. The development of a consensus and tools for a standardized home environment assessment is needed.

My home-my castle? Self-reported anxiety varies in relation to the subjective evaluation of home environment.

Introduction: Although people spend most of the day in their home environment, the focus of research in environmental psychology to date has been on factors outside the home. However, it stands to reason that indoor quality likewise has an impact on psychological well-being. Therefore, the present study addresses the question of whether the subjective evaluation of home environmental parameters are related to self-reported anxiety and whether they can additionally explain variance beyond the usual sociodemographic and general lifestyle variables. Methods: Data from the Hamburg City Health Study (first 10,000 participants) was analyzed. A subsample of N = 8,886 with available GAD-7 anxiety data was selected, and hierarchical regression models were computed, with demographic data entered first, followed by variables concerning lifestyle/habits and finally variables of the subjective evaluation of home environment. Results: Using the integrated model, we were able to explain about 13% of the variance in self-reported anxiety scores. This included both the demographic, lifestyle, and subjective evaluation of home environment variables. Protection from disturbing night lights, a greater sense of security, less disturbing noises, brighter accommodations, and a satisfactory window view explained almost 6% of the variance and was significantly associated with lower anxiety scores. Conclusion: The home as a place of refuge plays an increasingly important role as home office hours rise. It is therefore crucial to identify domestic factors contributing to people's mental well-being. The subjective evaluation of one's home environment has proven influential over and above modifiable lifestyle variables.

Spend time outdoors for your brain - an in-depth longitudinal MRI study.

OBJECTIVES: The effects of nature on physical and mental health are an emerging topic in empirical research with increasing influence on practical health recommendations. Here we set out to investigate the association between spending time outdoors and brain structural plasticity in conjunctions with self-reported affect. METHODS: We established the Day2day study, which includes an unprecedented in-depth assessment of variability of brain structure in a serial sequence of 40-50 structural magnetic resonance imaging (MRI) acquisitions of each of six young healthy participants for 6-8 months (n = 281 MRI scans in total). RESULTS: A whole-brain analysis revealed that time spent outdoors was positively associated with grey matter volume in the right dorsolateral prefrontal cortex and positive affect, also after controlling for physical activity, fluid intake, free time, and hours of sunshine. CONCLUSIONS: Results indicate remarkable and potentially behaviorally relevant plasticity of cerebral structure within a short time frame driven by the daily time spent outdoors. This is compatible with anecdotal evidence of the health and mood-promoting effects of going for a walk. The study may provide the first evidence for underlying cerebral mechanisms of so-called green prescriptions with possible consequences for future interventions in mental disorders.

Is Ejaculation Frequency in Men Related to General and Mental Health? Looking Back and Looking Forward.

Despite its relevance for human sexuality, literature on potential effects of ejaculation frequency and masturbation on general and mental health outcomes is sparse. Reasons for this knowledge gap include a general lack of interest, but also methodological challenges and still existing superstition. This paper reconciles literature from various fields to extract relevant information on how ejaculation frequency effects general and mental health outcomes. Culture-bound syndromes have been reported in countries still strictly tabooing or condemning masturbation. Masturbatory guilt describes a phenomenon in individuals experiencing a discrepancy between moral standards and own behavior with respect to masturbation. Abstinence is one aspect under study in the area of fertility treatment. Specific time frames and their respective implications on quality of sperm remain inconclusive. Limited temporal resolution capacities hamper the precise study of brain structures directly activated during ejaculation. The relation between ejaculation frequency and hormonal influences remains poorly understood. Future research that specifically addresses ejaculation frequency and potential mental and general health outcomes is needed. In contrast to extracting knowledge as a byproduct from other studies with a different focus, this enables sound study designs and could provide evidence-based results which could then be further discussed and interpreted.

Lifestyle Variables Do Not Predict Subjective Memory Performance Over and Above Depression and Anxiety.

The diagnostic value of subjective cognitive complaints for cognitive functioning in a clinical setting remains unresolved today. However, consensus exists on the relation between subjective cognitive complaints (SCC) and mood variables such as anxiety and depression. Hence, SCC have also been discussed as potential proxies of psychopathology rather than representing cognitive functioning. In order to shed more light on yet still unexplained variance in subjective cognitive complaints, the relation between lifestyle variables (such as nutrition habits, exercise, alcohol consumption, smoking, quality of sleep, and Body Mass Index) and subjective complaints of selective attention as well as subjective memory performance were assessed, additionally to the influence of objective memory performance, measures of anxiety, and depression. A sample of 877 (554 women) healthy, middle-aged individuals (51 years on average, age range 35-65) was assessed in the present study. In a logistic regression framework results revealed that the effect of lifestyle variables on subjective complaints of selective attention as well as subjective memory performance was rendered non-significant. Instead, subjective complaints of selective attention and subjective memory performance were significantly determined by measures of both, anxiety and depression. One unit increase in anxiety or depression led to an increase of 6 or 15% in subjective memory performance complaints, respectively. For subjective complaints of selective attention, a one unit increase in anxiety or depression led to an increase of 11 or 26%, respectively. The strong relation between SCC and measures of depression and anxiety corroborates the notion of SCC being indicative of mental health and general well-being.

Predicting change trajectories of neuroticism from baseline brain structure using whole brain analyses and latent growth curve models in adolescents.

Adolescence is a vulnerable time for personality development. Especially neuroticism with its link to the development of psychopathology is of interest concerning influential factors. The present study exploratorily investigates neuroanatomical signatures for developmental trajectories of neuroticism based on a voxel-wise whole-brain structural equation modelling framework. In 1,814 healthy adolescents of the IMAGEN sample, the NEO-FFI was acquired at three measurement occasions across five years. Based on a partial measurement invariance second-order latent growth curve model we conducted whole-brain analyses on structural MRI data at age 14 years, predicting change in neuroticism over time. We observed that a reduced volume in the pituitary gland was associated with the slope of neuroticism over time. However, no relations with prefrontal areas emerged. Both findings are discussed against the background of possible genetic and social influences that may account for this result.

Effects of computer gaming on cognition, brain structure, and function: a critical reflection on existing literature
.

Video gaming as a popular form of leisure activity and its effect on cognition, brain function, and structure has come into focus in the field of neuroscience. Visuospatial cognition and attention seem to benefit the most, whereas for executive functions, memory, and general cognition, the results are contradictory. The particular characteristics of video games driving these effects remain poorly understood. We critically discuss major challenges for the existing research, namely, the lack of precise definitions of video gaming, the lack of distinct choice of cognitive ability under study, and the lack of standardized study protocols. Less research exists on neural changes in addition to cognitive changes due to video gaming. Existing studies reveal evidence for the involvement of similar brain regions in functional and structural changes. There seems to be a predominance in the hippocampal, prefrontal, and parietal brain regions; however, studies differ immensely, which makes a meta-analytic interpretation vulnerable. We conclude that theoretical work is urgently needed.
.

El efecto de los videojuegos -una forma popular de entretención- sobre la cognición y la estructura y el funcionamiento cerebral se ha centrado en el campo de la neurociencia. La cognición visoespacial y la atención parecen ser las más beneficiadas; en cambio, para las funciones ejecutivas, la memoria y la cognición general, los resultados son contradictorios. Las características específicas de los videojuegos que producen estos efectos siguen siendo poco conocidas. Se discuten de forma crítica los principales desafíos para la investigación existente, como la falta de definiciones precisas de los videojuegos, la falta de una elección clara de la capacidad cognitiva que se estudia y la falta de protocolos de estudio estandarizados. La investigación es pobre tanto para los cambios cognitivos como para los cambios neuronales que producen los videojuegos. Los estudios existentes revelan evidencia de la participación de regiones cerebrales similares para los cambios funcionales y estructurales. Aunque las regiones cerebrales hipocámpicas, prefrontales y parietales parecen estar más involucradas; los estudios difieren enormemente, lo que hace que una interpretación meta-analítica sea frágil. Se concluye que se requiere con urgencia de un adecuado trabajo teórico.

Les jeux vidéo, loisir populaire, ont attiré l'intérêt des neurosciences quant à leurs effets sur la cognition, la structure et la fonction cérébrales. Si l'attention et la cognition visuospatiales semblent en bénéficier le plus, les résultats sont contradictoires pour les fonctions exécutives, la mémoire et la cognition générale. Les caractéristiques particulières des jeux vidéo à l'origine de ces effets restent mal comprises. Nous analysons de façon critique les principales difficultés pour la recherche actuelle, c'est-à-dire le manque de définitions précises du jeu vidéo, le manque de choix clair de capacité cognitive à l'étude et le manque de protocoles d'étude standardisés. Les modifications neuronales et les modifications cognitives dues au jeu vidéo font l'objet de peu de recherche. L'hippocampe, les régions préfrontale et pariétale semblent les plus concernées. Cependant, une interprétation méta-analytique est fragilisée par la grande variabilité des études. En conclusion, il est urgent de faire un travail théorique.

Patient safety in the care of mentally ill people in Switzerland: Action plan 2016 / Patientensicherheit in der Versorgung psychisch erkrankter Menschen in der Schweiz: Aktionsplan 2016

Background: Patient safety in mental healthcare has not attracted great attention yet, although the burden and the prevalence of mental diseases are high. The risk of errors with potential for harm of patients, such as aggression against self and others or non-drug treatment errors is particularly high in this vulnerable group. Aim: To develop priority topics and strategies for action to foster patient safety in mental healthcare. Method: The Swiss patient safety foundation together with experts conducted round table discussions and a Delphi questionnaire to define topics along the treatment pathway, and to prioritise these topics. Finally, fields of action were developed. Results: An action plan was developed including the definition and prioritization of 9 topics where errors may occur. A global rating task revealed errors concerning diagnostics and structural errors as most important. This led to the development of 4 fields of action (awareness raising, research, implementation, and education and training) including practice-oriented potential starting points to enhance patient safety. Conclusions: The action plan highlights issues of high concern for patient safety in mental healthcare. It serves as a starting point for the development of strategies for action as well as of concrete activities.

Patient safety climate profiles across time: Strength and level of safety climate associated with a quality improvement program in Switzerland-A cross-sectional survey study.

Safety Climate has been acknowledged as an unspecific factor influencing patient safety. However, studies rarely provide in-depth analysis of climate data. As a helpful approach, the concept of "climate strength" has been proposed. In the present study we tested the hypotheses that even if safety climate remains stable on mean-level across time, differences might be evident in strength or shape. The data of two hospitals participating in a large national quality improvement program were analysed for differences in climate profiles at two measurement occasions. We analysed differences on mean-level, differences in percent problematic response, agreement within groups, and frequency histograms in two large hospitals in Switzerland at two measurement occasions (2013 and 2015) applying the Safety Climate Survey. In total, survey responses of 1193 individuals were included in the analyses. Overall, small but significant differences on mean-level of safety climate emerged for some subgroups. Also, although agreement was strong at both time-points within groups, tendencies of divergence or consensus were present in both hospitals. Depending on subgroup and analyses chosen, differences were more or less pronounced. The present study illustrated that taking several measures into account and describing safety climate from different perspectives is necessary in order to fully understand differences and trends within groups and to develop interventions addressing the needs of different groups more precisely.

Patient safety priorities in mental healthcare in Switzerland: a modified Delphi study.

OBJECTIVE: Identifying patient safety priorities in mental healthcare is an emerging issue. A variety of aspects of patient safety in medical care apply for patient safety in mental care as well. However, specific aspects may be different as a consequence of special characteristics of patients, setting and treatment. The aim of the present study was to combine knowledge from the field and research and bundle existing initiatives and projects to define patient safety priorities in mental healthcare in Switzerland. The present study draws on national expert panels, namely, round-table discussion and modified Delphi consensus method. DESIGN: As preparation for the modified Delphi questionnaire, two round-table discussions and one semistructured questionnaire were conducted. Preparative work was conducted between May 2015 and October 2015. The modified Delphi was conducted to gauge experts' opinion on priorities in patient safety in mental healthcare in Switzerland. In two independent rating rounds, experts made private ratings. The modified Delphi was conducted in winter 2015. RESULTS: Nine topics were defined along the treatment pathway: diagnostic errors, non-drug treatment errors, medication errors, errors related to coercive measures, errors related to aggression management against self and others, errors in treatment of suicidal patients, communication errors, errors at interfaces of care and structural errors. CONCLUSIONS: Patient safety is considered as an important topic of quality in mental healthcare among experts, but it has been seriously neglected up until now. Activities in research and in practice are needed. Structural errors and diagnostics were given highest priority. From the topics identified, some are overlapping with important aspects of patient safety in medical care; however, some core aspects are unique.

Effect of a two-year national quality improvement program on surgical checklist implementation.

Use of the surgical checklist in Switzerland is still incomplete and unsatisfactory. A national improvement program was developed and conducted in Switzerland to implement and improve the use of the surgical safety checklists. The aims of the implementation program were to implement comprehensive and correct checklist use in participating hospitals in every patient and in every surgical procedure; and to improve safety climate and teamwork as important cultural context variables. 10 hospitals were selected for participation in the implementation program. A questionnaire assessing use, knowledge, and attitudes towards the checklist and the Safety Climate Survey were conducted at two measurement occasions each in October/November 2013 and January/February 2015. Significant increases emerged for frequency of checklist use (F(1,1001)=340.9, p<0.001), satisfaction (F(1,1232)=25.6, p<0.001), and knowledge(F(1,1294)=184.5, p<0.001). While significant differences in norms (F(1,1284)=17.9, p<0.001) and intentions (F(1,1284)=7.8, p<0.01) were observed, this was not the case for attitudes (F(1,1283)=.8, n.s.) and acceptance (F(1,1284)=0.1, n.s.). Significant differences for safety climate and teamwork emerged in the present study (F(1,3555)=11.8, p<0.001 and F(1,3554)=24.6, p<0.001, respectively). However, although statistical significance was reached, effects are very small and practical relevance is thus questionable. The results of the present study suggest that the quality improvement program conducted by the Swiss Patient Safety Foundation in 10 hospitals led to successful checklist implementation. The strongest effects were seen in aspects concerning behaviour and knowledge specifically related to checklist use. Less impact was achieved on general cultural variables safety climate and teamwork. However, as a trend was observable, these variables may simply need more time in order to change substantially.

Using the theory of planned behaviour to model antecedents of surgical checklist use: a cross-sectional study.

BACKGROUND: Compliance with surgical checklist use remains an obstacle in the context of checklist implementation programs. The theory of planned behaviour was applied to analyse attitudes, perceived behaviour control, and norms as psychological antecedents of individuals' intentions to use the checklist. METHODS: A cross-sectional survey study with staff (N = 866) of 10 Swiss hospitals was conducted in German and French. Group mean differences between individuals with and without managerial function were computed. Structural equation modelling and confirmatory factor analysis was applied to investigate the structural relation between attitudes, perceived behaviour control, norms, and intentions. RESULTS: Significant mean differences in favour of individuals with managerial function emerged for norms, perceived behavioural control, and intentions, but not for attitudes. Attitudes and perceived behavioural control had a significant direct effect on intentions whereas norms had not. CONCLUSIONS: Individuals with managerial function exhibit stronger perceived behavioural control, stronger norms, and stronger intentions. This could be applied in facilitating checklist implementation. The structural model of the theory of planned behaviour remains stable across groups, indicating a valid model to describe antecedents of intentions in the context of surgical checklist implementation.

[How patient safety programmes can be successfully implemented - an example from Switzerland]. / Wie kann die Implementierung von Patientensicherheitsprogrammen gelingen? Ein Beispiel aus der Schweiz.

Internationally, the implementation of patient safety programmes poses a major challenge. In the first part, we will demonstrate that various measures have been found to be effective in the literature but that they often do not reach the patient because their implementation proves difficult. Difficulties arise from both the complexity of the interventions themselves and from different organisational settings in individual hospitals. The second part specifically describes the implementation of patient safety improvement programmes in Switzerland and discusses measures intended to bridge the gap between the theory and practice of implementation in Switzerland. Then, the national pilot programme to improve patient safety in surgery is presented, which was launched by the federal Swiss government and has been implemented by the patient safety foundation. Procedures, challenges and highlights in implementing the programme in Switzerland on a national level are outlined. Finally, first (preliminary) results are presented and critically discussed.

Safety climate in Swiss hospital units: Swiss version of the Safety Climate Survey.

RATIONALE, AIMS AND OBJECTIVES: Safety climate measurements are a broadly used element of improvement initiatives. In order to provide a sound and easy-to-administer instrument for the use in Swiss hospitals, we translated the Safety Climate Survey into German and French. METHODS: After translating the Safety Climate Survey into French and German, a cross-sectional survey study was conducted with health care professionals (HCPs) in operating room (OR) teams and on OR-related wards in 10 Swiss hospitals. Validity of the instrument was examined by means of Cronbach's alpha and missing rates of the single items. Item-descriptive statistics group differences and percentage of 'problematic responses' (PPR) were calculated. RESULTS: 3153 HCPs completed the survey (response rate: 63.4%). 1308 individuals were excluded from the analyses because of a profession other than doctor or nurse or invalid answers (n = 1845; nurses = 1321, doctors = 523). Internal consistency of the translated Safety Climate Survey was good (Cronbach's alpha German = 0.86; Cronbach's alpha French = 0.84). Missing rates at item level were rather low (0.23-4.3%). We found significant group differences in safety climate values regarding profession, managerial function, work area and time spent in direct patient care. At item level, 14 out of 21 items showed a PPR higher than 10%. CONCLUSIONS: Results indicate that the French and German translations of the Safety Climate Survey might be a useful measurement instrument for safety climate in Swiss hospital units. Analyses at item level allow for differentiating facets of safety climate into more positive and critical safety climate aspects.

Frequency of use and knowledge of the WHO-surgical checklist in Swiss hospitals: a cross-sectional online survey.

BACKGROUND: The WHO-surgical checklist is strongly recommended as a highly effective yet economically simple intervention to improve patient safety. Its use and potentially influential factors were investigated as little data exist on the current situation in Switzerland. METHODS: A cross-sectional online survey with members (N = 1378) of three Swiss professional associations of invasive health care professionals was conducted in German, French, and Italian. The survey assessed use of, knowledge of and satisfaction with the WHO-surgical checklist. T-Tests and ANOVA were conducted to test for differences between professional groups. Bivariate correlations were computed to test for associations between measures of knowledge and satisfaction. RESULTS: 1090 (79.1%) reported the use of a surgical checklist. 346 (25.1%) use the WHO-checklist, 532 (38.6%) use the Swiss Patient Safety Foundation recommendations to avoid Wrong Site Surgery, and 212 (15.7%) reported the use of other checklists. Satisfaction with checklist use was generally high (doctors: 71.9% satisfied, nurses: 60.8% satisfied) and knowledge was moderate depending on the use of the WHO-checklist. No association between measures of subjective and objective knowledge was found. CONCLUSIONS: Implementation of a surgical checklist remains an important task for health care institutions in Switzerland. Although checklist use is present in Switzerland on a regular basis, a substantial group of health care personnel still do not use a checklist as a routine. Influential factors and the associations among themselves need to be addressed in future studies in more detail.

Anger expression in Swiss adolescents: establishing measurement invariance across gender in the AX scales.

The present study examined measurement invariance in the three anger expression subscales of the STAXI (Spielberger, 1988) with respect to gender. In a sample of 576 male and 531 female students, strict measurement invariance was found. For all three anger expression factors, no differences in variances or factor correlations were found. A large negative relation between Anger-Out and Anger-Control emerged. Girls reported significantly lower levels in Anger-Out and Anger-Control than boys. Results suggest that the questionnaire functions the same way across gender. Also, boys and girls exhibited the same range of interindividual differences in anger expression. The negative relation between Anger-Out and Anger-Control suggests that high levels of Anger-Out might be an obstacle in controlling anger. Lower levels of Anger-Out and -Control in girls suggest that girls might need less control because they express anger less outwardly.

Age-related differences in typical intellectual engagement between young and old adults.

UNLABELLED: BACKGROUND/STUDY CONTEXT: Typical intellectual engagement has been postulated as a trait-like construct that can explain interindividual differences in the extent of engaging in cognitively challenging tasks. Although formulated within the framework of cognitive development, the developmental aspects of typical intellectual engagement itself have not been studied yet. METHODS: Three hundred thirty-four participants from the Zurich Longitudinal Study on Cognitive Aging (73 years on average, ranging from 60 to 85) and 468 graduate students (21 years on average, ranging from 18 to 25) were administered a self-rating scale on typical intellectual engagement. Structural equation modeling was used to study differences in factor means, differences in factor variances, and differences in factor covariances between the two groups. RESULTS: Significant mean-level differences between age groups exhibit both decline and increase in old age. An increase in factor variances was shown in the old. Factor correlations were higher in old age compared to young adults. CONCLUSION: Both higher and lower mean levels in the old group imply that typical intellectual engagement is a variable that contributes incremental information compared to well-known measures of basic personality traits. Larger variances in the old imply greater heterogeneity in the old sample, which fits into literature on fan-spread phenomenon. Higher factor covariances in the old imply dedifferentiation of typical intellectual engagement in the old.