Effects of ICU diaries on psychological disorders and sleep quality in critically ill patients and their family members: A systematic review and meta-analysis.

BACKGROUND: The psychological health and sleep quality of intensive care unit (ICU) patients and their families have health implications, and greater attention should be devoted to developing effective interventions to address these concerns. Due to an increasing amount of evidence on ICU diary interventions, their comparative effectiveness should be evaluated. AIMS: This systematic review and meta-analysis aimed to evaluate the effect of ICU diaries on psychological disorders and sleep quality in critically ill patients and on psychological disorders in their family members. METHODS: The PubMed, Embase, Web of Science, Cochrane Library, China Biomedical Literature Database, China National Knowledge Network, Wanfang Database, and Weipu Chinese Journal databases were searched up to November 2023 to identify randomized controlled trials. We used the Cochrane Risk of Bias Tool for quality assessment, and we used Review Manager 5.4 software to conduct meta-analysis. RESULTS: Eleven studies with a total of 1682 patients met the inclusion criteria. PATIENTS: PTSD (7 studies, 1015 patients): OR 0.63 (95%CI 0.45-0.87), p = 0.005; Anxiety (6 studies, 546 patients): OR 0.52 (95%CI 0.22-1.27), p = 0.15; Depression (6 studies, 546 patients): OR 0.62 (95%CI 0.39-0.97), p = 0.04; sleep quality (2 studies, 203 patients): OR -3.97 (95%CI -7.71-0.23), p = 0.04. Family members: PTSD (2 studies, 652 patients): OR 0.81 (95%CI 0.37-1.79), p = 0.60; Anxiety (2 studies, 650 family members): OR 1.09 (95%CI 0.79-1.49), p = 0.62; Depression (2 studies, 650 patients): OR 1.03 (95%CI 0.71-1.50), p = 0.87. The pooled results of the meta-analysis showed that ICU diaries reduced the incidence of depression and post-traumatic stress disorder and improved sleep quality in patients, but had no significant effects on patients' anxiety status or family members' psychological disorders. Three of the included studies had a high quality, and the remaining eight studies had a moderate quality. CONCLUSIONS: For patients, ICU diaries can improve their depression and post-traumatic stress disorder, improve sleep quality, but has no significant effect on anxiety; For family members, ICU diaries were not significant. Due to the existence of bias and the limited sample size, the results should be interpreted with caution. Researchers need to further elucidate the multidisciplinary collaborative process of diary-based treatment in ICUs and its impact on psychological disorders in family members. Furthermore, large-scale, multicentre, robust studies should be conducted in the future.

Better together: A systematic review of studies combining magnetic resonance imaging with ecological momentary assessment.

Social neuroscientists often use magnetic resonance imaging (MRI) to understand the relationship between social experiences and their neural substrates. Although MRI is a powerful method, it has several limitations in the study of social experiences, first and foremost its low ecological validity. To address this limitation, researchers have conducted multimethod studies combining MRI with Ecological Momentary Assessment (EMA). However, there are no existing recommendations for best practices for conducting and reporting such studies. To address the absence of standards in the field, we conducted a systematic review of papers that combined the methods. A systematic search of peer-reviewed papers resulted in a pool of 11,558 articles. Inclusion criteria were studies in which participants completed (a) Structural or functional MRI and (b) an EMA protocol that included self-report. Seventy-one papers met inclusion criteria. The following review compares these studies based on several key parameters (e.g., sample size) with the aim of determining feasibility and current standards for design and reporting in the field. The review concludes with recommendations for future research. A special focus is given to the ways in which the two methods were combined analytically and suggestions for novel computational methods that could further advance the field of social neuroscience.

Alcohol Use Predicts Longer But More Fragmented Sleep: A Daily Diary Study of Alcohol, Sleep, and PTSD in Nurses.

BACKGROUND: Due to the demanding nature of their profession, nurses are at risk of experiencing irregular sleep patterns, substance use, and fatigue. Evidence supports a reciprocal relationship between alcohol use and sleep disturbances; however, no research has examined such a link in a sample of nurses. One factor that may further impact the dynamic between alcohol and sleep patterns is posttraumatic stress disorder (PTSD) symptoms. We investigated the daily bidirectional associations between alcohol use and several sleep domains (i.e., self-report and actigraphy-determined sleep), and moderation by baseline PTSD symptom severity. METHOD: Over a 14-day period, 392 nurses (92% female; 78% White) completed sleep diaries and actigraphy to assess alcohol use and sleep patterns. Within-person bidirectional associations between alcohol and sleep were examined using multilevel models, with symptoms of PTSD as a cross-level moderator. RESULTS: Daily alcohol use (i.e., ≥ 1 alcoholic beverage; 25.76%) was associated with shorter self-reported sleep onset latency (b = -4.21, p = .003) but longer self-reported wake after sleep onset (b = 2.36, p = .009). Additionally, days with any alcohol use were associated with longer self-reported sleep duration (b = 15.60, p = .006) and actigraphy-determined sleep duration (b = 10.06, p = .037). No sleep variables were associated with next-day alcohol use. Bidirectional associations between alcohol consumption and sleep were similar regardless of baseline PTSD symptoms. CONCLUSION: Our results suggested that on days when nurses drank alcohol, they experienced longer but also more fragmented sleep.

Assessment of Nutritional Intake in Patients With Kidney Failure Treated by Haemodialysis on Dialysis and Non-dialysis Days.

INTRODUCTION/AIMS/OBJECTIVE: Inadequate nutritional intake in haemodialysis (HD) patients increases the risk of muscle wasting, nutrient deficiencies, leading to an increased risk of additional morbidity and mortality. We aimed to assess nutritional intake on the dialysis day and nondialysis day (NDD) of patients established on HD. METHODS: We employed a 2-day dietary record, one on the day of dialysis and one on the NDD, and then determined nutritional intake using the Nutritics software. Muscle strength was assessed by hand grip strength, and the body composition was determined using multifrequency bioelectrical impedance recorded postdialysis. RESULTS: We recruited 51 established HD patients dialysing between May 2022 and July 2022, of mean age 60 ± 15 years, 52.9% male, and 51% diabetic. Only 25% achieved the calorie and protein intake recommended by Kidney Disease Outcomes Quality Initiative. Most patients had inadequate consumption of fiber (96%), calcium (86%), iron (80%), zinc (82%), selenium (92%), folate (82%), vitamin A (88%), and (100%) vitamin D. On the other hand, the great majority followed the restriction guidelines for potassium (96%), phosphorus (86%), and sodium (84%), respectively. However, consumption was greater for potassium (P = .007), phosphorus (P = .015), and zinc (P = .032) on NDDs versus dialysis days, but there was no difference in protein or calorie intake between days. CONCLUSION: Our results suggest that many of our HD patients do not achieve the recommended nutritional targets. Patient compliance with restricting sodium, potassium, and phosphate limits protein and calorie intake. HD patients are at increased risk of sarcopenia, so failure to achieve dietary protein intake will further increase this risk.

Development of a Novel Prediction Tool for Response to First-Line Treatments of Monosymptomatic Nocturnal Enuresis: A Randomized, Controlled, International, Multicenter Study (DRYCHILD).

PURPOSE: Nocturnal urine volume and bladder reservoir function are key pathogenic factors behind monosymptomatic nocturnal enuresis (MNE). We investigated the predictive value of these together with other demographic and clinical variables for response to first-line treatments in children with MNE. MATERIALS AND METHODS: A randomized, controlled, international, multicenter study was conducted in 324 treatment-naïve children (6-14 years old) with primary MNE. The children were randomized to treatment with or without prior consideration of voiding diaries. In the group where treatment choice was based on voiding diaries, children with nocturnal polyuria and normal maximum voided volume (MVV) received desmopressin (dDAVP) treatment, and children with reduced MVV and no nocturnal polyuria received an enuresis alarm. In the other group, treatment with dDAVP or alarm was randomly allocated. RESULTS: A total of 281 children (72% males) were qualified for statistical analysis. The change of responding to treatment was 21% higher in children where treatment was individualized compared to children where treatment was randomly selected (risk ratio = 1.21 [1.02-1.45], P = .032). In children with reduced MVV and no nocturnal polyuria (35% of all children), individualized treatment was associated with a 46% improvement in response compared to random treatment selection (risk ratio = 1.46 [1.14-1.87], P = .003). Furthermore, we developed a clinically relevant prediction model for response to dDAVP treatment (receiver operating characteristic curve 0.85). CONCLUSIONS: The present study demonstrates that treatment selection based on voiding diaries improves response to first-line treatment, particularly in specific subtypes. Information from voiding diaries together with clinical and demographic information provides the basis for predicting response. CLINICAL TRIAL REGISTRATION NO.: NCT03389412.

Associations Between Multiple Dimensions of Sleep and Mood During Early Adolescence: A Longitudinal Daily Diary Study.

Prior research has observed reciprocal associations between sleep and mood. However, these findings are primarily based on the examination of one or two aspects of sleep behaviors (e.g., duration, quality), neglecting how multiple dimensions of sleep (particularly indicators pertinent to adolescence, e.g., sleep variability) are linked to adolescent mood both daily and longitudinally. Drawing on a multidimensional framework for sleep, this study addressed the knowledge gap by examining the directionality of and differential effects for associations between multiple dimensions of sleep and mood during early adolescence. Participants were 273 Chinese early adolescents (34.39% girls; Mage = 11.57, SD = 1.31), who filled out a pre-survey on demographics (T1) and 7-day diaries on sleep (i.e., duration, quality, disturbance, and latency) and mood (i.e., positive and negative mood). Adolescents completed another wave of diary reports 1 year later (T2). Findings revealed both bidirectional and unidirectional, within-person effects depending on specific sleep parameters, suggesting differential associations between multiple dimensions of sleep and mood. Specifically, on days when adolescents had longer sleep latency and greater disturbance than usual, they reported higher negative mood the next day, whereas higher negative mood was linked to poorer sleep quality the next day. The longitudinal investigation found that greater variability in sleep quality at T1 was associated with higher negative mood at T2. These findings underscore the importance of understanding the complex interplay between sleep and mood by examining the directionality of and differential effects for the daily and longer-term associations between multiple dimensions of sleep and mood among early adolescents.

Age-related changes in ventrolateral prefrontal cortex activation are associated with daily prosocial behaviors two years later.

As adolescents acquire agency and become contributing members of society, it is necessary to understand how they help their community. Yet, it is unknown how prosocial behavior develops in the context of community-based prosocial behaviors that are relevant to adolescents, such as donating time to charities. In this longitudinal functional magnetic resonance imaging study, adolescents (N=172; mean age at wave 1=12.8) completed a prosocial task annually for three years (N=422 and 375 total behavioral and neural data points, respectively), and 14 days of daily diaries reporting on their prosocial behaviors two years later. During the task, adolescents decided how many minutes they would donate to a variety of local charities. We found that adolescents donated less time to charities from early to mid adolescence. Longitudinal whole-brain analyses revealed declines in ventrolateral prefrontal cortex (vlPFC) activation, as well as inverted U-shaped changes in precuneus activation when adolescents donated their time from early to mid adolescence. A less steep decrease in vlPFC activation predicted greater real-life prosocial behaviors in youth's daily lives two years later. Our study elucidates the neurodevelopmental mechanisms of prosocial behavior from early to mid adolescence that have enduring effects on daily prosocial behaviors in late adolescence.

Does Dietary Intake Differ in Kidney Failure Patients With Sarcopenia and Frailty Treated by Hemodialysis.

Background: Inadequate nutrition is common for both sarcopenia and frailty. We investigated whether hemodialysis patients with sarcopenia and frailty have reduced dietary intakes. Methods: Dietary intake, and physical activity were analyzed, along with body composition and relevant clinical data. Results: We studied 51 hemodialysis patients; 52.9% male, age 60 ± 15 years; 33.3% sarcopenic, and 72.5% frail. Dietary protein and calories were similar for sarcopenic and non-sarcopenic patients 0.68 (0.38-3.5) vs. 0.68 (0.18-2.9) g protein/kg/day and 19.2 (8.2-77.5) vs. 15.2 (6.2-38.5) kcal/kg/day. More sarcopenic patients had low physical activity (88.2% vs. 58.8%, X2 4.6, p = .03). Frail and non-frail patients had similar intakes 0.67 (0.28-3.5) versus 0.83 (0.18-1.6) g protein/kg/day and 15.5 (8.1-77.5) vs. 18.8 (6.2-45.4) kcal/kg/day. Sarcopenia was associated with age [Odds ratio (OR) 1.09, 95% confidence interval (CI) [1.02, 1.18], p = .017], body mass index [OR 0.84, 95% CI [0.71, 0.99], p = .042] and lack of exercise [OR 7.62, 95% CI [1.16, 50.29], p = .035]. Frailty was associated with female gender [OR 17.79, 95% CI [2.09, 151.59], p = .008], age [OR 1.13, 95% CI [1.04, 1.22], p = .006], and dialysis vintage [OR 1.55, 95% CI [1.06, 2.26], p = .024]. Conclusion: Hemodialysis patients with sarcopenia and frailty did not have lower dietary protein and calorie intake. Frailty was associated with age and sarcopenia with a sedentary lifestyle.

Over- and underreporting of seizures: How big is the problem?

OBJECTIVE: Clinical decisions on managing epilepsy patients rely on patient accuracy regarding seizure reporting. Studies have noted disparities between patient-reported seizures and electroencephalographic (EEG) findings during video-EEG monitoring periods, chiefly highlighting underreporting of seizures, a well-recognized phenomenon. However, seizure overreporting is a significant problem discussed within the literature, although not in such a large cohort. Our aim is to quantify the over- and underreporting of seizures in a large cohort of ambulatory EEG patients. METHODS: We performed a retrospective data analysis on 3407 patients referred to a diagnostic service for ambulatory video-EEG between 2020 and 2022. Both patient-reported events and events discovered on review of the video-EEG were analyzed and classified as epileptic, psychogenic (typically clinical motor events, without accompanying EEG change), or noncorrelated events (NCEs; without perceivable clinical or EEG change). Events were analyzed by state of arousal and indication for referral. Subgroup analysis was performed in patients with focal and generalized epilepsies. RESULTS: A total of 21 024 events were recorded by 3407 patients. Fifty-eight percent of reported events were NCEs, whereas 27% of all events were epileptic. Sixty-four percent of epileptic seizures were not reported by the patient but discovered by the clinical service on review of the recording. NCEs were in the highest proportion in the awake and drowsy arousal states and were the most common event type for the majority of referral indications. Subgroup analysis found a significantly higher proportion of NCEs in the patients with focal epilepsy (23%) compared to generalized epilepsy (10%; p < .001, chi-squared proportion test). SIGNIFICANCE: Our results reaffirm the phenomenon of underreporting and highlight the prevalence of overreporting. Overreporting likely represents irrelevant symptoms or electrographic discharges not represented on scalp electrodes, identification of which has important clinical relevance. Future studies should analyze events by risk factors to elucidate relationships clinicians can use and investigate the etiology of NCEs.

Family's preferences for and experiences of writing practices in adult intensive care and its use in early bereavement: A descriptive qualitative study.

BACKGROUND: Family partaking in writing practices, such as writing intensive care unit (ICU) patient diaries, personal diaries/journaling, social media, or instant messaging services, during ICU admission may allow the family to unintentionally participate in a form of expressive writing. These writing practices could provide structure for the family authors to explore emotions and manage significant life events, including death of a loved one. Limited studies have explored the family's postmortem experiences and perceived value of writing practices maintained during an ICU admission. OBJECTIVES: The objective of this study was to explore the family member's preferences for and experiences of writing practices in the adult ICU and its use in early bereavement. METHODS: descriptive qualitative design using inductive reflexive thematic analysis from a purposeful, convenience sample of 16 bereaved participants from a tertiary referral, adult ICU in Australia who discussed their experiences of and preferences in writing practices. Reporting adheres to the consolidated criteria for reporting qualitative research checklist. FINDINGS: Six participants maintained writing practices during the ICU admission and 10 did not. Three themes were generated from the data: the decision to maintain writing practices was shaped by past behaviours and perceived utility; moments captured were influenced by the loved ones' clinical status and their ability to access the writing medium; and writing practices have limited utility as a memory making object in early bereavement. CONCLUSIONS: Based on the generated findings, participants who did not maintain writing practices did not later regret this decision during early bereavement. Participants who did maintain writing practices predominately used a personal diary/journal that they carried with them. As the loved one approached death, the written entries became shorter, then ceased. Most of the written entries were not read during early bereavement, suggesting the writing practices' psychological value might have been predominately gained at the time of writing, rather than during early bereavement.

Enhancing family experience in the paediatric intensive care unit through the adoption of the family care journal: A single-center study.

BACKGROUND: Multidisciplinary patient care rounds are increasingly seen as a vital complement to patient care management. Family engagement in these rounds, especially in the paediatric population, is important to treatment and outcomes, but there is little information about family experience in the Paediatric Intensive Care Unit (PICU). AIMS: To develop a process using family care journals (FCJ) to systematically evaluate family experience in the PICU and identify needed supportive resources that will enhance their critical care stay. STUDY DESIGN: This is a single-centre quasi-experimental design conducted at a large urban quaternary level freestanding children's hospital. A family care journal (FCJ) was distributed to families upon admission to PICU to serve as a resource tool during their stay. An electronic point of care (POC) questionnaire was used to assess families' experiences in the PICU. RESULTS: Three hundred sixty-six questionnaires were completed (100% response rate) and analysed. Overall, there was an improvement in all phases post FCJ implementation compared with the baseline. Seventy five percent of families found it a useful tool for communication with the PICU team. Open-ended comments revealed improvement opportunities related to communication, environment, and delay in care. Almost all commented on excellent nursing care. CONCLUSIONS: Introducing FCJ in a paediatric ICU is a practical approach, providing a cost-effective method to assess family experiences and gain insights for ongoing quality improvement efforts. Collaboration among all care team members, including nursing, medical, and administrative leaders, is crucial for empathetically addressing parental needs during hospitalization. RELEVANCE TO CLINICAL PRACTICE: Combining the use of journals and questionnaires provides the clinical team with an efficient means of collecting valuable feedback from parents regarding their experience in the PICU and the factors that foster ongoing commitment from families. Nurses play a crucial role in encouraging the adoption of these journals, as they promote greater parent involvement in their children's care.

Neurobiological sensitivity to popular peers moderates daily links between social media use and affect.

Social media behaviors increase during adolescence, and quantifiable feedback metrics (e.g., likes, followers) may amplify the value of social status for teens. Social media's impact on adolescents' daily affect may be exacerbated given the neurodevelopmental changes that increase youths' sensitivity to socio-emotional information. This study examines whether neurobiological sensitivity to popularity moderates daily links between social media use and affect. Adolescents (N = 91, Mage=13.6 years, SDage=0.6 years) completed an fMRI task in which they viewed faces of their high (>1 SD above the mean) and low (<1 SD below the mean) popular peers based on peer-nominated sociometric ratings from their school social networks. Two years later, adolescents reported their time spent on social media and affect daily for two weeks. Neural tracking of popularity in the ventromedial and dorsomedial prefrontal cortex moderated the association between time on social media and affect. Specifically, adolescents who tracked high popular peers in the vmPFC reported more positive affect on days when they used social media more. Adolescents who tracked low popular peers in the vmPFC and dmPFC reported more negative affect on days when they used social media more. Results suggest that links between social media and affect depend on individual differences in neural sensitivity to popularity.

Limited evidence of autocorrelation signaling upcoming affective episodes: a 12-month e-diary study in patients with bipolar disorder.

BACKGROUND: Increased autocorrelation (AR) of system-specific measures has been suggested as a predictor for critical transitions in complex systems. Increased AR of mood scores has been reported to anticipate depressive episodes in major depressive disorder, while other studies found AR increases to be associated with depressive episodes themselves. Data on AR in patients with bipolar disorders (BD) is limited and inconclusive. METHODS: Patients with BD reported their current mood via daily e-diaries for 12 months. Current affective status (euthymic, prodromal, depressed, (hypo)manic) was assessed in 26 bi-weekly expert interviews. Exploratory analyses tested whether self-reported current mood and AR of the same item could differentiate between prodromal phases or affective episodes and euthymia. RESULTS: A total of 29 depressive and 20 (hypo)manic episodes were observed in 29 participants with BD. Self-reported current mood was significantly decreased during the two weeks prior to a depressive episode (early prodromal, late prodromal), but not changed prior to manic episodes. The AR was neither a significant predictor for the early or late prodromal phase of depression nor for the early prodromal phase of (hypo)mania. Decreased AR was found in the late prodromal phase of (hypo)mania. Increased AR was mainly found during depressive episodes. CONCLUSIONS: AR changes might not be better at predicting depressive episodes than simple self-report measures on current mood in patients with BD. Increased AR was mostly found during depressive episodes. Potentially, changes in AR might anticipate (hypo)manic episodes.

A latent class analysis of adolescent dating violence: Associations with daily conflict management.

BACKGROUND: Adolescent dating violence (ADV) is a major public health concern experienced by more than half of adolescents. Previous studies have found considerable diversity in patterns of ADV and suggest that its various forms often occur concurrently and reciprocally within adolescent dating relationships. While multiple robust distal correlates of ADV have already been established, research on situational factors, such as conflict-related variables, is still sparse. OBJECTIVE: This study aimed to identify patterns of ADV based on the co-occurrence of different types of ADV victimization and perpetration. Multiple correlates of these ADV patterns were examined, including daily conflict-related factors (e.g., occurrence, resolution). METHODS: A sample of 216 adolescents (M = 17.03 years; SD = 1.49) who were currently involved in a dating relationship completed a baseline assessment followed by 14 consecutive daily diaries. RESULTS: Latent class analysis revealed five classes, including Low violence (21.8 %), Emotional violence (50.9 %), Emotional and sexual violence (13 %), Psychological violence and control (7.9 %), and Multiple violence (6.5 %). Demographic, relationship, distal, and daily conflict-related indicators differentiated the classes. Findings indicated that youth in the Psychological violence and control and Multiple violence classes were involved in longer-lasting relationships and displayed higher externalized problems and emotion dysregulation, more frequent experiences of childhood traumas, and, notably, more difficulties in managing daily conflicts. CONCLUSION: Adolescence is a crucial time to reduce the onset, persistence, and adverse consequences of ADV. By identifying situational conflict-related factors associated with ADV victimization and perpetration, this study can inform important prevention efforts.

Female sex steroids and epilepsy: Part 2. A practical and human focus on catamenial epilepsy.

Catamenial epilepsy is the best described and most researched sex steroid-specific seizure exacerbation. Yet despite this there are no current evidence-based treatments, nor an accepted diagnostic tool. The best tool we currently have is tracking seizures over menstrual cycles; however, the reality of tracking seizures and menstrual cycles is fraught with challenges. In Part 1 of this two-part review, we outlined the often complex and reciprocal relationship between seizures and sex steroids. An adaptable means of tracking is required. In this review, we outline the extent and limitations of current knowledge on catamenial epilepsy. We use sample data to show how seizure exacerbations can be tracked in short/long and even irregular menstrual cycles. We describe how seizure severity, an often overlooked and underresearched form of catamenial seizure exacerbation, can also be tracked. Finally, given the lack of treatment options for females profoundly affected by catamenial epilepsy, Section 3 focuses on current methods and models for researching sex steroids and seizures as well as limitations and future directions. To permit more informative, mechanism-focused research in humans, the need for both a consistent classification of catamenial epilepsy and an objective biomarker is highlighted.

Can we increase the value of data from bladder diaries? International Consultation on Incontinence-Research Society 2023.

BACKGROUND: Bladder diaries represent a fundamental component in the assessment of patients presenting with lower urinary tract symptoms. Nevertheless, their importance often remains underappreciated and undervalued within clinical practice. This paper aims to conduct a comprehensive review of the existing literature concerning the utility of bladder diaries, underscore the criticality of their precision, elucidate the factors contributing to noncompliance with bladder diary completion, and investigate potential strategies for enhancing patient compliance. MATERIALS AND METHODS: A review of the English-language scientific literature available in the domains of Medline, Embase, Emcare, Midirs, and Cinahl was conducted. This was supplemented by discussion at the International Consultation on Incontinence Research Society Proposal session to define knowledge and identify gaps in knowledge surrounding the utility of bladder diaries. The existing evidence and outcome of the relevant discussion held in the meeting are presented. RESULTS: Bladder diaries (BD) serve to characterize the nature and severity of storage lower urinary tract symptoms (LUTS) and provide an objective record of an individual's urination patterns. They aid in the refinement and customization of treatment strategies based on the clinical responses documented in the diary, optimizing treatment outcomes. Notably, both BD and urodynamic studies (UDS) play complementary yet distinct roles in LUTS evaluation. BD offers a more comprehensive and accessible approach to assessing specific storage LUTS, particularly due to their affordability and widespread availability, especially in resource-limited settings. Nevertheless, the absence of a standardized BD format across global healthcare systems presents a significant challenge. Despite being recognized as reliable, noninvasive, validated, and cost-effective tools for evaluating patients with LUTS, the implementation and completion of BD have proven to be complex. The introduction of automated bladder diaries heralds an era of precise, real-time data collection, potentially enhancing the patient-clinician relationship. Completion of bladder diaries depends on an array of individual, social, and healthcare-specific factors. Compliance with bladder diary completion could be enhanced with clear instructions, patient education, regular follow-ups and positive re-enforcement. This study has identified four critical areas for future research: Addressing healthcare disparities between affluent and developing nations, enhancing the current functionality and effectiveness of bladder diaries, exploring the feasibility of incorporating bladder diaries into the treatment and education process and improving the quality and functionality of existing bladder diaries. CONCLUSION: Bladder diaries play a pivotal role in the evaluation and management of patients with LUTS, providing a holistic perspective. When their complete potential is harnessed, they have the capacity to revolutionize the paradigm of LUTS management, ushering in a patient-centered era of care.

The thief of (bed)time: Examination of the daily associations between bedtime procrastination and multidimensional sleep health.

OBJECTIVES: Sleep insufficiency is associated with increased risk of morbidity and mortality. Bedtime procrastination, or the needless and voluntary delay in sleep, is a sleep-related behavior which may interfere with sleep health. The objective of this study is to comprehensively examine the daily associations among bedtime procrastination and measures of sleep regularity, satisfaction, timing, efficiency, and duration. METHODS: Two hundred and eighty young adult participants (79% female; Mage=24.4) completed daily sleep diaries and measures of bedtime procrastination and sleep restoration over 14days, in addition to measures of chronotype. Multilevel models were constructed to examine the associations between bedtime procrastination and sleep health. RESULTS: Greater bedtime procrastination was associated with poorer sleep health, including poorer self-reported sleep restoration, later sleep timing, less efficient sleep, and shorter sleep duration. These associations were significant at both within- and between-person levels, and persisted after statistically adjusting for individuals' chronotypes. CONCLUSIONS: This study offers bedtime procrastination as a putative mechanism for poor sleep health and finds that the associated risk of poor sleep from bedtime procrastination is independent of chronotype. Results presented here suggest that bedtime procrastination may be a relevant behavior in the development or maintenance of sleep and sleep-related disorders.

"Anxiety or enjoyment, I feel pleasant to welcome them both": thematic analysis of a Chinese PhD student's personal growth experiences.

Engaging with research is an emotionally demanding experience and a trajectory full of difficulties, challenges, and stress. This autoethnographic study explored my personal experiences as a PhD student in a four-year program and conducted a qualitative thematic analysis by analyzing 550 research diary entries collected between September 2018 and June 2022, in which supervisor feedback and reviewer comments were part of the content. Three recurring, unique, and salient themes pertaining to my personal experiences were identified: being fraught with anxiety, gaining a sense of enjoyment, and achieving personal growth. Whereas anxiety was from publication and dissertation writing, foreign language writing, and individual stressors, enjoyment was gained from the support network and conducting research. My personal growth was reflected from sustained engagement and improved autonomy. In the process, I experienced some negative emotions, but found more enjoyment. The findings indicate that anxiety and enjoyment are fluctuating, co-occurring, and reciprocal. The findings call for more attention to the role of research diary writing in scaffolding PhD research, providing emotional support, and facilitating personal growth and well-being of PhD students.

Social interpretation inflexibility moderates emotional reactions to social situations in children and adolescents.

Interpretation biases and inflexibility (i.e., difficulties revising interpretations) have been linked to increased internalizing symptoms. Although adolescence is a developmental period characterized by novel social situations and increased vulnerability to internalizing disorders, no studies have examined interpretation inflexibility in adolescents. Additionally, no studies (on adolescents or adults) have examined interpretation flexibility as a protective factor against adverse outcomes of interpersonal events. Using a novel task and a 28-day diary we examined relations among interpretation bias and inflexibility, internalizing symptoms, and negative interpersonal events in a sample of children and adolescents (N = 159, ages 9-18). At baseline, negative interpretation bias was positively correlated with social anxiety symptoms, and positive interpretation bias negatively correlated with social anxiety and depressive symptoms. Inflexible positive interpretations were correlated with higher social anxiety and depressive symptoms, while inflexible negative interpretations were correlated with higher social anxiety. Finally, interpretation inflexibility moderated daily associations between negative interpersonal events and depressive symptoms in daily life, such that higher inflexibility was associated with stronger associations between interpersonal events and subsequent depressive symptoms, potentially increasing depressive symptom instability. These results suggest that interpretation biases and inflexibility may act as both risk and protective factors for adolescent anxiety and depression.

Determinants and mediating mechanisms of quality of life and disease-specific symptoms among thyroid cancer patients: the design of the WaTCh study.

BACKGROUND: Thyroid cancer (TC) patients are understudied but appear to be at risk for poor physical and psychosocial outcomes. Knowledge of the course and determinants of these deteriorated outcomes is lacking. Furthermore, little is known about mediating biological mechanisms. OBJECTIVES: The WaTCh-study aims to; 1. Examine the course of physical and psychosocial outcomes. 2. Examine the association of demographic, environmental, clinical, physiological, and personality characteristics to those outcomes. In other words, who is at risk? 3. Reveal the association of mediating biological mechanisms (inflammation, kynurenine pathway) with poor physical and psychological outcomes. In other words, why is a person at risk? DESIGN AND METHODS: Newly diagnosed TC patients from 13 Dutch hospitals will be invited. Data collection will take place before treatment, and at 6, 12 and 24 months after diagnosis. Sociodemographic and clinical information is available from the Netherlands Cancer Registry. Patients fill-out validated questionnaires at each time-point to assess quality of life, TC-specific symptoms, physical activity, anxiety, depression, health care use, and employment. Patients are asked to donate blood three times to assess inflammation and kynurenine pathway. Optionally, at each occasion, patients can use a weighing scale with bioelectrical impedance analysis (BIA) system to assess body composition; can register food intake using an online food diary; and can wear an activity tracker to assess physical activity and sleep duration/quality. Representative Dutch normative data on the studied physical and psychosocial outcomes is already available. IMPACT: WaTCh will reveal the course of physical and psychosocial outcomes among TC patients over time and answers the question who is at risk for poor outcomes, and why. This knowledge can be used to provide personalized information, to improve screening, to develop and provide tailored treatment strategies and supportive care, to optimize outcomes, and ultimately increase the number of TC survivors that live in good health.