Rome III and IV criteria are less discordant to diagnose irritable bowel syndrome in clinic patients than in community subjects.

BACKGROUND: Though Rome IV criteria for irritable bowel syndrome (IBS) are less sensitive; they select Rome III patients with greater severity and consultation behavior. Since severity of IBS may determine consultation behavior, we compared Rome III and IV criteria in clinic patients and compared with earlier published data from Indian community hypothesizing that the diagnostic discordance between these criteria would be less in clinic than in community. METHODS: Tertiary clinic patients were screened for IBS using Hindi translated-validated Rome III and IV questionnaires; IBS symptom severity scores (IBS-SSS) was also assessed. Diagnostic discordance between Rome III and IV criteria for IBS was compared with earlier published Indian community data. RESULTS: Of 110 clinic patients with functional gastrointestinal disorders, 72 met IBS criteria (47 [42.7%], 22 [20%] and three [2.7%] both Rome III and IV criteria, Rome III criteria only and Rome IV criteria only, respectively). In contrast, of 40 IBS subjects from Indian community published earlier, nine (22.5%), 28 (70%) and three (7.5%) fulfilled both Rome III and IV, Rome III only, Rome IV only criteria, respectively. Clinic patients with IBS fulfilling both Rome III and IV criteria or Rome IV criteria had higher IBS-SSS than those fulfilling Rome III criteria only (295.3 ± 80.7 vs. 205.6 ± 65.7; p < 0.00001). This difference was primarily related to pain severity and number of days with pain. CONCLUSION: Discordance between Rome IV and Rome III criteria in tertiary care clinic patients is less than in community subjects with IBS in India.

Hope and its relationship with treatment/ physical related factors in lung cancer patients receiving immunotherapy.

BACKGROUNDPURPOSE: Immunotherapy is a new treatment option for patients with Lung Cancer (LC). However, relatively limited research has explored about patients' perception of hope and its associated factors during the process. This study aimed to examine level of perceived hope and the factors related to hope, with a particular focus on treatment and physically related factors, in LC patients receiving immunotherapy. METHODS: A cross-sectional study was conducted and patients who had already received at least one immunotherapy cycle were recruited from two hospitals in northern Taiwan. The questionnaire included a background information form, the Herth's Hope Index, and the Symptom Severity Scale. Stepwise regression was applied to identify the most robust factors related to level of hope in the participants. RESULTS: A total of 130 patients were recruited. Overall, patients reported moderate to high levels of hope and mild symptoms. Fatigue, weakness, appearance changes, pruritus, and shortness of breath were identified as the most severe symptoms. Further regression analysis showed that patients with poor performance status, less immunotherapy cycles, higher level of fatigue, and more severe pruritus reported to have lower level of hope which explained 47% of the variances. CONCLUSIONS: This study revealed that lung cancer patients undergoing immunotherapy had moderate level of hope. Patients' performance status, selected symptoms and times of receiving immunotherapy were the robust factors related to hope. Systematic assessment of patients' symptoms and the development of appropriate interventions to reduce distress and enhance hope are strongly recommended for both clinical care and research.

Symptom propagation in respiratory pathogens of public health concern: a review of the evidence.

Symptom propagation occurs when the symptom set an individual experiences is correlated with the symptom set of the individual who infected them. Symptom propagation may dramatically affect epidemiological outcomes, potentially causing clusters of severe disease. Conversely, it could result in chains of mild infection, generating widespread immunity with minimal cost to public health. Despite accumulating evidence that symptom propagation occurs for many respiratory pathogens, the underlying mechanisms are not well understood. Here, we conducted a scoping literature review for 14 respiratory pathogens to ascertain the extent of evidence for symptom propagation by two mechanisms: dose-severity relationships and route-severity relationships. We identify considerable heterogeneity between pathogens in the relative importance of the two mechanisms, highlighting the importance of pathogen-specific investigations. For almost all pathogens, including influenza and SARS-CoV-2, we found support for at least one of the two mechanisms. For some pathogens, including influenza, we found convincing evidence that both mechanisms contribute to symptom propagation. Furthermore, infectious disease models traditionally do not include symptom propagation. We summarize the present state of modelling advancements to address the methodological gap. We then investigate a simplified disease outbreak scenario, finding that under strong symptom propagation, isolating mildly infected individuals can have negative epidemiological implications.

Associations between menopausal symptoms and cardiovascular disease in middle-aged Chinese women.

OBJECTIVE: This study aimed to examine the association between severity of menopausal symptoms and cardiovascular disease (CVD) risk among middle-aged Chinese women. METHODS: A cross-sectional study recruited 9679 women aged 40-70 years from three socioeconomic regions of China in 2018. Menopausal symptoms were assessed by the modified Kupperman Menopausal Index (KMI). The severity of individual symptoms was classified as none (0 points), mild (1 points) and moderate-to-severe symptoms (2-3 points), and overall menopausal symptoms were classified as none (<15 points), mild (15-24 points) or moderate-to-severe (≥25 points) according to the sum score of the KMI. Logistic regression models were used to examine associations of the severity of menopausal symptoms with CVD risk. RESULTS: A total of 5.6% of participants reported being diagnosed with CVD. Overall menopausal symptoms were more common in women aged 60-70 years than in women aged 40-59 years. After multiple adjustment, mild (odds ratio [OR] = 2.07, 95% confidence interval [CI]: 1.64-2.61) and moderate-to-severe (OR = 2.64, 95% CI: 1.92-3.63) overall menopausal symptoms were associated with increased risk of CVD compared with no symptoms. Significant positive associations between the severity of individual menopausal symptoms and CVD risk were observed for all 13 items. CONCLUSION: The severity of menopausal symptoms was positively associated with CVD risk in middle-aged Chinese women.

Association between cumulative trauma and severity of psychotic symptoms among patients experiencing psychosis.

Psychosis-related trauma is a prevalent condition that significantly impacts patients and often leads to an increased reliance on psychiatric nursing services. This study aimed to provide a deeper understanding of the complex relationship between cumulative trauma and the severity of psychosis symptoms among patients experiencing psychosis. Utilizing a cross-sectional research design, data were collected from 76 community-dwelling patients recruited. Patients' sociodemographic and clinical data, Cumulative Trauma Measure scores, and psychosis symptom severity scale scores were collected. A significant difference was observed between collective identity trauma and the presence of hallucinations and abnormal psychomotor behavior (Z = 4.1 and 2.69, respectively). Significant differences were also observed between role identity trauma and the presence of delusions and abnormal psychomotor behavior (Z = 3.86 and 2.06, respectively); attachment trauma and the presence of hallucinations, abnormal psychomotor behavior, and mania (Z = 2.16, 2.12, and 2.11, respectively); and survival trauma and the presence of disorganized speech (Z = 2.61). Moreover, there was a significant difference regarding secondary trauma and the presence of hallucinations, delusions, disorganized speech, abnormal psychomotor behavior, depression, and mania (Z = 4.29, 2.15, 2.11, 2.12, 4.42, and 3.39, respectively). In conclusion, total cumulative trauma explained 44.2 %, 25.8 %, 24.7 %, 16.2 %, 13.6 %, and 13.2 % of the severity of delusion, hallucination, depression, mania, abnormal psychomotor behavior, and disorganized speech, respectively, among patients experiencing psychosis. Implication for nursing practice, by recognizing the nuanced interplay between cumulative trauma and diverse manifestations of psychosis symptoms, nursing professionals can tailor their approaches to provide more holistic and patient-centered care that may significantly contribute to improved patient outcomes and the overall well-being of individuals navigating the complex landscape of psychosis-related trauma.

Prospective Associations Between Personality Traits and Major Depressive Disorder Symptom Severity: The Mediating Role of Illness Representations.

Major depressive disorder (MDD) patients' personality traits and illness representations are linked to MDD severity. However, the associations between personality and illness representations in MDD and the mediating role of illness representations between personality and MDD severity have not been investigated. This study aimed to prospectively investigate the aforementioned associations and the possible mediating role of illness representations between personality and MDD severity. One hundred twenty-five patients with a MDD diagnosis, aged 48.18 ± 13.92 (84% females), participated in the study. Personality traits were measured with the Traits Personality Questionnaire at baseline. Illness representations were measured with the Illness Perception Questionnaire-Mental Health about five months later (mean = 5.08 ± 1.14 months). MDD severity was measured about 10 months after the baseline assessment (mean = 9.53 ± 2.36 months) with the Beck Depression Inventory. SPSS 29 and AMOS 27 were used to conduct correlational and parallel mediation analyses. According to the results, Neuroticism was positively and Extraversion was negatively linked to MDD severity. Negative MDD impact representations fully mediated these associations. Neuroticism and Extraversion are linked to future MDD severity through patients' representations of MDD's impact. Restructuring maladaptive representations about MDD's impact can be a promising way to reduce symptom severity in patients with high Neuroticism and low Extraversion levels.

Abnormal circadian rhythm of heart rate variability and their association with symptoms in patients with major depressive disorder.

BACKGROUND: Heart rate variability (HRV) is often reduced in patients with major depressive disorder (MDD) and is linked to symptoms. However, prior studies have mainly focused on short-term HRV, with limited exploration of the 24-h HRV circadian rhythm, despite its ability to comprehensively capture overall HRV distribution and dynamic fluctuations. In this study, we investigated the circadian rhythms of 24-h HRV indices in patients with MDD and their associations with symptom severity. METHODS: We recorded 24-h electrocardiograms in 73 patients with MDD (53 in major depressive episode and 20 in remission period) and 31 healthy controls. An extended cosine model was used to model the circadian rhythm of six HRV indices by five parameters: the mesor, amplitude, duty cycle, curve smoothness, and acrophase. Symptom severity was evaluated using the Hamilton Depression Scale and Hamilton Anxiety Scale. RESULTS: Compared with the control group, patients with MDD had a significantly smaller SampEn mesor, higher HF duty cycle, and lower heart rate (HR) duty cycle. They also had a significantly higher curve smoothness for HR, RMSSD, and HF. The mesor for SampEn, along with the curve smoothness for HR and ln RMSSD, were associated with certain symptoms in patients with MDD. LIMITATIONS: The cross-sectional design and psychiatric treatment of most patients with MDD limited our findings. CONCLUSION: Patients with MDD exhibit abnormal HRV circadian rhythms that are associated with symptoms. Moreover, 24-h ECG monitoring may potentially serve as an adjunct value to objectively evaluate clinical symptoms in these patients.

Sensitivity to change and responsiveness of provocative load tests among athletes with patellar tendinopathy.

BACKGROUND: Pain provocation tests are recommended for assessing pain severity and as an outcome measure for individuals with patellar tendinopathy. OBJECTIVE: To evaluate floor and ceiling effects, sensitivity to change, and responsiveness cut-offs of two provocative load tests among athletes with patellar tendinopathy. METHODS: Athletes (N = 41) performed six repetitions for the single leg decline squat (SLDS) and resisted knee extension (KE) at baseline and 12 weeks. Participants rated their pain during each test on a visual analog scale (VAS). Sensitivity to change was assessed by calculating effect size (ES) and the standardized response mean (SRM). The responsiveness cut-offs were assessed using a combination of anchor and distribution- based methods to determine the minimal clinically important difference (MCID) for each test. RESULTS: A floor or ceiling effect was observed in only a small number of participants for both tests except for KE, for which approximately one third of participants had a floor effect at week 12. There was higher sensitivity to change for SLDS (ES: 1.93/SRM: 1.43) compared with KE (ES:0.96/SRM: 1.09). The MCID corresponded to a decrease of 1.6 points for SLDS and 1.0 for KE, while the distribution-based method estimated 1.2 points for SLDS and 1.1 for KE. CONCLUSION: This study found moderate to high sensitivity to change and established MCID values for the SLDS and KE test in athletes with patellar tendinopathy before and after rehabilitation. Both tests may be useful as pain on loading outcomes as athletes progress with their rehabilitation, but the KE test results in higher floor effects and has lower sensitivity to change.

Health locus of control and symptom distress: The mediating role of illness acceptance and symptom severity in acute leukemia patients.

OBJECTIVE: This study aims to explore the multiple mediating roles of illness acceptance and symptom severity between health locus of control and symptom distress in acute leukemia patients. METHODS: From June 2022 to March 2023, a convenience sampling method was used to recruit 208 acute leukemia patients in the inpatient center of a hospital in Hebei. The Chinese versions of Multidimensional Health Locus of Control Scale, Illness Acceptance Scale, and Anderson Symptom Assessment Scale was used in the cross-sectional study. RESULTS: All participants reported the presence of symptom distress. Symptom distress was significantly correlated with chance health locus of control, illness acceptance, and symptom severity (P＜0.05). Illness acceptance alone played a mediating role in the relationship between chance health locus of control and symptom distress in acute leukemia patients (ß=0.087, 95%CI 0.030-0.167). The indirect role of chance health locus of control on symptom distress through symptom severity alone was also statistically significant (ß=0.131, 95%CI 0.008-0.252). Furthermore, the multiple mediating role of chance health locus of control and symptom distress through illness acceptance and symptom severity combined was verified (ß=0.027, 95%CI 0.001-0.089). The alternative model is also valid, indicating bidirectional relationships between symptom severity, illness acceptance, and chance health locus of control, collectively influencing symptom distress. CONCLUSION: There is a positive relationship between chance health locus of control and symptom distress; additionally, increasing social psychological interventions for illness acceptance and strengthening the management of core symptoms will help alleviate the impact of health chance locus of control on symptom distress in acute leukemia patients. Longitudinal studies are needed to confirm the causal relationships among the variables explored within the model. IMPACT ON NURSING PRACTICE: It is recommended that healthcare professionals pay attention to the assessment of health locus of control in patients, identify patients with health chance locus of control in a timely manner, take measures to enhance their disease acceptance, and strengthen the management of core symptoms, thereby reducing their level of symptom distress.

The effect of repeated concussions on clinical and neurocognitive symptom severity in different contact sports.

INTRODUCTION: The potential consequences of repeated concussions in sport are well documented. However, it remains unclear whether the cumulative impact of sports-related concussions differs between different contact sports. Therefore, the aim of the current study was to investigate the cumulative effects of sports-related concussions on clinical and neurocognitive health in different contact sports. MATERIALS AND METHODS: In a prospective multicenter study, we examined 507 (74 females) active professional athletes between 18 and 40 years of age from five different contact sports (soccer, handball, American football, basketball, and ice hockey). Data collection involved concussion history, clinical symptom evaluation, neurocognitive assessment, and the collection of other sports-related information. Composite scores were built for clinical symptoms (such as neck pain and balance disturbances) and for neurocognitive symptoms (such as memory and attention impairments). RESULTS: Athletes having suffered 3+ concussions in the past showed disproportionally higher clinical symptom severity than athletes with less than three concussions across all sports. The level of clinical symptom burden in athletes with 3+ concussions indicated mild impairment. The number of past concussions did not affect neurocognitive performance. DISCUSSION: Repeated sports-related concussions appear to have a cumulative impact on clinical-but not cognitive-symptom severity. Although clinical symptom burden in athletes with 3+ concussions in the past was not alarmingly high yet in our sample, increased caution should be advised at this point. Despite few exceptions, results are similar for different contact sports, suggesting a similar multidisciplinary concussion management across all types of sport.

Ambient pollen exposure and pollen allergy symptom severity in the EPOCHAL study.

BACKGROUND: Ambient pollen exposure causes nasal, ocular, and pulmonary symptoms in allergic individuals, but the shape of the exposure-response association is not well characterized. We evaluated this association and determined (1) whether symptom severity differs between subpopulations; (2) how the association changes over the course of the pollen season; and (3) which pollen exposure time lags affect symptoms. METHODS: Adult study participants (n = 396) repeatedly scored severity of nasal, ocular, and pulmonary allergic symptoms, resulting in three composite symptom scores. We calculated hourly individually relevant pollen exposure to seven allergenic plants (alder, ash, birch, hazel, grasses, mugwort, and ragweed) considering personal sensitization and exposure time lags of up to 96 h. We fitted generalized additive mixed models, with a random personal intercept, adjusting for weather and air pollution as potential time-varying confounders. RESULTS: We identified a clear nonlinear positive association between pollen exposure and ocular and nasal symptom severity in the pollen allergy group: Symptom severity increased steeply with increasing exposure initially, but attenuated beyond approximately 80 pollen/m3. We found no evidence of an exposure threshold, below which no symptoms occur. While recent pollen exposure in the last approximately 5 h affected symptoms most, associations lingered for up to 60 h. Grass pollen exposure (compared to tree pollen) and younger age (18-30 years, as opposed to 30-65 years) were both associated with higher nasal and ocular symptom severity. CONCLUSIONS: The lack of a threshold and attenuated dose-response curve may have implications for pollen warning systems, which may be revised to include multiday pollen concentrations in the future.

Effect of Educational Intervention on Psychological Well-Being in CRS: A Randomized Controlled Trial.

Chronic Rhinosinusitis (CRS) affects nearly 10% of the global population, leading to substantial economic and quality-of-life burdens. While patient education has improved outcomes in other chronic conditions, its impact on CRS remains understudied. The study aims to evaluate the effectiveness of a structured patient education program on the psychological well-being and symptom severity of individuals diagnosed with CRS. This was a prospective, randomized controlled trial conducted in a tertiary care centre from January 2021 to December 2022. We enrolled 200 adult patients diagnosed with CRS based on the European Position Paper on Rhinosinusitis and Nasal Polyps guidelines. Participants were randomized into two groups: the control group, receiving conventional CRS medical management, and the intervention group, receiving conventional treatment plus a structured patient education program. By the end of the study, 100 participants from each group completed the 2-year follow-up. The intervention group showed significant improvements in psychological well-being, with HADS scores decreasing from 10 ± 3.5 to 7 ± 3.0. CRS symptom severity, as measured by SNOT-22 scores, also significantly improved in the intervention group, dropping from 45 ± 10 to 35 ± 9. Additionally, the intervention group had fewer acute CRS flare-ups over two years compared to the control group. Adherence to nasal spray usage was higher in the intervention group, and feedback on the educational program was largely positive. A structured patient education program, when added to conventional CRS treatment, enhances psychological well-being, and reduces symptom severity. Given these promising results, there's need to integrate patient education into standard CRS management and explore its long-term benefits. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04407-8.

Development and Validation of a Symptom Scale for Indian Patients With Medically Unexplained Physical Symptoms.

Introduction Patients with medically unexplained physical symptoms (MUPS) account for a substantial proportion of patients visiting the outpatient department. Diagnosis of MUPS is a challenge for most physicians. An accurate diagnosis relies on obtaining a detailed history from patients regarding the nature of their symptoms, their onset, and any associated aggravating or relieving factors. This study aims to develop a symptom scale for Indian patients with MUPS. Methods The study had a mixed-method study design. Phase 1 involved designing the questionnaire using qualitative techniques, such as literature reviews, focus-group discussions, expert evaluation, and pre-testing of a Hindi and English language Likert-rated interviewer-administered scale. In phase 2, the construct validity of the questionnaire was established using quantitative approaches among 116 patients diagnosed with MUPS. Results The final questionnaire consists of 38 items, with good internal consistency (Cronbach 𝛂 = 0.916). Confirmation sampling adequacy for factor analysis was done using the Kaiser-Meyer-Olkin test (KMO value = 0.792) and Bartlett's test of sphericity (p < 0.001). The newly developed scale showed a Pearson correlation coefficient of 0.568 (p < 0.001) with Patient Health Questionnaire (PHQ)-15 scores. Conclusion A reliable and valid tool has been developed to assess patients' symptoms with MUPS in English and Hindi languages. This questionnaire can be used for assessment, screening, and diagnostic purposes as well as to chart longitudinal changes in patients with MUPS.

Autism Severity and its Relationship to Disability.

Autism severity is currently defined and measured based exclusively on the severity levels of the two core symptom domains: social-communication and restricted or repetitive patterns of behaviors and interests. Autistic individuals, however, are often diagnosed with other medical, developmental, and psychological co-occurring conditions. These additional challenges such as intellectual disability, limited expressive and/or receptive language, and anxiety disorders, can have a tremendous impact on the day-to-day lives of autistic individuals, for both their adaptive functioning as well as their sense of wellbeing. Furthermore, the initial presentation of core symptoms and their likelihood of changing over time are influenced by the presence of such co-occurring conditions. In order to truly understand how a person's autism impacts their life, both core symptoms as well as other challenges should be considered. This approach was recently taken by The Lancet Commission on the future of care and clinical research in autism, which proposed the term "profound autism" for a subgroup of individuals presenting with high core symptom severity, co-occurring intellectual disability, and little or no language, who require extensive long-term care. Considering other individual factors such as daily living skills, specific support needs and environmental resources would also enhance the evaluation of disability in autistic individuals. As currently employed in the assessment of intellectual disability, a multidimensional approach to autism could provide a more comprehensive system for classification of impairment. At present, however, there is no formal way to designate the combined effect of these different aspects of autism on a person's life. A comprehensive outlook that acknowledges impairments, capabilities, co-occurring conditions, and environmental factors would be useful for identifying subgroups of individuals as well as for determining individual needs and strengths in clinical assessments. Lay Summary: The severity of a person's autism is currently defined based on the severity of their core autism symptoms: impaired social-communication and the presence of restricted or repetitive patterns of behaviors and interests. But autistic people often face additional challenges such as intellectual disability, epilepsy, and anxiety disorder, that considerably impact their everyday life, wellbeing, and the need for support. A more complete view of autism severity, one that includes core symptoms as well as additional challenges, could help identify meaningful sub-groups of autistic individuals and could be useful in clinical care. Appeared originally in Autism Res 2023; 16:685-696.

[Laparoscopic ultrasound-guided radiofrequency ablation of uterine fibroid: A retrospective study]. / Myolyse des fibromes utérins par radiofréquence cœlioscopique sous contrôle échographique : à propos d'une série rétrospective.

OBJECTIVE: To assess clinical and radiological efficacy and safety of laparoscopic ultrasound-guided radiofrequency ablation of uterine leiomyomas. MATERIAL AND METHODS: Thirty-three patients with symptomatic uterine leiomyomas FIGO type 2 to 7, have undergone a laparoscopic ultrasound-guided radiofrequency ablation at Croix Rousse University Hospital Center (Hospices civils de Lyon) and at Saint-Vincent de Paul Hospital in Lille, between June 2020 and December 2022. The characteristics of each myoma and the symptoms were assessed with pelvic MRI and with Higham score, SSS and HRQL scores preoperatively and at 6 months. RESULTS: A total of 54 fibroids have been treated in 33 patients. We observed a significant decrease of the volume 6 months after the surgery, on average 21mL (55.97 vs. 74.37mL, 95% CI [7.13-34.88], P=0.001). The maximum diameter of each fibroid was also significantly reduced on average 11.78mm (41.89 vs. 52.06, 95% CI [8.83-14.73], P<0.05). We noticed a significant decrease of the NRS for dysmenorrhea on average 2.79 points (2.1 vs. 4.89, 95% CI [1.14-4.42], P<0.05). There was also a trend to improvement of menorrhagia, assess by Higham score. Indeed, 70.8% of the patients had menorrhagia. Menorrhagia was improved of 108,3 points with an average Higham score before surgery of 197.3 versus 87.9 after surgery (95% CI [47.9-168.8], P=0.001). Concerning UFS-QOL score: the symptom severity score (SSS) decreased on average 33 points, testifying of symptom improvement (27.04 vs. 60.89, 95% CI [22.92-43.39], P<0.001) and the HRQL score increased on average 20 points testifying quality of life improvement (65.57 vs. 42.7, 95% CI [15.83-37.85]. P<0.001). No severe adverse event has been reported. CONCLUSION: In this first French study about radiofrequency ablation. We confirm its efficiency for improvement of symptoms and quality of life but other study is mandatory to confirm the safety of this procedure in particular in patients with a wish to conceive.

Relationship between severity of concussion's symptoms and functional performance in children.

INTRODUCTION: Concussion is a common brain injury that has significant effects on multiple functional domains in children. However, limited research exists on the relationship between concussion severity and functional performance in this population. This study aimed to examine the relationship between the severity of concussion symptoms and children's balance and functional performance. METHODS: This cross-sectional study recruited 23 children (9 males and 14 females; mean age 13.9 ± 2.2 years) with clinically diagnosed concussions from a tertiary balance center in 2016. Participants underwent clinical and functional evaluations by specialized physical therapists. Symptom severity was assessed using the Post-Concussion Symptom Scale (PCSS), while functional performance was measured using the Functional Gait Assessment (FGA). RESULTS: There was a trend suggesting a negative correlation between symptom severity (PCSS) and functional performance (FGA), indicating potentially better performance in individuals with milder symptoms. However, this trend was not significant (rs (21) = -.072, p = 0.744). Furthermore, no significant correlation was found between FGA scores and the severity of individual symptoms. CONCLUSION: The findings suggest that concussion symptom severity may not be directly related to functional performance in children. Therefore, it is crucial to incorporate functional performance measures alongside symptom assessment for comprehensive concussion management.

Sino-nasal Outcome Test (SNOT22) score in adult population with no known sino-nasal disease.

PURPOSE: This cross-sectional study aimed to establish normative values for Sino-Nasal Outcome Test (SNOT-22) score in adult Indian population without known sino-nasal diseases. The purpose was to fill a critical knowledge gap, providing insights into how various host factors influence SNOT-22 scores which seek to serve as reference for clinical studies, facilitating comparisons of symptom severity and aid in patient counselling based on specific score patterns. METHODS: One thousand and twelve adults meeting inclusion criteria participated in the study. Participants provided demographic information, occupation details, addiction history, and medical background. They completed SNOT-22 questionnaire, grading their symptoms on Likert scale of 0-5 based on severity experienced in the past 2 weeks. The collected data were analysed to derive meaningful insights. RESULTS: Mean SNOT-22 score for the study population was 6.80, with 90% scoring below 15, and 40% within 0-3 range. Females exhibited significantly lower mean scores than males. Residents of rural areas reported higher scores than urban counterparts. Education levels had no significant influence on scores. Occupational exposure to aeroallergens, addiction (especially tobacco), and a history of allergies, bronchial asthma, or atopy were associated with significantly higher SNOT-22 scores. Principal component analysis identified four distinct domains, with the nasal symptom domain consistently emerging as the major contributor to differences in subgroups with significantly different total SNOT-22 scores. CONCLUSION: The normative data and subgroup analyses established in this study serve as a foundation for future research, aiding clinicians in predicting symptoms and providing tailored counselling for individuals with sino-nasal pathologies.

Duration of daily life activities in persons with and without obsessive-compulsive disorder.

Persons with obsessive-compulsive disorder (OCD) are often impaired in their daily level of functioning due to their time-consuming obsessions and/or compulsions. To date, however, studies are lacking that quantify how much time persons with OCD actually spend on activities of daily living. Therefore, the current study assessed 13 daily life activities (in minutes) with a self-report questionnaire in 299 persons with OCD at admission to inpatient treatment and 300 age- and sex-matched persons without OCD. A majority of persons with OCD indicated that they experienced obsessions and/or compulsions when leaving (84%) and cleaning (70%) the apartment, grocery shopping (66%), changing clothes (66%), and showering with (62%) and without (63%) shampooing. Persons with OCD who experienced obsessions and/or compulsions during a given daily life activity-but not those who did not experience obsessions and/or compulsions during these activities-reported longer durations for performing 10 of the 13 activities than persons without OCD. For most activities, longer durations related weakly but significantly to higher OCD symptom severity. Results indicate that the duration of daily life activities seems to depend more on whether persons with OCD experience obsessions and/or compulsions during a specific activity and less on whether a person is diagnosed with OCD in general. Future studies may use other assessment methods that allow for tracking the duration in daily life in real time.

Children's emotional reactivity and negative affect predict future ADHD symptom severity beyond initial ADHD symptom severity.

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience significant emotion dysregulation. However, there is limited longitudinal data on associations between multiple aspects of emotion dysregulation and ADHD symptoms. Additionally, given substantial evidence that increased levels and variability of negative affect (NA) are identified in children with ADHD, it is important to examine the role of NA in this relationship. The present study used momentary and longitudinal data to examine the relation between two aspects of emotion dysregulation (emotional lability and emotional reactivity), the two ADHD symptom clusters separately (inattentive and hyperactive/impulsive), total ADHD symptom severity, and NA variability over a period of six months. Participants (N = 68) were parents of children aged 7-12 years old (M = 9.80, SD = 1.34) who completed baseline and 6-month follow-up reports of children's ADHD symptoms and emotion dysregulation as well as ecological momentary assessments (EMA) of their children's NA for one week. Results were threefold: (1) children's emotional reactivity predicted inattentive, hyperactive/impulsive, and total ADHD symptom severity above and beyond initial ADHD symptom severity, but emotional lability did not significantly predict severity of any ADHD symptom cluster; (2) NA variability predicted hyperactive/impulsive and total ADHD symptom severity, but not inattentive severity; and (3) initial ADHD symptom severity did not predict emotion dysregulation at follow-up. The current study provides novel insight regarding the longitudinal influence of specific aspects of emotion dysregulation and NA on ADHD symptom severity in children and suggests that targeting emotional reactivity could minimize ADHD symptom severity.

Self-compassion and health-related quality of life in individuals with endometriosis.

OBJECTIVE: International research highlights the detrimental impact of endometriosis on health-related quality of life (HRQoL), yet few studies have examined positive resources such as self-compassion and resilience as correlates. This cross-sectional study aimed to examine the relationship between self-compassion and HRQoL in individuals with endometriosis in Aotearoa New Zealand. Resilience and perceived symptom severity were examined as potential mediators. METHODS AND MEASURES: Six hundred and three individuals with endometriosis completed an online questionnaire measuring demographic and endometriosis-related information, endometriosis symptoms (number and severity), HRQoL, self-compassion and resilience. RESULTS: In line with international research, the current sample reported significant impairment in all aspects of HRQoL. As expected, those with higher levels of self-compassion reported less impairment in HRQoL, and this relationship was partially mediated by perceived symptom severity (all aspects of HRQoL). Resilience mediated the relationship between self-compassion and two aspects of HRQoL (emotional wellbeing and control/powerlessness). CONCLUSION: These findings confirm that HRQoL is significantly impaired in individuals with endometriosis in Aotearoa New Zealand and point to the potential role of self-compassion and resilience as protective factors in encouraging positive coping styles to manage symptoms and maintain high HRQoL. Interventions targeting self-compassion may be a promising tool to improve wellbeing in individuals with endometriosis.