[Factors Associated with Stress Check Attendance: Possible Effect of Timing of Annual Health Examination].

OBJECTIVES: The stress check program has been part of annual employees' health screening since 2015. Employees are recommended, but not obliged, to undergo the stress check offered. This study was designed to examine the factors associated with stress check attendance. METHODS: A total of 31,156 Japanese employees who underwent an annual health examination and a stress check service at an Occupational Health Service Center in 2016 participated in this study. Data from the annual health examination and stress check service included stress check attendance, date of attendance (if implemented), gender, age, workplace industry, number of employees at the workplace, and tobacco and alcohol consumption. Data were analyzed using multiple logistic regression. RESULTS: The mean rate of stress check attendance was 90.8%. A higher rate of stress check attendance was associated with a lower duration from the annual health examination, age ≥30 years, construction and transport industry, and 50-999 employees at the workplace. A lower rate of stress check attendance was associated with medical and welfare industry and ≥1,000 employees at the workplace. CONCLUSIONS: These findings provide insights into developing strategies for improving the rate of stress check attendance. In particular, stress check attendance may improve if the stress check service and annual health examination are conducted simultaneously.

Prevalência de disfunção temporomandibular e associação com fatores psicológicos em estudantes de Odontologia / Prevalencia de trastornos temporomandibulares y su asociación con factores psicológicos en los estudiantes de Odontología / Prevalence of temporomandibular dsorders and association with psychological factors in students of undergraduate Dentistry students

Introdução: a abordagem dos fatores biopsicossociais tem ganhado destaque quando se analisa a natureza multifatorial da Disfunção Temporomandibular, mas alguns estudos trazem resultados conflitantes quanto à sua relação com fatores psicológicos. Objetivo: determinar a prevalência de sinais e sintomas desta disfunção e sua associação com a tensão emocional, ansiedade e depressão em estudantes universitários do curso de Odontologia. Métodos: do universo de acadêmicos de odontologia de uma universidade pública do nordeste brasileiro (344 estudantes), foram selecionados aleatoriamente 135 voluntários. Os critérios de exclusão foram: ausência de dois ou mais dentes (exceto os terceiros molares); uso de prótese removível; uso de aparelhos ortodônticos (fixo ou móvel), no momento do estudo; participantes em tratamento para disfunção ou outras dores orofaciais; não assinatura do termo de consentimento livre e esclarecido. Os sinais e sintomas de Disfunção Temporomandibular foram coletados através de uma ficha contendo um questionário anamnésico adaptado e de um protocolo de exame clínico. Para estimar a presença de fatores psicológicos foi utilizada a escala Hospital Anxiety and Depression, traduzida e validada para o português. Os dados foram tabulados e analisados descritiva e estatisticamente. Associações entre as variáveis, tensão emocional, ansiedade, depressão e disfunção foram verificadas pelos testes estatísticos Qui-quadrado (x2) e Exato de Fisher, com p< 0,05. Resultados: 76,3 porcento da amostra apresentaram disfunção, sendo que em 54,1 porcento esta foi considerada de grau leve, enquanto que em 22,2 porcento foi verificada necessidade ativa de tratamento. 34,1 porcento da amostra afetada apresentaram apenas sinais clínicos articulares. Tensão emocional foi estaticamente associada à presença de disfunção e a necessidade de tratamento. Ansiedade e depressão foram associadas apenas a necessidade de tratamento. Conclusão: a prevalência de Disfunção Temporomandibular na amostra de estudantes universitários foi elevada, com maior frequência de sinais clínicos articulares e associação com gênero feminino, tensão emocional, ansiedade e depressão(AU)

Introducción: el enfoque de los factores biopsicosociales tiene gran importancia en la naturaleza multifactorial de los trastornos temporomandibulares, pero algunos estudios presentan resultados contradictorios en cuanto a su relación con los factores psicológicos. Objetivo: determinar la prevalencia de signos y síntomas de este trastorno y su asociación con el estrés emocional, la ansiedad y la depresión en estudiantes de Odontología. Métodos: del universo de estudiantes de Odontología de una universidad pública en el noreste de Brasil (344 estudiantes) se seleccionaron 135 alumnos. Los criterios de exclusión fueron: ausencia de dos o más dientes (excluyendo los terceros molares); uso de prótesis desmontable; uso de aparatos de ortodoncia (fijo o móvil), en el momento del estudio; participantes en tratamiento para trastorno u otro dolor orofacial; no firmar el consentimiento informado. Los signos y síntomas del trastorno fueron recolectados a través de cuestionario y examen clínico. Para estimar la presencia de factores psicológicos se utilizó la escala Hospital Anxiety and Depression, traducida y validada para el portugués. Los datos fueron tabulados y analizados de forma descriptiva y estadística. Las asociaciones entre las variables, el estrés emocional, la ansiedad, la depresión y trastorno fueron verificadas por las pruebas estadísticas Chi Cuadrado (x2) y Exacta de Fisher (p< 0,05). Resultados: el transtorno se presentó em 76,3 por ciento de la muestra; en 54,1 por ciento fue considerado como leve, mientras que en 22,2 % fue verificada la necesidad de tratamiento. En 34,1 por ciento de la muestra afectada, solamente se presentaron signos clínicos articulares. El estrés emocional se asoció estadísticamente con el trastorno y la necesidad de tratamiento. La ansiedad y la depresión están asociados solo con la necesidad de tratamiento. Conclusión: la prevalencia de trastornos temporomandibulares en la muestra de estudiantes universitarios fue alta, con mayor frecuencia de signos clínicos articulares y asociados con el sexo femenino, el estrés emocional, la ansiedad y la depresión(AU)

Introduction: the approach of biopsychosocial factors have gained prominence when considering the multifactorial nature of Temporomandibular Disorders but some studies present conflicting results as to its relationship with psychological factors. Objective: to determine the prevalence of signs and symptoms of this disorder and its association with emotional stress, anxiety and depression in college students of Dentistry course. Methods: therefore, we randomly selected 135 volunteers from a Brazilian public university, from a total of 344 undergratuate dental students. Exclusion criteria were: absence of two or more teeth (excluding third molars); use of a removable prosthesis; use of orthodontic appliances (fixed or mobile), at the time of the study; participants treated for orofacial pain or dysfunction; not signing the free and informed consent. The signs and symptoms of temporomandibular dysfunction were collected through a form with an appropriate history questionnaire and a clinical examination protocol. To estimate the presence of psychological factors we used the scale Hospital Anxiety and Depression, translated and validated to Portuguese. Data were tabulated and analyzed descriptively and statistically. Associations between variables, emotional stress, anxiety, depression and dysfunction were verified by statistical tests chi-square (x2) and Fisher's exact, with p< 0.05. Results: 76.3 percent had dysfunction, and in 54.1 percent it was considered mild, while in 22.2 percent were observed active treatment needs. 34.1 percent of the sample had only affected joint clinical signs. Emotional tension is statically associated with the presence of disorder and need of treatment. Anxiety and depression are associated only with the need for treatment. Conclusion: the prevalence of Temporomandibular Disorders in the sample of college students was high, with higher frequency of joint clinical signs and associated with the female gender, emotional stress, anxiety and depression(AU)

Validity of brief screening questionnaires to detect depression in primary care in Ethiopia.

BACKGROUND: Brief depression screening questionnaires may increase detection of depression in primary care settings but there have been few validation studies carried out in typical populations in low-income countries. METHODS: Cultural validation of the Patient Health Questionnaire (PHQ-9/PHQ-2), the 20-item Self-Reporting Questionnaire (SRQ-20) and the Kessler scales (K6/K10) was carried out in 306 adults consecutively attending primary care facilities in small towns in Ethiopia. To assess criterion validity, the gold standard assessment for presence of Major Depressive Disorder (MDD) was made by Ethiopian psychiatric nurses using the Mini International Neuropsychiatric Interview. RESULTS: The prevalence of gold standard MDD was 5.9%, with irritability more common than depressed mood or anhedonia. The area under the receiver operating characteristic curve indicated good performance of the PHQ-9, SRQ-20, K6 and K10 (0.83-0.85) but only fair for the PHQ-2 (0.78). No cut-off score had acceptable sensitivity combined with adequate positive predictive value. All screening questionnaires were associated with disability and the PHQ-9 and SRQ-20 were associated with higher health service contacts, indicating convergent validity. Construct validity of all scales was indicated by unidimensionality on exploratory factor analysis. LIMITATIONS: Test-retest reliability was not assessed. CONCLUSIONS: Brief depression screening questionnaires were found to be valid in primary care in this low-income country. However, these questionnaires do not have immediate applicability in routine clinical settings. Further studies should evaluate utility of indicated screening embedded within health system changes that support MDD detection. Investigation of irritability as a core depression symptom is warranted.

Assessment of presurgical psychological screening in patients undergoing spine surgery: use and clinical impact.

STUDY DESIGN: Prospective survey. OBJECTIVE: To determine the prevalence of use of presurgical psychological screening (PPS) among spine surgeons in the United States, identify factors associated with PPS use, evaluate surgeons' opinions of PPS, and investigate how PPS is applied in clinical practice. SUMMARY OF BACKGROUND DATA: The United States Preventive Services Task Force recommends PPS for patients undergoing back surgery. The prevalence of PPS is unknown. Thus, it may be difficult to improve preoperative care for such patients with psychological conditions. METHODS: An online survey invitation was emailed to 340 spine surgeons. Questions addressed surgeon characteristics (eg, number of years in practice), practice characteristics (eg, practice type), inclusion of integrated rehabilitation and psychological services, and use of PPS. The impact of psychological factors on rehabilitation and recovery was assessed using an 11-point Likert scale (0, no impact; 10, highest impact). We analyzed the 110 (32%) responses with a χ(2) test (significance, P<0.05). RESULTS: PPS was used by 37% (41) to screen for depression (100%) or anxiety (85%). PPS use was highest among surgeons with more experience, higher annual volume, and no university affiliation. Among those screening for fear avoidance, use was highest among surgeons more recently entering the field. Surgeons reported a strong belief regarding the impact of psychological factors on pain relief, adherence to therapy, and return to work (mean impact rating, >7.0); however, impact on return for follow-up was only moderate (mean rating, 5.8). CONCLUSIONS: A minority of surgeons reported using PPS. Surgeons were less likely to use PPS if they had completed residency or begun practice within 14 years, had fewer than 200 cases annually, or were university affiliated. This study highlights the need to advocate for the use of North American Spine Society guidelines regarding the use of PPS.

Comparing discrete distributions when the sample space is smal / Comparando las distribuciones discretas cuando el espacio muestral es pequeño

This paper describes two new methods for comparing two independent, discrete distributions, when the sample space is small, using an extension of the Storer-Kim method for comparing independent binomials. These methods are relevant, for example, when comparing groups based on a Likert scale, which was the motivation for the paper. In essence, the goal is to test the hypothesis that the cell probabilities associated with two independent multinomial distributions are equal. Both a global test and a multiple comparison procedure are proposed. The small-sample properties of both methods are compared to four other techniques via simulations: Cliff's generalization of the Wilcoxon-Mann-Whitney test that effectively deals with heteroscedasticity and tied values, Yuen's test based on trimmed means, Welch's test and Student's t test. For the simulations, data were generated from beta-binomial distributions. Both symmetric and skewed distributions were used. The sample space consisted of the integers 0(1)4 or 0(1)10. For the global test that is proposed, when testing at the 0.05 level, simulation estimates of the actual Type I error probability ranged between 0.043 and 0.059. For the new multiple comparison procedure, the estimated family wise error rate ranged between 0.031 and 0.054 for the sample space 0(1)4. But for 0(1)10, the estimates dropped as low as 0.016 in some situations. Given the goal of comparing means, Student's t is well known to have practical problems when distributions differ. Similar problems are found here among the situations considered. No single method dominates in terms of power, as would be expected, because different methods are sensitive to different features of the distributions being compared. But in general, one of the new methods tends to have relatively good power based on both simulations and experience with data from actual studies. If, however, there is explicit interest in comparing means, rather than comparing the cell probabilities, Welch's test was found to perform well. The new methods are illustrated using data from the Well-Elderly Study where the goal is to compare groups in terms of depression and the strategies used for dealing with stress.

En este artículo se describen dos nuevos métodos para comparar dos distribuciones discretas independientes, cuando el espacio muestral es pequeño, usando una extensión del método Storer-Kim para comparar binomios independientes. Estos métodos son relevantes, por ejemplo, cuando se comparan grupos basados en una escala Likert, la cual motivó la escritura del artículo. En esencia, el objetivo es evaluar la hipótesis de que las probabilidades de células asociadas con dos distribuciones multinominales independientes son iguales. Se propone una prueba global y un procedimiento de comparación múltiple. Las propiedades de las muestras pequeñas de ambos métodos fueron comparadas con otras cuatro técnicas a través de simulaciones: generalización de Cliff de la prueba de Wilcoxon-Mann-Whitney que trata eficazmente con heteroscedasticidad y valores vinculados, la prueba de Yuen basada en medias truncadas, la prueba de Welch y la prueba t de Student. Para las simulaciones, los datos se generaron a partir de distribuciones beta-binomiales. Se utilizaron distribuciones tanto simétricas como asimétricas. El espacio muestral consistió en los enteros 0(1)4 o 0(1)10. Para la prueba global que se propone, cuando se evaluó al nivel de 0.05, la simulación estimó la probabilidad del error tipo I osciló entre 0.043 y 0.059. Para el nuevo procedimiento de comparación múltiple, la tasa de error estimada oscilaba entre 0.031 y 0.054 para el espacio de la muestra 0(1)4. Pero para 0(1)10, las estimaciones fueron tan bajas como 0.016 en algunas situaciones. Teniendo en cuenta el objetivo de la comparación de medias, la prueba t de Student es bien conocida por tener problemas prácticos cuando distribuciones difieren. Problemas similares se encuentraron entre las situaciones consideradas. No existe un único método que domina en términos de poder, como sería de esperar, debido a que los diferentes métodos son sensibles a las diferentes características de las distribuciones que son comparadas. Pero en general, uno de los nuevos métodos tiende a tener relativamente buen poder basado tanto en simulaciones y la experiencia con los datos de estudios reales. Si, sin embargo, existe un interés explícito en comparar medias, en lugar de comparar las probabilidades de celda, la prueba de Welch se encuentra que tiene un buen desempeño. Los nuevos métodos se ilustran usando datos del estudio Well-Elderly donde el objetivo es comparar los grupos en cuanto a la depresión y las estrategias utilizadas para hacer frente al estrés.

Affective decision-making is predictive of three-month relapse in polysubstance-dependent alcoholics.

BACKGROUND/AIMS: Common and long-lasting deficits in decision-making in polysubstance-dependent alcoholics (PSA) reflect neurobiological alterations that define the chronic nature of addiction. These deficits affect goal-directed behavior and might be critical risk factors predicting relapse in PSA. METHODS: The Delay Discounting Task (DDT) and the Iowa Gambling Task (IGT) assessed the delay-discounting and decision-making skills among 37 abstinent PSA. RESULTS: The findings indicated that IGT but not DDT performances were associated with 3-month abstinence, irrespective of the influence of personality traits and coexistent medications. CONCLUSION: The results show that the IGT, which assesses processes that are important in the latter stages of addiction, is ecologically more valid compared to the DDT, which assesses processes important in the early stages. They underline the importance of using neurocognitive measures to identify high relapse risk patients and emphasize the relevance of promoting new treatments.

Limited-information goodness-of-fit testing of hierarchical item factor models.

In applications of item response theory, assessment of model fit is a critical issue. Recently, limited-information goodness-of-fit testing has received increased attention in the psychometrics literature. In contrast to full-information test statistics such as Pearson's X(2) or the likelihood ratio G(2) , these limited-information tests utilize lower-order marginal tables rather than the full contingency table. A notable example is Maydeu-Olivares and colleagues'M2 family of statistics based on univariate and bivariate margins. When the contingency table is sparse, tests based on M2 retain better Type I error rate control than the full-information tests and can be more powerful. While in principle the M2 statistic can be extended to test hierarchical multidimensional item factor models (e.g., bifactor and testlet models), the computation is non-trivial. To obtain M2 , a researcher often has to obtain (many thousands of) marginal probabilities, derivatives, and weights. Each of these must be approximated with high-dimensional numerical integration. We propose a dimension reduction method that can take advantage of the hierarchical factor structure so that the integrals can be approximated far more efficiently. We also propose a new test statistic that can be substantially better calibrated and more powerful than the original M2 statistic when the test is long and the items are polytomous. We use simulations to demonstrate the performance of our new methods and illustrate their effectiveness with applications to real data.

New-onset psychosis associated with dandy-walker variant in an adolescent female patient.

The relationship between psychotic disorders, in particular, schizophrenia, and neurodevelopmental abnormalities has been conceptualized in the latest literature. Dandy-Walker variant, defined by cystic dilatation of the fourth ventricle and hypoplasia of the inferior portion of the vermis without enlargement of the posterior fossa, is a distinctive entity believed to represent a mild subtype of Dandy-Walker complex. The authors hypothesize a correlation between new onset of psychosis and cerebellar abnormalities in an adolescent patient.

Direct behavior rating scales as screeners: a preliminary investigation of diagnostic accuracy in elementary school.

This study presents an evaluation of the diagnostic accuracy and concurrent validity of Direct Behavior Rating Single Item Scales for use in school-based behavior screening of second-grade students. Results indicated that each behavior target was a moderately to highly accurate predictor of behavioral risk. Optimal universal screening cut scores were also identified for each scale, with results supporting reduced false positive rates through the simultaneous use of multiple scales.

The physiological response to Trier Social Stress Test relates to subjective measures of stress during but not before or after the test.

The Trier Social Stress Test (TSST) is an effective psychosocial laboratory protocol for inducing stress in humans and has been used in numerous research studies. The stressor leads to a physiological response of the hypothalamus-pituitary-adrenal axis (HPAA) and the autonomous nervous system (ANS). Common biomarkers are cortisol levels and heart rate. In addition to the physiological stress response, the TSST also triggers a psychological response such as an increase in perceived stress, anxiety and emotional insecurity. Whereas HPA and ANS measures can easily be obtained for the TSST period itself, psychological measures are usually determined prior to (baseline) and after the TSST. This may exclude information of the stressful event itself. In the present study, we assessed perceived stress, anxiety and emotional insecurity before, during and after the TSST using visual analogue scales. In addition, cortisol levels and heart rates were assessed. Data of 260 healthy non-smoking males aged 16-60 yrs were used for analyses. Our results show that stress perception, anxiety and emotional insecurity were significantly higher during the TSST as compared to post-TSST ratings. Furthermore, our results suggest a covariance of the psychological stress response during the TSST and the physiological stress responses (cortisol and heart rate) for stress perception though the explained variance was small. This observation was not found for pre- and post-TSST ratings suggesting that assessing psychological stress measures during the stressor itself present a more informative measure of the stress response.

Producción de conocimiento en psicometría en instituciones de educación superior de Bogotá y Chía / Production of knowledge in psychometrics in higher education institutions in Bogotá and Chía

Esta investigación se propone describir la producción de conocimiento en psicometría e identificar aspectos que permitan retroalimentar las políticas de formación en el área. Para ello, se recolectaron tesis y trabajos de investigación de docentes de Psicología de Bogotá y Chía desde 1960 hasta el 2009. De un total de 7.259 trabajos, se revisaron con una rejilla diseñada 241 relacionados con el área de medición. Se identificó un incipiente pero creciente interés en el área en las dos últimas décadas, y la necesidad de profundizar en la apropiación y evaluación de los modelos vigentes en teoría de los test: teoría clásica y teoría de respuesta al ítem. Se señala, desde la doble perspectiva, teórica y aplicada, de la psicometría, la necesidad de fortalecer el dominio de los modelos, criterios y procedimientos de producción de evidencias de validez y confiabilidad de las pruebas construidas o evaluadas. Se resalta también la falta de consenso en relación con la clasificación de estudios en psicometría.

The main goal of this research project is to describe the production of knowledge in psychometrics and to identify aspects that make it possible to provide feedback for the development of training policies in this area. For this purpose, 7.259 theses and research projects carried out by professors of psychology in Bogotá and Chía between 1960 and 2009 were gathered, and 241 of them, related to the field of measurement, were analyzed using a grid designed for that purpose. results showed an incipient yet growing interest in the area over the past two decades, as well as a need for further appropriation and assessment of the existing models in test theory: classical theory and item response theory. From the dual perspective of theoretical and applied psychometrics, the study indicated the need to strengthen the models domain, the criteria, and the evidence production processes for the validity and reliability of constructed or evaluated tests. The study also showed the lack of consensus regarding the classification of psychometric studies.

Examining classification criteria: a comparison of three cut score methods.

This study compared 3 different methods of creating cut scores for a screening instrument, T scores, receiver operating characteristic curve (ROC) analysis, and the Rasch rating scale method (RSM), for use with the Behavioral and Emotional Screening System (BESS) Teacher Rating Scale for Children and Adolescents (Kamphaus & Reynolds, 2007). Using the BESS norm data set, we compared the methods across 7 classification indices. Additional information about accuracy was used with a subset of children who had been given a prior diagnosis for selected disorders. The results showed that the methods were generally in concordance, with similarities identified across methods. RSM and ROC analysis methods performed similarly, with both methods identifying the same optimal cut-point. The method based on T scores appeared to be more conservative, identifying a lower cut score as optimal.

Using Rasch modeling to measure acculturation in youth.

Ethnic differences in health outcomes are assumed to reflect levels of acculturation, among other factors. Health surveys frequently include language and social interaction items taken from existing acculturation instruments. This study evaluated the dimensionality of responses to typical bilinear items in Latino youth using Rasch modeling. Two seven-item scales measuring Anglo-Hispanic orientation were adapted from Marin and Gamba (1996) and Cuellar, Arnold, and Maldonado (1995). Most of the items fit the Rasch model. However, there were gaps in both the Hispanic and Anglo scales. The Anglo items were not well targeted for the sample because most students reported they always spoke English. The lack of variability found in a heterogeneous sample of Latino youth has negative implications for the common practice of relying on language as a measure of acculturation. Acculturation instruments for youth probably need more sensitive items to discriminate linguistic differences, or to measure other factors.

Caracterización psicológica de jóvenes masculinos con síncope vasovagal recurrente / Psychological characterization of young male patients presenting with recurrent vasovagal syncope

INTRODUCCION: Sobre el síncope vasovagal o desmayo común, se ha reportado en la literatura que diversos factores parecen sugerir la presencia de una asociación entre la aparición del síncope vasovagal y factores psicológicos. OBJETIVO: Caracterizar desde el punto de vista psicológico a jóvenes con síncope vasovagal recurrente. MÉTODOS: Se recogen los resultados psicológicos obtenidos en 156 pacientes masculinos jóvenes, entre 18 y 25 años de edad, con síncope vasovagal recurrente, comparados con un grupo control de 132 sujetos supuestamente sanos, de la misma edad y sexo. La respuesta a la prueba de tolerancia a la bipedestación activa prolongada (PTBAP) permitió subdividir a los pacientes en un grupo de positivos y en otro de negativos. RESULTADOS: No se constataron diferencias estadísticamente significativas en los aspectos psicológicos evaluados entre ambos grupos de pacientes, mientras que se diferenciaron significativamente del grupo control. CONCLUSIONES:Los pacientes con síncope vasovagal, independientemente de la respuesta a la bipedestación prolongada, presentan manifestaciones psicológicas comunes que permiten caracterizarlos. Estudios futuros posibilitarán establecer si esas manifestaciones son la causa o el efecto del síncope vasovagal

INTRODUCTION: On the vasovagal syncope or common faints in the literature has been reported that different factors appear to suggest the presence of association between the appearance of the vasovagal syncope and the psychological factors. OBJECTIVE: To characterize from the psychological point of view to young patients presenting with recurrent vasovagal syncope. METHODS: The psychological results obtained in 156 young male patients aged between 18 and 25 with recurrent vasovagal syncope compared with a control group including 132 patients supposedly healthy of similar age and sex. The response to tolerance test to prolonged active bipedal attitude (PABA) allowed subdivide patients in a positive group and in other negative. RESULTS: There were not statistically significant differences in psychological features assessed among both groups of patients significantly different from the control group. CONCLUSIONS: The patients presenting with vasovagal syncope, independently of the response to prolonged bipedal attitude, have usual psychological manifestations allowing their characterization. Future studies will allow establishing if those manifestations are the cause or the effect of the vasovagal syncope

Long-term adjustment of survivors of ovarian cancer treated for advanced-stage disease.

This study described the long-term adjustment of 42 ovarian cancer survivors diagnosed with advanced-stage disease with no evidence of recurrence, a mean of 6.1 years postdiagnosis. 64% of survivors' mental health was at or above the norm of medical outpatients (Mental Health Inventory-17). No patients reported post-traumatic stress disorder at a diagnosable level (Post-Traumatic Stress Disorder (PTSD) Checklist-Civilian). The majority of survivors (> or = 75%) reported a positive impact of cancer on their lives (Impact of Cancer Scale) and excellent social support (Medical Outcomes Study Social Support Survey). However, a subset of survivors reported needing more help than was received regarding emotional problems (28.9%).

Quality of life measures (EORTC QLQ-C30 and SF-36) as predictors of survival in palliative colorectal and lung cancer patients.

OBJECTIVE: Self-reported health-related quality of life (HRQoL) is an important predictor of survival alongside clinical variables and physicians' prediction. This study assessed whether better prediction is achieved using generic (SF-36) HRQoL measures or cancer-specific (EORTC QLQ-C30) measures that include symptoms. METHOD: Fifty-four lung and 46 colorectal patients comprised the sample. Ninety-four died before study conclusion. EORTC QLQ-C30 and SF-36 scores and demographic and clinical information were collected at baseline. Follow-up was 5 years. Deaths were flagged by the Office of National Statistics. Cox regression survival analyses were conducted. Surviving cases were censored in the analysis. RESULTS: Univariate analyses showed that survival was significantly associated with better EORTC QLQ-C30 physical functioning, role functioning, and global health and less dyspnea and appetite loss. For the SF-36, survival was significantly associated with better emotional role functioning, general health, energy/vitality, and social functioning. The SF-36 summary score for mental health was significantly related to better survival, whereas the SF-36 summary score for physical health was not. In the multivariate analysis, only the SF-36 mental health summary score remained an independent, significant predictor, mainly due to considerable intercorrelations between HRQoL scales. However, models combining the SF-36 mental health summary score with diagnosis explained a similar amount of variance (12%-13%) as models combining diagnosis with single scale SF-36 Energy/Vitality or EORTC QLQ-C30 Appetite Loss. SIGNIFICANCE OF RESULTS: HRQoL contributes significantly to prediction of survival. Generic measures are at least as useful as disease-specific measures including symptoms. Intercorrelations between HRQoL variables and between HRQoL and clinical variables makes it difficult to identify prime predictors. We need to identify variables that are as independent of each other as possible to maximize predictive power and produce more consistent results.

Diseño y validación de una escala de competencia comunicativa y social para niños / Design and validation of a scale of communicative and social skill for children

Se exponen los resultados del diseño y validación de la escala de competencia comunicativa y social (ECCSO) en 1673 niños chilenos entre 9 y 15 años de edad (669 de sexo masculino y 1004 de sexo femenino). El alfa de Cronbach del formato para niños, padres y profesores fue de 0.93,0.95 y 0.97 respectivamente. El análisis factorial exploratorio con el formato para niños arrojó 8 factores que explican el 30.16 por ciento de la varianza. La ECCSO logró predecir el 50 por ciento de la variabilidad de los puntajes de la Escala de Autoestima de Rosenberg. La validez convergente fue calculada para aquellos niños (n=52) que fueron evaluados simultáneamente por sus padres y profesores; encontrándose moderada convergencia entre niños y padres; divergencia entre niños y profesores; y nula convergencia entre profesores y padres. Para el puntaje total en la ECCSO las niñas obtuvieron mejores puntajes que los niños y no se observaron diferencias por curso y el efecto de interacción entre el sexo y la edad no fue significativo.

This arricie show results about design and validation of the communicative and social competence scale (ECCSO) in 1673 Chilean children, between 9 and 15 years oíd (669 male and 1004 female sex). Cronbach's alpha for children, parents and teachers formats were 0.93, 0.95 and 0.97 respectively. Exploratory Factor Analy sis (EFA) was made for children's format showing 8 factors to explain 30.16 percent of variance. The ECCSO could predict 50 percent of variability in the scores of Rosenberg's Self-Esteem Scale. The convergent validity was calculated for those children (n=52) who were assessed by parents and teachers; finding a modérate convergence between children and parents scores; divergence between children and teachers; and nuil con-vergence between teachers and parents. Girls showed a total score in ECCSO higher than boys; differences between grade, and interaction effect between age and sex were not significant.

Concurrent validity in Taiwan of the Comprehensive Developmental Inventory for Infants and Toddlers who were full-term infants.

This study investigated the concurrent validity of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT) with the Bayley Scales of Infant Development-II (BSID-II) in full-term infants. 106 full-term infants ages 6 to 18 months (63 boys, 43 girls) were recruited as a convenience sample. One tester administered the CDIIT and BSID-II to all children. The Developmental Ages and Developmental Quotients of the motor and the mental scales from both tests were analyzed with Pearson correlations and quadratic weighted kappa tests. The results showed that correlation coefficients for Developmental Ages between both tests on cognitive and motor subtests were high (r = .91-.95) and for Developmental Quotients were moderate (r = .57-.67). Moderate classification agreement was found in the two scales (quadratic weighted kappa = .50-.53). Developmental Quotients classification for the CDIIT tended to be a little higher than for the BSID-II. It was concluded that although acceptable concurrent validity was found for the Motor and Cognitive subtests of the CDIIT, the tester should be cautious to compare Developmental Quotients obtained from the above two tests in clinical or in research settings.

[Organization of psychological activities in Italian cardiac rehabilitation and prevention. Survey on the implementation of guidelines for psychological activities in cardiac rehabilitation and prevention]. / Organizzazione delle attività di psicologia nelle strutture di cardiologia riabilitativa italiane. Indagine conoscitiva sulla implementazione delle linee guida per le attività di psicologia in cardiologia riabilitativa e preventiva.

UNLABELLED: The present study was developed as part of a comprehensive evaluation of the state of the art of knowledge and implementation of the Italian Guidelines for psychological activities in Cardiac Rehabilitation, published in 2003 by the Working Group of Psychology of the Italian Society of Cardiac Rehabilitation (GICR). METHODS: A questionnaire was designed to collect detailed information on facilities, organization, staffing level, professional background and activities carried out by psychologists working in Italian Cardiac Rehabilitation Units (CRU). Out of 144 Italian CRU (inventory 2004), 107 reported structured psychological programmes. The questionnaires were sent by conventional mail to the referring psychologist of these 107 CRU; they were invited to participate in the survey on a purely voluntary basis. RESULTS: Responses were received from 70 (65.4%) of 107 CRU. 55 CRU (79.8%) report a good knowledge of the published GL; 10.1% declare that the psychologists did not know the current GL. 84.5% consider the GL to be fully applicable, while 15.5% believe that they are only partly applicable. Psychological assessment is performed through clinical interview (94.3%) and psychometric tests (81.4%). 92.8% of the CRU use screening instruments in order to evaluate psychosocial risk factors, in particular anxiety and depression (64.3%). Quality of life (22.8%) and cognitive impairment (17.1%) are not routinely assessed. Educational interventions are planned in 87.1% of the CR programme and are extended to the family members (51%) as well as counselling (57%). Psychological programme includes smoking (56%) and eating behaviour (55%) group interventions. Stress management is routinely planned in 69% of the CRU. Psychological intervention tailored to individual needs of the patients is performed in 62.9% CRU. Written final reports are available in 88.6% cases. The follow-up is carried out by 48.6% of the CRU, 15.7% in a structured way. CONCLUSIONS. The survey shows wide discrepancies in the provision of psychological activities in Italian CRU. Nevertheless psychological assessment and interventions seem acceptably coherent with current national GL on CR.

Errores estándar de medida condicionales para las normas metropolitanas de la adaptación chilena del EPQ-R: aplicación de un modelo binomial a un test de personalidad / Conditional standards of the error of measurement for the chilean norms of the EPQ-R: applying a binomial model to a personality test

El Error Estándar de Medida (EEM) es un índice de la precisión de la puntuación obtenida por una persona en un test. El EEM, sin embargo, no es constante a través de todo el rango de puntuaciones. Estudios teóricos y empíricos indican que el EEM es más pequeño para las puntuaciones cercanas al extremo de la escala y mayor alrededor del centro de la escala. Un valor de EEM que aplica a un nivel de puntuación específica es denominado Error Estándar de Medida Condicional (EEM ). Este trabajo utiliza un Modelo Beta Binomial (Lord, 1964, 1965) para estimar los EEMCOND de las normas chilenas del EPQ-R (N=1666), desarrolladas por Kaplan y Liberman (1992). Se concluye que los EEMCOND proveen información psicométrica más útil sobre las escalas del EPQ-R que el EEM tradicional. Adicionalmente, los resultados muestran la validez del Modelo Beta Binomial como enfoque psicométrico para analizar un test de personalidad. Se entregan recomendaciones prácticas para el uso de los EEMCOND.